Automated Rotational Percussion Bed and Bronchoscopy Improves Respiratory Mechanics and Oxygenation in ARDS Patients Supported with Extracorporeal Membrane Oxygenation

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Nirmal S SharmaEnrique Diaz-Guzman

Abstract

Extracorporeal membrane oxygenation (ECMO) has been used to provide "lung rest" through the use of low tidal volume (6 ml/kg) and ultralow tidal volume (<6 ml/kg) ventilation in acute respiratory distress syndrome (ARDS). Low and ultralow tidal volume ventilation can result in low dynamic respiratory compliance and potentially increased retention of airway secretions. We present our experience using automated rotational percussion beds (ARPBs) and bronchoscopy in four ARDS patients to manage increased pulmonary secretions. These beds performed automated side-to-side tilt maneuver and intermittent chest wall percussion. Their use resulted in substantial reduction in peak and plateau pressures in two patients on volume control ventilation, while the driving pressures (inspiratory pressure) to attain the desired tidal volumes in patients on pressure control ventilation also decreased. In addition, mean partial pressure of oxygen in arterial blood (PaO2)/fraction of inspired oxygen (FiO2) ratio (109 pre-ARPB vs. 157 post-ARPB), positive end-expiratory pressure (10 cm H2O vs. 8 cm H2O), and FiO2 (0.88 vs. 0.52) improved after initiation of ARPB. The improvements in the respiratory mechanics and oxygenation helped us to initiate earl...Continue Reading

References

May 4, 2000·The New England Journal of Medicine·UNKNOWN Acute Respiratory Distress Syndrome NetworkArthur Wheeler
Aug 21, 2013·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·G CorkG Ntoumenopoulos
May 17, 2014·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Nadir YehyaTodd J Kilbaugh
Oct 12, 2014·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Christopher M SauerPramod Bonde
Jan 31, 2015·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Andrew J MichaelsRobert H Bartlett

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Citations

Apr 29, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Victor van Berkel

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