PMID: 9447853Feb 3, 1998Paper

Effect of inverse I:E ratio ventilation on pulmonary gas exchange in acute respiratory distress syndrome

Anesthesiology
E ZavalaA Rossi

Abstract

It is not known whether inverse I:E ratio ventilation (IRV) offers any real benefit over conventional mechanical ventilation with positive end-expiratory pressure (CMV-PEEP) at similar levels of end-expiratory pressure. The effects of volume-controlled and pressure-controlled IRV (VC-IRV and PC-IRV, respectively) on VA/Q inequality were compared with those of CMV-PEEP at a similar level of end-expiratory pressure and with CMV without PEEP (CMV) in eight patients in the early stages of acute respiratory distress syndrome (ARDS). Respiratory blood gases, inert gases, lung mechanics, and hemodynamics were measured 30 min after the onset of each ventilatory mode. Recruitment of nonventilated, poorly ventilated (or both) but well-perfused alveoli increased the partial pressure of oxygen (PaO2) during CMV-PEEP (+13 mmHg) and IRV-VC (+10 mmHg; P < 0.05) compared with CMV. In contrast, PC-IRV did not affect PaO2 but caused a decrease in PaCO2 (-7 mmHg; P < 0.05). The latter was due to a concomitant decrease in dead space (P < 0.01) and shift to the right of VA/Q distributions. During PC-IRV, the increase in the mean of blood flow distribution (mean Q; P < 0.01) without a change in the dispersion (log SD Q) did not result in an increase...Continue Reading

References

Sep 1, 1988·The American Review of Respiratory Disease·J F MurrayM R Flick
Mar 1, 1994·American Journal of Respiratory and Critical Care Medicine·G R BernardR Spragg
Jun 1, 1995·Intensive Care Medicine·A RossiG Conti
May 1, 1994·American Journal of Respiratory and Critical Care Medicine·A RossiR Rodriguez-Roisin

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Citations

Jun 29, 2006·Operative Dentistry·M AnagnostouM Gaintantzopoulou
Sep 29, 2000·Critical Care Medicine·R C McIntyreE Abraham
Feb 15, 2001·Critical Care Medicine·A MercatC Richard
Feb 24, 2015·Critical Care Medicine·Carlos Ferrando, Francisco Javier Belda
May 12, 2000·American Journal of Respiratory and Critical Care Medicine·P NeumannG Hedenstierna
Oct 29, 2000·Journal of Applied Physiology·J E BaumgardnerB E Marshall
Feb 25, 2003·American Journal of Respiratory and Critical Care Medicine·Cyrus EdibamAndrew D Bersten
Aug 29, 2006·Indian Journal of Pediatrics·Ajay R Desai, Akash Deep
Sep 9, 2006·Journal of Applied Physiology·Rebecca S SyringJames E Baumgardner
Jul 1, 2021·Chaos, Solitons, and Fractals·Abdellah El-HadjHanaa Abu-Zinadah

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