Abstract
Tidal hyperinflation can still occur with mechanical ventilation using low tidal volume (LVT) (6 mL/kg predicted body weight (PBW)) in acute respiratory distress syndrome (ARDS), despite a well-demonstrated reduction in mortality. Retrospective chart review from August 2012 to October 2014. Inclusion: Age >18years, PaO2/FiO2<200 with bilateral pulmonary infiltrates, absent heart failure, and ultra-protective mechanical ventilation (UPMV) defined as tidal volume (VT) <6 mL/kg PBW. Exclusion: UPMV use for <24 h. Demographics, admission Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, arterial blood gas, serum bicarbonate, ventilator parameters for pre-, during, and post-UPMV periods including modes, VT, peak inspiratory pressure (PIP), plateau pressure (Pplat), driving pressure, etc. were gathered. We compared lab and ventilator data for pre-, during, and post-UPMV periods. Fifteen patients (male:female = 7:8, age 42.13 ± 11.29 years) satisfied criteria, APACHEII 20.6 ± 7.1, mean days in intensive care unit and hospitalization were 18.5 ± 8.85 and 20.81 ± 9.78 days, 9 (60%) received paralysis and 7 (46.67%) required inotropes. Eleven patients had echocardiogram, 7 (63.64%) demonstrated right ventricular volum...Continue Reading
References
Feb 5, 1998·The New England Journal of Medicine·M B AmatoC R Carvalho
May 4, 2000·The New England Journal of Medicine·UNKNOWN Acute Respiratory Distress Syndrome NetworkArthur Wheeler
Sep 11, 2001·American Journal of Respiratory and Critical Care Medicine·A F BroccardM D Schaller
Aug 3, 2002·American Journal of Respiratory and Critical Care Medicine·Scott E SinclairMichael P Hlastala
Dec 24, 2005·Critical Care Medicine·David A KregenowErik R Swenson
Dec 24, 2005·Critical Care Medicine·Alain F Broccard
Mar 25, 2006·Critical Care Medicine·Jesús VillarArmando Aguirre-Jaime
Oct 14, 2006·American Journal of Respiratory and Critical Care Medicine·Pier Paolo TerragniV Marco Ranieri
Jul 28, 2007·American Journal of Respiratory and Critical Care Medicine·Salvatore GrassoTommaso Fiore
Oct 22, 2008·Journal of Biomedical Informatics·Paul A HarrisJose G Conde
Aug 5, 2009·Intensive Care Medicine·Armand Mekontso DessapAntoine Vieillard-Baron
Sep 11, 2009·Anesthesiology·Pier Paolo TerragniV Marco Ranieri
Jun 4, 2011·Critical Care : the Official Journal of the Critical Care Forum·Carol L HodgsonAlistair D Nichol
Apr 12, 2012·BMJ : British Medical Journal·Dale M NeedhamPeter J Pronovost
Jan 12, 2013·Respiratory Physiology & Neurobiology·Michael J EmeryErik R Swenson
Jan 12, 2013·Intensive Care Medicine·Thomas BeinArthur S Slutsky
Jan 29, 2013·Critical Care : the Official Journal of the Critical Care Forum·Jaime RetamalAlejandro Bruhn
Nov 29, 2013·The New England Journal of Medicine·Arthur S Slutsky, V Marco Ranieri
Jul 18, 2014·Critical Care : the Official Journal of the Critical Care Forum·Marianne FitzgeraldJames J McNamee
Feb 19, 2015·The New England Journal of Medicine·Marcelo B P AmatoRoy G Brower
Feb 11, 2016·Critical Care : the Official Journal of the Critical Care Forum·Vito FanelliAlain Combes
Apr 15, 2016·Journal of Thoracic Disease·S Clark BerngardAtul Malhotra
Nov 30, 2016·Current Opinion in Critical Care·Jesús Villar, Arthur S Slutsky
May 2, 2017·American Journal of Respiratory and Critical Care Medicine·Eddy FanUNKNOWN American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine
Oct 6, 2017·Journal of the Intensive Care Society·J J McNameeD F McAuley