| Alveolar recruitment maneuver in patients with subarachnoid hemorrhage and acute respiratory distress syndrome: A comparison of 2 approaches. | |
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MedLine Citation:
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PMID: 20646904 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: The purpose of the study was to compare 2 alveolar recruitment maneuvers (ARMs) approaches in patients with subarachnoid hemorrhage (SAH) and acute respiratory distress syndrome (ARDS). MATERIAL AND METHODS: Sixteen SAH patients with ARDS were randomized in 2 similar groups. One received ARM with continuous positive airway pressure (CPAP) of 35 cm H(2)O for 40 seconds (CPAP recruitment), whereas the other received pressure control ventilation with positive-end expiratory pressure of 15 cm H(2)O and pressure control above positive end-expiratory pressure of 35 cm H(2)O for 2 minutes (pressure control recruitment maneuver [PCRM]). Intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were measured before and after ARM. The ratio of arterial oxygen tension to fraction of inspired oxygen was measured before and 1 hour after the ARM. RESULTS: After ARM, ICP was higher in CPAP recruitment (20.50 ± 4.75 vs 13.13 ± 3.56 mm Hg; P = .003); and CPP was lower in CPAP recruitment (62.38 ± 9.81 vs 79.60 ± 6.8 mm Hg; P = .001). One hour after the ARM, the ratio of arterial oxygen tension to fraction of inspired oxygen increased significantly only in PCRM (108.5 to 203.6; P = .0078). CONCLUSION: In SAH patients with ARDS, PCRM did not affect ICP and decreased CPP in safe levels, besides improving oxygenation. |
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Authors:
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Sérgio N Nemer; Jefferson B Caldeira; Leandro M Azeredo; João Márcio Garcia; Ricardo T Silva; Darwin Prado; Ricardo G Santos; Bruno S Guimarães; Rodrigo A Ramos; Rosângela A Noé; Paulo Cesar P Souza |
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Publication Detail:
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Type: Journal Article Date: 2010-06-19 |
Journal Detail:
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Title: Journal of critical care Volume: 26 ISSN: 1557-8615 ISO Abbreviation: J Crit Care Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8610642 Medline TA: J Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 22-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2011. Published by Elsevier Inc. |
Affiliation:
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Hospital de Clínicas de Niterói, Rua La Salle 12, Centro, Niterói, Rio de Janeiro 24020-090, Brazil. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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