Document Detail


Alveolar recruitment maneuver in patients with subarachnoid hemorrhage and acute respiratory distress syndrome: A comparison of 2 approaches.
MedLine Citation:
PMID:  20646904     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2010-06-19
Journal Detail:
Title:  Journal of critical care     Volume:  26     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Hospital de Clínicas de Niterói, Rua La Salle 12, Centro, Niterói, Rio de Janeiro 24020-090, Brazil.
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