| Combination of high frequency oscillatory ventilation and interventional lung assist in severe acute respiratory distress syndrome. | |
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MedLine Citation:
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PMID: 20074908 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The combination of high-frequency oscillatory ventilation (HFOV) and extracorporeal carbon dioxide removal with the interventional lung assist (iLA) in severe acute respiratory distress syndrome (ARDS) represents a novel treatment option. METHODS: The study used a retrospective single-center analysis of 21 consecutive adult patients with severe ARDS, ventilated with HFOV/iLA. Efficiency, side effects, and outcome of combined treatment are presented as median (interquartile range). MEASUREMENTS AND MAIN RESULTS: The following were used to determine patient characteristics: sequential organ failure assessment score, 14; simplified acute physiology score II, 41; and Murray score, 4. The duration of combined treatment was 6 days. The blood flow through the iLA was 1.9 L/min. The Pao(2)/inspired fraction of oxygen ratio increased from 61 (47-86) to 98 (67-116) within 2 hours and to 106 (70-135) mm Hg at 24 hours. Paco(2) decreased from 58 (50-76) to 37 (29-47) mm Hg at 2 hours with normalization of pH 7.28 (7.16-7.36) to 7.43 (7.33-7.49) after 2 hours associated with hemodynamic stabilization. In 6 patients, complications due to iLA treatment were observed, and in 3 patients, complications associated with HFOV were seen. Weaning from HFOV/iLA was successful in 10 patients. The 30-day mortality rate was 43%, and hospital mortality rate was 57%. CONCLUSION: The combination of HFOV/iLA is an option in severe pulmonary failure if conventional ventilation fails and pumpdriven extracorporeal membrane oxygenation therapy is not available. |
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Authors:
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Matthias Lubnow; Andreas Luchner; Alois Philipp; Stefan Buchner; Andreas Jeron; Christian Karagiannidis; Thomas Bein; Michael Pawlik; Carsten Jungbauer; Christof Schmid; Günter A J Riegger; Michael Pfeifer; Thomas Müller |
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Publication Detail:
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Type: Journal Article Date: 2010-01-15 |
Journal Detail:
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Title: Journal of critical care Volume: 25 ISSN: 1557-8615 ISO Abbreviation: J Crit Care Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-14 Completed Date: 2010-12-13 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: 436-44 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany. matthias.lubnow@klinik.uni-regensburg.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anoxia / therapy Combined Modality Therapy Extracorporeal Membrane Oxygenation / methods* Female High-Frequency Ventilation* Hospital Mortality Humans Hypercapnia / therapy Male Middle Aged Respiratory Distress Syndrome, Adult / mortality, therapy* Retrospective Studies Severity of Illness Index Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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