Document Detail


Combination of high frequency oscillatory ventilation and interventional lung assist in severe acute respiratory distress syndrome.
MedLine Citation:
PMID:  20074908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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
Related Documents :
20142338 - A comparison of four techniques of emergency transcricoid oxygenation in a manikin.
23766628 - Correlation of inflammatory and proangiogenic cytokines from undiluted vitreous samples...
1519688 - Nosocomial sinusitis in ventilated patients. nasotracheal versus orotracheal intubation.
17281258 - Joint symbolic dynamic analysis of cardiorespiratory interactions in patients on weanin...
20101778 - Mucosal patterns of helicobacter pylori-related gastritis without atrophy in the gastri...
23996918 - Intimal hyperplasia and vascular remodeling after everolimus-eluting and sirolimus-elut...
Publication Detail:
Type:  Journal Article     Date:  2010-01-15
Journal Detail:
Title:  Journal of critical care     Volume:  25     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2010-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  436-44     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany. matthias.lubnow@klinik.uni-regensburg.de
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  The association between deprivation and hospital mortality for admissions to critical care units in ...
Next Document:  A hierarchical model for the relationships between general and specific vulnerability factors and sy...