| Continuous flow biphasic positive airway pressure by helmet in patients with acute hypoxic respiratory failure: effect on oxygenation. | |
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MedLine Citation:
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PMID: 20521025 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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PURPOSE: We investigated the effects of periodical high pressure breaths (SIGH) or biphasic positive pressure ventilation (BIPAP) during helmet continuous positive airway pressure (CPAP) in patients with acute hypoxic respiratory failure. METHODS: We used a recently developed electromechanical expiratory valve (TwinPAP, StarMed, Mirandola, Italy), which is time-cycled between two customizable positive end-expiratory pressure (PEEP) levels. We studied 21 patients (67 ± 17 years old) undergoing helmet CPAP. Continuous flow CPAP system was set at 60 l/min flow rate while maintaining clinical FiO(2) (51 ± 15%). Five steps, lasting 1 h each, were applied: (1) spontaneous breathing with PEEP 0 cmH(2)O (SB), (2) CPAP with PEEP 8 cmH(2)O (CPAP(basal)), (3) low PEEP, 8 cmH(2)O, for 25 s and high PEEP, 25 cmH(2)O, for 5 s (SIGH), (4) low PEEP, 8 cmH(2)O, for 3 s and high PEEP, 20 cmH(2)O, for 3 s (BIPAP), (5) CPAP with PEEP 8 cmH(2)O (CPAP(final)). We randomized the sequence of SIGH and BIPAP. RESULTS: PaO(2) was significantly higher during all steps compared to SB. When compared to CPAP(basal), both SIGH and BIPAP induced a further increase in PaO(2). PaO(2) during SIGH and BIPAP were not different. The oxygenation improvement was maintained during CPAP(final). CONCLUSIONS: Superimposed, nonsynchronized positive pressure breaths delivered during helmet CPAP by means of the TwinPAP system may improve oxygenation in patients with acute hypoxemic respiratory failure, even at a rate as low as two breaths per minute. |
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Authors:
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Stefano Isgrò; Alberto Zanella; Chiara Sala; Giacomo Grasselli; Giuseppe Foti; Antonio Pesenti; Nicolò Patroniti |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-03 |
Journal Detail:
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Title: Intensive care medicine Volume: 36 ISSN: 1432-1238 ISO Abbreviation: Intensive Care Med Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1688-94 Citation Subset: IM |
Affiliation:
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Department of Experimental Medicine, Azienda Ospedaliera San Gerardo, University of Milano-Bicocca, via Cadore 48, 20048 Monza (MI), Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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