Document Detail

Early recovery from post-traumatic acute respiratory distress syndrome.
MedLine Citation:
PMID:  17042905     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To present and discuss the rationale and possible benefits of timely alveolar recruitment in early post-traumatic acute respiratory distress syndrome. METHODS: A 17-year-old patient who had sustained blunt thoracic trauma presented with severe hypoxaemia on admission and whole body computed tomography showed pulmonary contusion and substantial bilateral atelectasis. Oxygenation and lung mechanics did not improve with low tidal volume ventilation using high positive end-expiratory pressures (PEEPs). Therefore we applied an alveolar recruitment manoeuvre 7 h after admission. After alveolar recruitment, PEEP was titrated to the lowest level which prevented alveolar derecruitment. RESULTS: Oxygenation and lung compliance improved rapidly and aeration of the entire lung was confirmed by computed tomography 27 h after the recruitment manoeuvre. The patient recovered completely and was discharged after 17 days. CONCLUSION: Although robust evidence is still lacking, several lines of evidence suggest potential benefits of timely alveolar recruitment. Patients with early post-traumatic respiratory failure seem to most readily respond to alveolar recruitment manoeuvres and could thus benefit from the gain in functional lung volume and oxygenation. Moreover the probability of ventilator associated complications may be reduced.
Andreas Reske; Matthias Seiwerts; Alexander Reske; Udo Gottschaldt; Dierk Schreiter
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical physiology and functional imaging     Volume:  26     ISSN:  1475-0961     ISO Abbreviation:  Clin Physiol Funct Imaging     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-17     Completed Date:  2007-02-02     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  101137604     Medline TA:  Clin Physiol Funct Imaging     Country:  England    
Other Details:
Languages:  eng     Pagination:  376-9     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany.
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MeSH Terms
Anoxia / etiology
Brain Edema / etiology
Contusions / complications
Lung / physiopathology*,  radiography
Lung Compliance
Lung Injury*
Oxygen / analysis
Positive-Pressure Respiration
Pulmonary Atelectasis / complications
Recovery of Function*
Respiratory Distress Syndrome, Adult / etiology*,  physiopathology,  radiography,  therapy
Tidal Volume
Time Factors
Tomography, X-Ray Computed
Wounds, Nonpenetrating / complications*,  physiopathology
Reg. No./Substance:

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