Document Detail


Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome.
MedLine Citation:
PMID:  17019545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: High fractions of inspired oxygen (FIO(2)) used in acute lung injury (ALI) may promote resorption atelectasis. The impact of derecruitment related to high FIO(2) in ALI is debated. We evaluated derecruitment with 100% vs. 60% FIO(2) at two levels of positive end-expiratory pressure (PEEP). PATIENTS: Fourteen consecutive patients with ALI were studied. INTERVENTIONS: Recruited volume at two PEEP levels was computed from two pressure-volume curves, recorded from PEEP and from zero end-expiratory pressure, using the sinusoidal flow modulation method. PEEP-induced recruitment was measured during prolonged expiration as the difference between the two curves at a given pressure. PaO(2)/FIO(2) was also measured. PEEP was 5 +/- 1 or 14 +/- 3 cmH(2)O and FIO(2) was 60% or 100%, yielding four combinations. We looked for differences between the beginning and end of a 30-min period with each combination. MEASUREMENT AND RESULTS: With low PEEP and 100% FIO(2), recruited volume decreased significantly from 68 +/- 53 to 39 +/- 43 ml and PaO(2)/FIO(2) from 196 +/- 104 to 153 +/- 83 mmHg. With the three other combinations (low PEEP and 60% FIO(2) or high PEEP and 60% or 100% FIO(2)) none of the parameters decreased significantly. CONCLUSION: In mechanically ventilated patients with ALI the breathing of pure oxygen leads to derecruitment, which is prevented by high PEEP.
Authors:
Jérôme Aboab; Bjorn Jonson; Achille Kouatchet; Solenne Taille; Lisbet Niklason; Laurent Brochard
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2006-09-22
Journal Detail:
Title:  Intensive care medicine     Volume:  32     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-28     Completed Date:  2007-07-25     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1979-86     Citation Subset:  IM    
Affiliation:
Service de Réanimation Médicale de L'hôpital Henri Mondor, AP-HP, 51, av du Maréchal de Lattre de Tassigny, Créteil, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Humans
Middle Aged
Oxygen / administration & dosage,  adverse effects*
Positive-Pressure Respiration / adverse effects*,  methods
Pulmonary Atelectasis / chemically induced*
Pulmonary Gas Exchange
Respiratory Distress Syndrome, Adult / therapy*
Tidal Volume
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
Intensive Care Med. 2006 Dec;32(12):1933-4   [PMID:  17019544 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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