Document Detail


Effects of tidal volume reduction in acute respiratory distress syndrome on gastric mucosal perfusion.
MedLine Citation:
PMID:  11430549     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study was conducted with the aim of testing the effects of a reduction in tidal volume (V(T)) on gastric mucosal perfusion using laser-Doppler flowmetry in patients with acute respiratory distress syndrome (ARDS). DESIGN: It was designed as a prospective study. PATIENTS: Seventeen patients with ARDS were enrolled in the study. All patients were mechanically ventilated in volume-controlled mode. Before the start of the protocol, V(T) was set at 9 ml/kg body weight. INTERVENTION: V(T) was reduced to 6 ml/kg body weight. MEASUREMENTS AND RESULTS: Measurements of systemic hemodynamic parameters and gastric mucosal blood flow (GMBF) were obtained before and after reduction of V(T). Cardiac index, heaart rate and pulmonary arterial pressure increased significantly after V(T) reduction. The increase in cardiac output was observed in all patients. However, despite a mean 25% increase in cardiac output after V(T) reduction, no significant increase in mean GMBF was observed, and individual GMBF responses were heterogeneous. CONCLUSION: V(T) reduction in patients with ARDS, despite resulting in an increase in cardiac output, did not change gastric mucosal perfusion. The heterogeneity in the individual response of GMBF to V(T) reduction could be due to opposite direct (i.e., local vasodilatory effect) and indirect (i.e., global sympathetic stimulation) effects of hypercapnia on gut vessels.
Authors:
P Sitbon; J L Teboul; J Duranteau; N Anguel; C Richard; K Samii
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  27     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-06-29     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  911-5     Citation Subset:  IM    
Affiliation:
Service d'Anesthésie-Réanimation, Hĵpital de Bicêtre, Assistance Publique des Hopitaux de Paris, Le Kremlin-Becêtre France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Gastric Mucosa / blood supply*
Humans
Laser-Doppler Flowmetry
Male
Middle Aged
Positive-Pressure Respiration*
Prospective Studies
Regional Blood Flow
Respiratory Distress Syndrome, Adult / physiopathology*,  therapy*
Tidal Volume

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


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