Document Detail


Respiratory mechanics in brain-damaged patients.
MedLine Citation:
PMID:  17053881     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess respiratory mechanics on the 1st and 5th days of mechanical ventilation in a cohort of brain-damaged patients on positive end-expiratory pressure (PEEP) of 8 cmH(2)O or zero PEEP (ZEEP). DESIGN AND SETTING: Physiological study with randomized control trial design in a multidisciplinary intensive care unit of a university hospital. PATIENTS AND MEASUREMENTS: Twenty-one consecutive mechanically ventilated patients with severe brain damage and no acute lung injury were randomly assigned to be ventilated with ZEEP (n = 10) or with 8 cmH(2)O of PEEP (n = 11). Respiratory mechanics and arterial blood gases were assessed on days 1 and day 5 of mechanical ventilation. RESULTS: In the ZEEP group on day 1 static elastance and minimal resistance were above normal limits (18.9 +/- 3.8 cmH(2)O/l and 5.6 +/- 2.2 cmH(2)O/l per second, respectively); on day 5 static elastance and iso-CO(2) minimal resistance values were higher than on day 1 (21.2 +/- 4.1 cmH(2)O/l; 7.0 +/- 1.9 cmH(2)O/l per second, respectively). In the PEEP group these parameters did not change significantly. One of the ten patients on ZEEP developed acute lung injury. On day 5 there was a significant decrease in PaO(2)/FIO(2) in both groups. CONCLUSIONS: On day 1 of mechanical ventilation patients with brain damage exhibit abnormal respiratory mechanics. After 5 days of mechanical ventilation on ZEEP static elastance and minimal resistance increased significantly, perhaps reflecting "low lung volume" injury. Both could be prevented by administration of moderate levels of PEEP.
Authors:
Antonia Koutsoukou; Helen Perraki; Asimina Raftopoulou; Nikolaos Koulouris; Christina Sotiropoulou; Anastasia Kotanidou; Stylianos Orfanos; Charis Roussos
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2006-10-20
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:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1947-54     Citation Subset:  IM    
Affiliation:
Department of Critical Care and Pulmonary Services, Evangelismos General Hospital and M Simou Laboratory, Medical School, University of Athens, Athens, Greece. koutsoukou@yahoo.gr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain Injuries / therapy*
Female
Humans
Intensive Care Units
Intracranial Pressure
Male
Middle Aged
Positive-Pressure Respiration / adverse effects*,  methods
Pulmonary Gas Exchange
Respiratory Distress Syndrome, Adult / etiology*
Respiratory Mechanics*
Tidal Volume
Comments/Corrections
Comment In:
Intensive Care Med. 2006 Dec;32(12):1925-7   [PMID:  17053880 ]

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


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