| Respiratory mechanics in brain-damaged patients. | |
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MedLine Citation:
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PMID: 17053881 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Antonia Koutsoukou; Helen Perraki; Asimina Raftopoulou; Nikolaos Koulouris; Christina Sotiropoulou; Anastasia Kotanidou; Stylianos Orfanos; Charis Roussos |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2006-10-20 |
Journal Detail:
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Title: Intensive care medicine Volume: 32 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-11-28 Completed Date: 2007-07-25 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: 1947-54 Citation Subset: IM |
Affiliation:
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Department of Critical Care and Pulmonary Services, Evangelismos General Hospital and M Simou Laboratory, Medical School, University of Athens, Athens, Greece. koutsoukou@yahoo.gr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Intensive Care Med. 2006 Dec;32(12):1925-7
[PMID:
17053880
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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