Document Detail


Short-term cardiorespiratory effects of proportional assist and pressure-support ventilation in patients with acute lung injury/acute respiratory distress syndrome.
MedLine Citation:
PMID:  17006068     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent data indicate that assisted modes of mechanical ventilation improve pulmonary gas exchange in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Proportional assist ventilation (PAV) is a new mode of support that amplifies the ventilatory output of the patient effort and improves patient-ventilator synchrony. It is not known whether this mode may be used in patients with ALI/ARDS. The aim of this study was to compare the effects of PAV and pressure-support ventilation on breathing pattern, hemodynamics, and gas exchange in a homogenous group of patients with ALI/ARDS due to sepsis. METHODS: Twelve mechanically ventilated patients with ALI/ARDS (mean ratio of partial pressure of arterial oxygen to fractional concentration of oxygen 190 +/- 49 mmHg) were prospectively studied. Patients received pressure-support ventilation and PAV in random order for 30 min while maintaining mean airway pressure constant. With both modes, the level of applied positive end-expiratory pressure (7.1 +/- 2.1 cm H2O) was kept unchanged throughout. At the end of each study period, cardiorespiratory data were obtained, and dead space to tidal volume ratio was measured. RESULTS: With both modes, none of the patients exhibited clinical signs of distress. With PAV, breathing frequency and cardiac index were slightly but significantly higher than the corresponding values with pressure-support ventilation (24.5 +/- 6.9 vs. 21.4 +/- 6.9 breaths/min and 4.4 +/- 1.6 vs. 4.1 +/- 1.3 l . min . m, respectively). None of the other parameters differ significantly between modes. CONCLUSIONS: In patients with ALI/ARDS due to sepsis, PAV and pressure-support ventilation both have clinically comparable short-term effects on gas exchange and hemodynamics.
Authors:
Eumorfia Kondili; Nectaria Xirouchaki; Katerina Vaporidi; Maria Klimathianaki; Dimitris Georgopoulos
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesiology     Volume:  105     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-28     Completed Date:  2006-11-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  703-8     Citation Subset:  AIM; IM    
Affiliation:
Intensive Care Medicine Department, University Hospital of Heraklion 71110, University of Crete, Heraklion, Crete, Greece. konde@med.uoc.gr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Blood Gas Analysis
Data Interpretation, Statistical
Female
Hemodynamics / physiology*
Humans
Male
Middle Aged
Oxygen / blood
Positive-Pressure Respiration
Prospective Studies
Pulmonary Gas Exchange
Respiration, Artificial*
Respiratory Distress Syndrome, Adult / physiopathology*
Respiratory Mechanics / physiology*
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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


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