Document Detail

Time required for equilibration of arterial oxygen pressure after setting optimal positive end-expiratory pressure in acute respiratory distress syndrome.
MedLine Citation:
PMID:  15891327     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the time course of Pao2 change following the setting of optimal positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome (ARDS). DESIGN: Prospective clinical study. SETTING: Multidisciplinary intensive care unit of a university hospital. PATIENTS: Twenty-five consecutive patients with ARDS. INTERVENTIONS: ARDS was diagnosed during pressure-regulated volume control ventilation with tidal volume of 7 mL/kg actual body weight, respiratory rate of 12 breaths/min, inspiratory/expiratory ratio of 1:2, Fio2 of 1, and PEEP of 5 cm H2O. A critical care attending physician obtained pressure volume curves and determined the lower inflection point. Following a rest period of 30 mins with initial ventilation variables, PEEP was set at 2 cm H2O above the lower inflection point, and serial blood samples were collected during 1-hr ventilation with optimal PEEP. Arterial blood gas analyses were performed at 1, 3, 5, 7, 9, 11, 15, 20, 30, 45, and 60 mins. MEASUREMENTS AND MAIN RESULTS: Twenty-five patients were found eligible for the study. Three patients were excluded due to deterioration of oxygen saturation and hemodynamic instability following the initiation of optimal PEEP. Eight cases (36%) were considered to be of pulmonary origin and 14 cases (64%) of extrapulmonary origin. Optimal PEEP levels were 14 +/- 3 cm H2O and 14 +/- 4 cm H2O in pulmonary and extrapulmonary ARDS, respectively. Pao2 demonstrated a 130 +/- 101% increase at the end of 1-hr period in total study population. This improvement did not differ significantly between pulmonary and extrapulmonary forms of ARDS (135 +/- 118% vs. 127 +/- 95%, p = .8). Mean 90% oxygenation time was found to be 20 +/- 19 mins. In the subset of patients with ARDS of pulmonary origin, 90% oxygenation time was 25 +/- 26 mins, whereas it was 17 +/- 15 mins in patients with ARDS of extrapulmonary origin (p = .8). CONCLUSIONS: Our data showed that 20 mins would be adequate for obtaining a blood gas sample in ARDS patients with pulmonary and extrapulmonary origin after application of optimal PEEP 2 cm H2O above the lower inflection point.
Simru Tugrul; Nahit Cakar; Ozkan Akinci; Perihan Ergin Ozcan; Rian Disci; Figen Esen; Lutfi Telci; Kutay Akpir
Related Documents :
1539477 - Pulmonary effects of body position, peep, and surfactant depletion in dogs.
8905427 - Effects of positive end-expiratory pressure on right ventricular function in copd patie...
3057937 - Relationships between lung computed tomographic density, gas exchange, and peep in acut...
9498967 - Pulmonary epithelial permeability and gas exchange: a comparison of inverse ratio venti...
24508757 - Can pyrene probes be used to measure lateral pressure profiles of lipid membranes? pers...
2308307 - Experimental analysis of pulsatile flow through elastic collapsible tubes: application ...
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  33     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-13     Completed Date:  2005-05-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  995-1000     Citation Subset:  AIM; IM    
Department of Anesthesiology, Istanbul Medical Faculty, Istanbul, Turkey.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Intensive Care Units
Middle Aged
Oxygen / blood*
Positive-Pressure Respiration / methods*
Prospective Studies
Respiratory Distress Syndrome, Adult / therapy*
Time Factors
Reg. No./Substance:

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

Previous Document:  Use of an inspiratory impedance threshold device on a facemask and endotracheal tube to reduce intra...
Next Document:  NH2 terminal pro-brain natriuretic peptide plasma level as an early marker of prognosis and cardiac ...