| Use of low tidal volume in septic shock may decrease severity of subsequent acute lung injury. | |
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MedLine Citation:
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PMID: 15257087 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Recent studies have indicated that protective lung strategies may improve outcomes in acute lung injury. We hypothesized that the use of a lower tidal volume early during septic shock may protect against the subsequent development of acute lung injury. Fourteen fasted, anesthetized, invasively monitored, mechanically ventilated, female sheep (26.4 +/- 4.5 kg) underwent cecal ligation and perforation to induce sepsis. Sheep were then randomized to ventilation with low (6 mL/kg) or high (12 mL/kg) tidal volumes. A positive end-expiratory pressure of 10 cm H(2)O was applied in each case. Ringer's lactate was titrated to maintain pulmonary artery occlusion pressure at baseline levels. No vasoactive agents or antibiotics were used. Survival time was longer in the low- than in the high-tidal-volume group (21.8 +/- 2.4 vs. 17.6 +/- 4.1 h, respectively, P < 0.05). The times to develop hypotension and anuria were longer in the low-tidal-volume group (18.1 +/- 3.1 vs. 12.0 +/- 2.8 h, P < 0.05, and 17.6 +/- 1.6 vs. 14.1 +/- 3.8 h, P < 0.05). Although the Pao2/Fio2 tended to be lower in the low- than in the high-tidal-volume group (P = 0.06), postmortem examination showed a lower lung tissue wet/dry ratio in the low- than in the high-tidal-volume group (7.1 +/- 0.5 vs. 9.1 +/- 0.7, P < 0.05). A low-tidal-volume ventilation strategy applied early during septic shock may be beneficial in terms of reducing the amount of lung edema and prolonging survival time. |
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Authors:
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Fuhong Su; Nam Duc Nguyen; Jacques Creteur; Ying Cai; Nathalie Nagy; Hoang Anh-Dung; Andre Amaral; Frederico Bruzzi de Carvalho; Didier Chochrad; Jean-Louis Vincent |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Shock (Augusta, Ga.) Volume: 22 ISSN: 1073-2322 ISO Abbreviation: Shock Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-07-16 Completed Date: 2005-01-31 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 9421564 Medline TA: Shock Country: United States |
Other Details:
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Languages: eng Pagination: 145-50 Citation Subset: IM |
Affiliation:
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Department of Intensive Care, Erasme Hospital, Brussels, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Pressure Cecum / surgery Edema Female Hemodynamics Humans Lung / blood supply Lung Injury Neutrophils Pressure Pulmonary Edema Respiratory Distress Syndrome, Adult / diagnosis, prevention & control* Sheep Shock, Septic / complications, therapy* Temperature Tidal Volume Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Shock. 2004 Dec;22(6):586-7
[PMID:
15545833
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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