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The effect of induced hypothermia on respiratory parameters in mechanically ventilated patients.
MedLine Citation:
PMID:  20947237     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIM: Mild hypothermia is increasingly applied in the intensive care unit. Knowledge on the effects of hypothermia on respiratory parameters during mechanical ventilation is limited. In this retrospective study, we describe the effect of hypothermia on gas exchange in patients cooled for 24 h after a cardiac arrest.
METHODS: Respiratory parameters were derived from electronic patient files from 65 patients at the start and end of the hypothermic phase and at every centigrade increase in body temperature until normo-temperature, including tidal volume, positive end expiratory pressure (PEEP), plateau pressure, respiratory rate, exhaled CO(2) concentrations (etCO(2)) and FIO(2). Static compliance was calculated as V(T)/P(plateau)-PEEP. Dead space ventilation was calculated as (PaCO(2)-etCO(2))/PaCO(2).
RESULTS: During hypothermia, PaCO(2) decreased, at unchanged PaCO(2)-etCO(2) gap and minute ventilation. During rewarming, PaCO(2) did not change, while etCO(2) increased at unchanged minute ventilation. Dead space ventilation did not change during hypothermia, but lowered during rewarming. During hypothermia, PaO(2)/FIO(2) ratio increased at unchanged PEEP levels. Respiratory static compliance did not change during hypothermia, nor during rewarming.
CONCLUSION: Hypothermia possibly improves oxygenation and ventilation in mechanically ventilated patients. Results may accord with the hypothesis that reducing metabolism with applied hypothermia may be beneficial in patients with acute lung injury, in whom low minute ventilation results in severe hypercapnia.
Authors:
Hamid Aslami; Jan M Binnekade; Janneke Horn; Sandra Huissoon; Nicole P Juffermans
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Publication Detail:
Type:  Journal Article     Date:  2010-10-14
Journal Detail:
Title:  Resuscitation     Volume:  81     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  1723-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Centre, Amsterdam, The Netherlands. h.aslami@amc.uva.nl
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