Document Detail


The effects of inversed ratio ventilation (IRV) on arterial oxygenation during mechanical ventilation in patients with acute respiratory failure.
MedLine Citation:
PMID:  1658898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated the effects of inversed ratio ventilation by altering the inspiratory:expiratory (I:E) ratio and assessing the time course changes in the intrapulmonary shunting (Qs/Qt) in 14 patients with acute respiratory failure. Stepwise prolongation of the I:E ratio from 1:1.9 to 2:1 and then to 2.6 or 4:1 was applied when PEEP failed to raise the PaO2 above 80 mmHg while breathing oxygen. A significant decrease in Qs/Qt was observed following prolongation of the I:E ratio from 1:1.9 (Qs/Qt = 45 +/- 9%) to 2:1 (Qs/Qt = 29 +/- 9%) but not with further prolongation of the I:E ratio (Qs/Qt = 27 +/- 7%). Improvement of the pulmonary ventilation/perfusion imbalance became more marked with continued IRV and a significant increase in PaO2 was observed at 6 h after initiating prolongation of the inspiratory time (P less than 0.05). There were no significant changes in hemodynamics, PaCO2, or peak inspiratory pressure during IRV. This ventilatory pattern may be indicated when PEEP fails to improve PaO2, but prolongation of the inspiratory time above an I:E ratio of 2:1 did not produce a greater improvement in Qs/Qt and further increases in PaO2 did not occur after more than 10 h of IRV in our 14 patients.
Authors:
A Sari; S Yamashita; T Toriumi; K Nakashima; R Kawata; M Kunihiro; A Yonei
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  22     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-12-18     Completed Date:  1991-12-18     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  93-101     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Kurashiki Central Hospital, Okayama, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Female
Hemodynamics
Humans
Male
Middle Aged
Oxygen / blood*
Positive-Pressure Respiration
Pulmonary Circulation
Respiration, Artificial* / methods
Respiratory Insufficiency / blood,  physiopathology,  therapy*
Vascular Resistance
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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