Airway pressure release ventilation as a primary ventilatory mode in acute respiratory distress syndrome
| العنوان: | Airway pressure release ventilation as a primary ventilatory mode in acute respiratory distress syndrome |
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| المؤلفون: | V V Pettilä, O. Takkunen, R Niemi, Päivi Valta, Tero Varpula, Markku Hynynen |
| المصدر: | Acta Anaesthesiologica Scandinavica. 48:722-731 |
| بيانات النشر: | Wiley, 2004. |
| سنة النشر: | 2004 |
| مصطلحات موضوعية: | Adult, Male, Mean arterial pressure, ARDS, Time Factors, medicine.medical_treatment, Blood Pressure, Statistics, Nonparametric, Intermittent Positive-Pressure Ventilation, Airway pressure release ventilation, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Continuous positive airway pressure, Cardiac Output, Propofol, Mechanical ventilation, Respiratory Distress Syndrome, Continuous Positive Airway Pressure, Dose-Response Relationship, Drug, Respiratory distress, Pulmonary Gas Exchange, business.industry, Hemodynamics, 030208 emergency & critical care medicine, General Medicine, Hydrogen-Ion Concentration, Middle Aged, medicine.disease, 3. Good health, Fentanyl, Oxygen, Treatment Outcome, Anesthesiology and Pain Medicine, 030228 respiratory system, Anesthesia, Respiratory Mechanics, Breathing, Female, business, Anesthetics, Intravenous, Respiratory minute volume |
| الوصف: | Background: Airway pressure release ventilation (APRV) is a ventilatory mode, which allows unsupported spontaneous breathing at any phase of the ventilatory cycle. Airway pressure release ventilation as compared with pressure support (PS), another partial ventilatory mode, has been shown to improve gas exchange and cardiac output. We hypothesized whether the use of APRV with maintained unsupported spontaneous breathing as an initial mode of ventilatory support promotes faster recovery from respiratory failure in patients with acute respiratory distress syndrome (ARDS) than PS combined with synchronized intermittent ventilation (SIMV-group). Methods: In a randomized trial 58 patients were randomized to receive either APRVor SIMV after a predefined stabilization period. Both groups shared common physiological targets, and uniform principles of general care were followed. Results: Inspiratory pressure was significantly lower in the APRV-group (25.9 � 0.6 vs. 28.6 � 0.7 cmH2O) within the first week of the study (P ¼0.007). PEEP-levels and physiological variables (PaO2/FiO2-ratio, PaCO2, pH, minute ventilation, mean arterial pressure, cardiac output) were comparable between the groups. At day 28, the number of ventilator-free days was similar (13.4 � 1.7 in the APRV-group and 12.2 � 1.5 in the SIMV-group), as was the mortality (17% and 18%, respectively). Conclusion: We conclude that when used as a primary ventilatory mode in patients with ARDS, APRV did not differ from SIMV with PS in clinically relevant outcome. |
| تدمد: | 1399-6576 0001-5172 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::133cdfd7463f7b70d8280042991ae46cTest https://doi.org/10.1111/j.0001-5172.2004.00411.xTest |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....133cdfd7463f7b70d8280042991ae46c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13996576 00015172 |
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