دورية أكاديمية
Feasibility of Setting the Tidal Volume Based on End-Expiratory Lung Volume: A Pilot Clinical Study
| العنوان: | Feasibility of Setting the Tidal Volume Based on End-Expiratory Lung Volume: A Pilot Clinical Study |
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| المؤلفون: | Alice Grassi, MD, Maddalena Teggia-Droghi, MD, Asia Borgo, MD, Konstanty Szudrinsky, MD, PhD, Giacomo Bellani, MD, PhD |
| المصدر: | Critical Care Explorations, Vol 6, Iss 1, p e1031 (2024) |
| بيانات النشر: | Wolters Kluwer, 2024. |
| سنة النشر: | 2024 |
| المجموعة: | LCC:Medical emergencies. Critical care. Intensive care. First aid |
| مصطلحات موضوعية: | Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
| الوصف: | OBJECTIVES:. To assess the feasibility of setting the tidal volume (TV) as 25% of the actual aerated lung volume (rather than on ideal body weight) in patients with Acute Respiratory Distress Syndrome (ARDS). DESIGN:. Physiologic prospective single-center pilot study. SETTING:. Medical ICU specialized in the care of patients with ARDS. PATIENTS:. Patients with moderate-severe ARDS deeply sedated or paralyzed, undergoing controlled mechanical ventilation with a ventilator able to measure the end-expiratory lung volume (EELV) with a washin, washout technique. INTERVENTIONS:. Three-phase study (baseline, strain-selected TV setting, ventilation with strain-selected TV for 24 hr). The TV was calculated as 25% of the measured EELV minus the static strain due to the applied positive end-expiratory pressure. MEASUREMENTS AND MAIN RESULTS:. Gas exchanges and respiratory mechanics were measured and compared in each phase. In addition, during the TV setting phase, driving pressure (DP) and lung strain (TV/EELV) were measured at different TVs to assess the correlation between the two measurements. The maintenance of the set strain-selected TV for 24 hours was safe and feasible in 76% of the patients enrolled. Three patients dropped out from the study because of the need to set a respiratory rate higher than 35 breaths per minute to avoid respiratory acidosis. The DP of the respiratory system was a satisfactory surrogate for strain in this population. CONCLUSIONS:. In our population of 17 patients with moderate to severe ARDS, setting TV based on the actual lung size was feasible. DP was a reliable surrogate of strain in these patients, and DP less than or equal to 8 cm H2O corresponded to a strain less than 0.25. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2639-8028 00000000 |
| العلاقة: | http://journals.lww.com/10.1097/CCE.0000000000001031Test; https://doaj.org/toc/2639-8028Test |
| DOI: | 10.1097/CCE.0000000000001031 |
| الوصول الحر: | https://doaj.org/article/32016223057743579fb5f2f8f9ff28ccTest |
| رقم الانضمام: | edsdoj.32016223057743579fb5f2f8f9ff28cc |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 26398028 00000000 |
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| DOI: | 10.1097/CCE.0000000000001031 |