OBJECTIVE: To assess the safety and efficacy of a sustained inflation, used as a lung volume recruitment maneuver in ventilated patients with hypoxemic respiratory failure. DESIGN: Prospective data collection as part of a quality assurance program following introduction of a lung volume recruitment guideline in the intensive care unit. SETTING: Academic medical-surgical critical care unit. PATIENTS: Hypoxemic patients with bilateral pulmonary infiltrates. Patients with chronic obstructive pulmonary disease, pulmonary barotrauma and hemodynamic instability were excluded. INTERVENTIONS: A sustained inflation using a pressure of 30 to 45 cmH2O was applied for 20 s. The pressure was determined as the lesser of 45 cmH2O or the peak pressure while ventilated at a tidal volume of 12 ml/kg. Intra-arterial blood pressure and pulse oximetry were monitored continuously. MEASUREMENTS AND RESULTS: Significant improvement in oxygenation occurred in the majority of patients within 10 min. The mean oxygen saturation improved from 86.9 +/- 5.5 to 94.3 +/- 2.3% (p < 0.01). No significant adverse effects were noted: hypotension and mild oxygen desaturation occurred in some patients during the 20-s inflation, reversing rapidly after inflation was terminated. No barotrauma occurred. CONCLUSIONS: A sustained inflation is a safe, clinically applicable method of lung volume recruitment which improves oxygenation in selected patients and may have a role in ventilatory management.
OBJECTIVE: To assess the safety and efficacy of a sustained inflation, used as a lung volume recruitment maneuver in ventilated patients with hypoxemic respiratory failure. DESIGN: Prospective data collection as part of a quality assurance program following introduction of a lung volume recruitment guideline in the intensive care unit. SETTING: Academic medical-surgical critical care unit. PATIENTS: Hypoxemic patients with bilateral pulmonary infiltrates. Patients with chronic obstructive pulmonary disease, pulmonary barotrauma and hemodynamic instability were excluded. INTERVENTIONS: A sustained inflation using a pressure of 30 to 45 cmH2O was applied for 20 s. The pressure was determined as the lesser of 45 cmH2O or the peak pressure while ventilated at a tidal volume of 12 ml/kg. Intra-arterial blood pressure and pulse oximetry were monitored continuously. MEASUREMENTS AND RESULTS: Significant improvement in oxygenation occurred in the majority of patients within 10 min. The mean oxygen saturation improved from 86.9 +/- 5.5 to 94.3 +/- 2.3% (p < 0.01). No significant adverse effects were noted: hypotension and mild oxygen desaturation occurred in some patients during the 20-s inflation, reversing rapidly after inflation was terminated. No barotrauma occurred. CONCLUSIONS: A sustained inflation is a safe, clinically applicable method of lung volume recruitment which improves oxygenation in selected patients and may have a role in ventilatory management.
Authors: Helena Odenstedt; Anders Aneman; Sigurbergur Kárason; Ola Stenqvist; Stefan Lundin Journal: Intensive Care Med Date: 2004-12-17 Impact factor: 17.440
Authors: Juan P Boriosi; Anil Sapru; James H Hanson; Jeanette Asselin; Ginny Gildengorin; Vivienne Newman; Katie Sabato; Heidi R Flori Journal: Pediatr Crit Care Med Date: 2011-07 Impact factor: 3.624
Authors: Jonas Nielsen; Morten Østergaard; Jesper Kjaergaard; Jens Tingleff; Preben G Berthelsen; Eigil Nygård; Anders Larsson Journal: Intensive Care Med Date: 2005-08-12 Impact factor: 17.440
Authors: Guillermo Bugedo; Alejandro Bruhn; Glenn Hernández; Gonzalo Rojas; Cristián Varela; Juan Carlos Tapia; Luis Castillo Journal: Intensive Care Med Date: 2003-01-18 Impact factor: 17.440