OBJECTIVE: To study the hypothesis, that systemic levels of pro-inflammatory and anti-inflammatory cytokines may be affected by a single recruitment maneuver in mechanically ventilated patients. DESIGN: Prospective, interventional clinical trial. SETTING: Intensive care unit of a university hospital. PATIENTS: Sixteen mechanically ventilated patients with clinical and radiological signs of atelectasis. INTERVENTIONS: A single recruitment maneuver (RM) was performed by elevating the airway pressure to 40 cmH(2)O for 7s. MEASUREMENTS AND MAIN RESULTS: Plasmatic concentrations of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12p70 and tumor necrosis factor (TNF-alpha), arterial blood gases and hemodynamic parameters were measured immediately before and 5-360 min after the RM. The RM caused a minor, nevertheless significant improvement of oxygenation (p = 0.02) and carbon dioxide elimination (p=0.006) as well as a moderate drop of the mean arterial pressure (p=0.025). In contrast, plasma concentrations remained unaffected by the RM in all six mediators measured. CONCLUSION: A single inflation with an airway pressure of 40cmH(2)O for 7 s improved gas exchange only slightly and did not modify systemic levels of inflammatory mediators in mechanically ventilated patients with radiological evidence of atelectasis.
OBJECTIVE: To study the hypothesis, that systemic levels of pro-inflammatory and anti-inflammatory cytokines may be affected by a single recruitment maneuver in mechanically ventilated patients. DESIGN: Prospective, interventional clinical trial. SETTING: Intensive care unit of a university hospital. PATIENTS: Sixteen mechanically ventilated patients with clinical and radiological signs of atelectasis. INTERVENTIONS: A single recruitment maneuver (RM) was performed by elevating the airway pressure to 40 cmH(2)O for 7s. MEASUREMENTS AND MAIN RESULTS: Plasmatic concentrations of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12p70 and tumor necrosis factor (TNF-alpha), arterial blood gases and hemodynamic parameters were measured immediately before and 5-360 min after the RM. The RM caused a minor, nevertheless significant improvement of oxygenation (p = 0.02) and carbon dioxide elimination (p=0.006) as well as a moderate drop of the mean arterial pressure (p=0.025). In contrast, plasma concentrations remained unaffected by the RM in all six mediators measured. CONCLUSION: A single inflation with an airway pressure of 40cmH(2)O for 7 s improved gas exchange only slightly and did not modify systemic levels of inflammatory mediators in mechanically ventilated patients with radiological evidence of atelectasis.
Authors: G R Bernard; A Artigas; K L Brigham; J Carlet; K Falke; L Hudson; M Lamy; J R LeGall; A Morris; R Spragg Journal: Intensive Care Med Date: 1994 Impact factor: 17.440
Authors: V M Ranieri; P M Suter; C Tortorella; R De Tullio; J M Dayer; A Brienza; F Bruno; A S Slutsky Journal: JAMA Date: 1999-07-07 Impact factor: 56.272
Authors: Nicoló Patroniti; Giuseppe Foti; Barbara Cortinovis; Elena Maggioni; Luca M Bigatello; Maurizio Cereda; Antonio Pesenti Journal: Anesthesiology Date: 2002-04 Impact factor: 7.892
Authors: Daniel Talmor; Todd Sarge; Anna Legedza; Carl R O'Donnell; Ray Ritz; Stephen H Loring; Atul Malhotra Journal: Chest Date: 2007-10-09 Impact factor: 9.410