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1.	Gogniat, Emiliano, et al. (författare) Dead space analysis at different levels of positive end-expiratory pressure in acute respiratory distress syndrome patients 2018 Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 45, s. 231-238 Tidskriftsartikel (refereegranskat)abstract Purpose: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VDBohr/VT) in patients with acute respiratory distress syndrome (ARDS).Material and methods: Fourteen ARDS patients under lung protective ventilation settingswere submitted to 4 different levels of PEEP (0, 6, 10, 16 cmH(2)O). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step.Results: Two groups of patients responded differently to PEEP when comparing baseline with 16-PEEP: those in which driving pressure increased > 15% (Delta P.(15%), n = 7, p = .016) and those in which the change was <= 15% (Delta P-<= 15%, n = 7, p = .700). VDBohr/VT was higher in Delta P-<= 15% than in Delta P-<= 15% patients at baseline ventilation [0.58 (0.49-0.60) vs 0.46 (0.43-0.46) p = .018], at 0-PEEP [0.50 (0.47-0.54) vs 0.41 (0.40-0.43) p = .012], at 6-PEEP [0.55 (0.49-0.57) vs 0.44 (0.42-0.45) p = .008], at 10-PEEP [0.59 (0.51-0.59) vs 0.45 (0.44-0.46) p = .006] and at 16-PEEP [0.61 (0.56-0.65) vs 0.47 (0.45-0.48) p =. 001]. We found a good correlation between Delta P and VDBohr/VT only in the Delta P.(15%) group (r = 0.74, p < .001).Conclusions: Increases in PEEP result in higher VDBohr/VT only when associated with an increase in driving pressure.

Gogniat, Emiliano, et al. (författare)
Dead space analysis at different levels of positive end-expiratory pressure in acute respiratory distress syndrome patients
2018
Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 45, s. 231-238
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VDBohr/VT) in patients with acute respiratory distress syndrome (ARDS).Material and methods: Fourteen ARDS patients under lung protective ventilation settingswere submitted to 4 different levels of PEEP (0, 6, 10, 16 cmH(2)O). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step.Results: Two groups of patients responded differently to PEEP when comparing baseline with 16-PEEP: those in which driving pressure increased > 15% (Delta P.(15%), n = 7, p = .016) and those in which the change was <= 15% (Delta P-<= 15%, n = 7, p = .700). VDBohr/VT was higher in Delta P-<= 15% than in Delta P-<= 15% patients at baseline ventilation [0.58 (0.49-0.60) vs 0.46 (0.43-0.46) p = .018], at 0-PEEP [0.50 (0.47-0.54) vs 0.41 (0.40-0.43) p = .012], at 6-PEEP [0.55 (0.49-0.57) vs 0.44 (0.42-0.45) p = .008], at 10-PEEP [0.59 (0.51-0.59) vs 0.45 (0.44-0.46) p = .006] and at 16-PEEP [0.61 (0.56-0.65) vs 0.47 (0.45-0.48) p =. 001]. We found a good correlation between Delta P and VDBohr/VT only in the Delta P.(15%) group (r = 0.74, p < .001).Conclusions: Increases in PEEP result in higher VDBohr/VT only when associated with an increase in driving pressure.

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