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  • Gogniat, EmilianoHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)

Dead space analysis at different levels of positive end-expiratory pressure in acute respiratory distress syndrome patients

  • Article/chapterEnglish2018

Publisher, publication year, extent ...

  • W B SAUNDERS CO-ELSEVIER INC,2018
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:uu-356615
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-356615URI
  • https://doi.org/10.1016/j.jcrc.2018.01.005DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • 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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  • Ducrey, MarcelaHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)
  • Dianti, JoseHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)
  • Madorno, MatiasInst Tecnol Buenos Aires ITBA, Buenos Aires, DF, Argentina (author)
  • Roux, NicolasHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)
  • Midley, AlejandroHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)
  • Raffo, JulioHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)
  • Giannasi, SergioHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)
  • San Roman, EduardoHosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina (author)
  • Suarez-Sipmann, FernandoUppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet,CIBERES, Madrid, Spain;Hosp Univ & Politecn La Fe, Serv Med Intens, Valencia, Spain(Swepub:uu)fersi946 (author)
  • Tusman, GerardoHosp Privado Comunidad Mar Del Plata, Dept Anesthesiol, Mar Del Plata, Buenos Aires, Argentina (author)
  • Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, ArgentinaInst Tecnol Buenos Aires ITBA, Buenos Aires, DF, Argentina (creator_code:org_t)

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  • In:Journal of critical care: W B SAUNDERS CO-ELSEVIER INC45, s. 231-2380883-94411557-8615

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