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

Gogniat, Emiliano (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
Ducrey, Marcela (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
Dianti, Jose (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
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Madorno, Matias (author)
Inst Tecnol Buenos Aires ITBA, Buenos Aires, DF, Argentina
Roux, Nicolas (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
Midley, Alejandro (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
Raffo, Julio (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
Giannasi, Sergio (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
San Roman, Eduardo (author)
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina
Suarez-Sipmann, Fernando (author)
Uppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet,CIBERES, Madrid, Spain;Hosp Univ & Politecn La Fe, Serv Med Intens, Valencia, Spain
Tusman, Gerardo (author)
Hosp Privado Comunidad Mar Del Plata, Dept Anesthesiol, Mar Del Plata, Buenos Aires, Argentina
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 (creator_code:org_t)
W B SAUNDERS CO-ELSEVIER INC, 2018
2018
English.
In: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 45, s. 231-238
Related links:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

Keyword

ARDS
Volumetric capnography
PEEP
PACO(2)
Dead space
Carbon dioxide

Publication and Content Type

ref (subject category)
art (subject category)

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