Advanced Search

Home > Journals > Minerva Anestesiologica > Past Issues > Minerva Anestesiologica 1999 May;65(5) > Minerva Anestesiologica 1999 May;65(5):313-7

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUEMINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

 

Minerva Anestesiologica 1999 May;65(5):313-7

 ALVEOLAR RECRUITMENT IN ARDS

Acute Respiratory Distress Syndrome

Pelosi P., Bottino N., Panigada M., Eccher G., Gattinoni L.

Ospedale Maggiore - Milano, Policlinico IRCCS, Istituto di Anestesia e Rianimazione

We studied 10 consecutive, sedated and paralyzed patients with Acute Respiratory Distress Syndrome (ARDS). The entire study lasted 4 hours, divided in 3 periods: 2 hours of recommended ventilation [lung protective strategy, LPS, i.e., ventilation with low tidal volume (<8 mL/kg), limiting the plateau at 35 cm H2O, together with high positive end-expiratory pressure (PEEP)], 1 hour of sigh (LPS with 3 consecutive sighs/min at 45 cm H2O plateau pressure), and 1 hour of LPS. Total minute ventilation, PEEP, FiO2 and mean airway pressure were kept constant. The introduction of sighs induced a consistent recruitment and PaO2 improvement, and a decrease in venous admixture and PaCO2. Interrupting sighs and resuming LPS led to a progressive derecruitment, and all the physiological variables returned to baseline. Derecruitment was higher in patients with higher PaCO2 and lower VA/Q ratio. We conclude that: 1) LPS alone does not provide full lung recruitment and best oxygenation in ARDS; 2) application of sigh may provide pressure enough to recruit and volume enough to prevent reabsorption atelectasis.

language: Italian


FULL TEXT  REPRINTS

top of page