The effects of inversed ratio ventilation (IRV) on arterial oxygenation during mechanical ventilation in patients with acute respiratory failure
| Autor: | Kenn Nakashima, Akitomo Yonei, Mitsuru Kunihiro, Ryuichi Kawata, Atsuo Sari, Shigeki Yamashita, Takashi Toriumi |
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| Rok vydání: | 1991 |
| Předmět: |
Male
Artificial ventilation Pulmonary Circulation medicine.medical_treatment Emergency Nursing Mean airway pressure Positive-Pressure Respiration Humans Medicine Aged Mechanical ventilation business.industry Respiratory disease Hemodynamics Oxygen transport Oxygenation Middle Aged medicine.disease Respiration Artificial Oxygen Respiratory failure Anesthesia Acute Disease Emergency Medicine Breathing Female Vascular Resistance Respiratory Insufficiency Cardiology and Cardiovascular Medicine business |
| Zdroj: | Resuscitation. 22:93-101 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/0300-9572(91)90068-a |
| Popis: | We investigated the effects of inversed ratio ventilation by altering the inspiratory:expiratory (I:E) ratio and assessing the time course changes in the intrapulmonary shunting (Qs/Qt) in 14 patients with acute respiratory failure. Stepwise prolongation of the I:E ratio from 1:1.9 to 2:1 and then to 2.6 or 4:1 was applied when PEEP failed to raise the PaO2 above 80 mmHg while breathing oxygen. A significant decrease in Qs/Qt was observed following prolongation of the I:E ratio from 1:1.9 (Qs/Qt = 45 +/- 9%) to 2:1 (Qs/Qt = 29 +/- 9%) but not with further prolongation of the I:E ratio (Qs/Qt = 27 +/- 7%). Improvement of the pulmonary ventilation/perfusion imbalance became more marked with continued IRV and a significant increase in PaO2 was observed at 6 h after initiating prolongation of the inspiratory time (P less than 0.05). There were no significant changes in hemodynamics, PaCO2, or peak inspiratory pressure during IRV. This ventilatory pattern may be indicated when PEEP fails to improve PaO2, but prolongation of the inspiratory time above an I:E ratio of 2:1 did not produce a greater improvement in Qs/Qt and further increases in PaO2 did not occur after more than 10 h of IRV in our 14 patients. |
| Databáze: | OpenAIRE |
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