Quantifying unintended exposure to high tidal volumes from breath stacking dyssynchrony in ARDS: the BREATHE criteria
| Autor: | Jeremy R. Beitler, Robert L. Owens, Scott A. Sands, Michael A. Matthay, Stephen H. Loring, B. Taylor Thompson, Daniel Talmor, Roger G. Spragg, Atul Malhotra |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
ARDS medicine.medical_treatment Critical Care and Intensive Care Medicine 0302 clinical medicine Mechanical ventilation Reference Values Acute lung injury Lung Tidal volume Patient–ventilator dyssynchrony Ventilator-induced lung injury Expiratory Time Respiratory Distress Syndrome Acute respiratory distress syndrome Respiration digestive oral and skin physiology Middle Aged Respiratory Function Tests Inhalation Anesthesia Artificial Breathing Respiratory Public Health and Health Services Female Adult Respiratory rate Respiratory mechanics Ventilators Clinical Sciences Patient-ventilator dyssynchrony Respiratory physiology Lung injury Article 03 medical and health sciences Rare Diseases Respiratory Rate Clinical Research medicine Tidal Volume Humans Aged business.industry 030208 emergency & critical care medicine medicine.disease Mechanical Emergency & Critical Care Medicine 030228 respiratory system business |
| Zdroj: | Beitler, JR; Sands, SA; Loring, SH; Owens, RL; Malhotra, A; Spragg, RG; et al.(2016). Quantifying unintended exposure to high tidal volumes from breath stacking dyssynchrony in ARDS: the BREATHE criteria. INTENSIVE CARE MEDICINE, 42(9), 1427-1436. doi: 10.1007/s00134-016-4423-3. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/3qv5j1tp Intensive care medicine, vol 42, iss 9 |
| DOI: | 10.1007/s00134-016-4423-3. |
| Popis: | PurposeBreath stacking dyssynchrony generates higher tidal volumes than intended, potentially increasing lung injury risk in acute respiratory distress syndrome (ARDS). Lack of validated criteria to quantify breath stacking dyssynchrony contributes to its under-recognition. This study evaluates performance of novel, objective criteria for quantifying breath stacking dyssynchrony (BREATHE criteria) compared to existing definitions and tests if neuromuscular blockade eliminates high-volume breath stacking dyssynchrony in ARDS.MethodsAirway flow and pressure were recorded continuously for up to 72h in 33 patients with ARDS receiving volume-preset assist-control ventilation. The flow-time waveform was integrated to calculate tidal volume breath-by-breath. The BREATHE criteria considered five domains in evaluating for breath stacking dyssynchrony: ventilator cycling, interval expiratory volume, cumulative inspiratory volume, expiratory time, and inspiratory time.ResultsThe observed tidal volume of BREATHE stacked breaths was 11.3 (9.7-13.3)mL/kg predicted body weight, significantly higher than the preset volume [6.3 (6.0-6.8)mL/kg; p |
| Databáze: | OpenAIRE |
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