Reduction of ventilator settings allowed by intravenous oxygenator (IVOX) in ARDS patients
| Autor: | Bertrand Renaud, L. Fierobe, I. Hamy, A. Brusset, Jean-Paul Mira, J. L. Termignon, Mehran Monchi, M. Belghith, O. Soubrane, F. Brunet, Jean-François Dhainaut, E. Deslande |
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| Rok vydání: | 1995 |
| Předmět: |
Artificial ventilation
Adult Male medicine.medical_specialty ARDS medicine.medical_treatment Critical Care and Intensive Care Medicine Statistics Nonparametric Intensive care Anesthesiology Catheterization Peripheral medicine Ventilator settings Tidal Volume Humans Intensive care medicine Oxygenator Aged Oxygenators Membrane Mechanical ventilation Respiratory Distress Syndrome business.industry Pulmonary Gas Exchange Hemodynamics Femoral Vein Middle Aged medicine.disease Respiration Artificial Survival Analysis Respiratory support Anesthesia Female Blood Gas Analysis business |
| Zdroj: | Intensive care medicine. 21(1) |
| ISSN: | 0342-4642 |
| Popis: | To evaluate the possibility of reducing ventilator settings to "safe" levels by extrapulmonary gas exchange with IVOX in ARDS patients.Uncontrolled open clinical study.Medical Intensive Care Unit of a University Hospital.6 patients with ARDS who entered into IVOX phase II clinical trials.The end-point of this study was to reduce ventilator settings from the initial values, recorded on the day of inclusion, to the following: peak inspiratory pressure40 cmH2O, mean airway pressure25 cmH2O and tidal volume10 ml/kg. Trials to achieve this goal were made on volume-controlled ventilation within the 24 h before and after IVOX insertion. Comparison of the results achieved during these trials used Wilcoxon test.Before IVOX implantation reduction of ventilator settings was not possible in the 6 patients, despite a non-significant increase in PaO2/FIO2 was achieved. IVOX permitted significant decrease in PaCO2 (from 60.5 +/- 15 to 52 +/- 11 mmHg; p = 0.02) before any modification of the ventilatory mode. After IVOX insertion, a significant decrease of the ventilator settings was performed: peak and mean airway pressures dropped from 44 +/- 10 to 36.8 +/- 6.7; p = 0.02 and from 26.3 +/- 5.6 to 22.5 +/- 3.9 cmH2O; p = 0.02, respectively. Concommitantly, PaCO2 remained unchanged and PaO2/FIO2 increased significantly from 93 +/- 28 to 117 +/- 52; p = 0.04. The interruption of oxygen flow on IVOX was associated with a slight decrease of the oxygen variables. Tolerance of IVOX was satisfactory. However, a significant decrease both in cardiac index and in pulmonary wedge pressures (from 4.5 +/- 1.2 to 3.4 +/- 9; p = 0.03 and from 16 +/- 5 to 11 +/- 2; p = 0.04, respectively) was observed.Gas exchange achieved by IVOX allowed reduction of ventilator settings in 6 ARDS patients in whom previous attempts have failed. CO2 removal by the device, may explain these results. Efficacy of IVOX on arterial oxygenation was uncertain. |
| Databáze: | OpenAIRE |
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