| Author | Rotman, Vivian | |
| Author | Carvalho, Alysson Roncally | |
| Author | Rodrigues, Rosana Souza | |
| Author | Medeiros, Denise Machado | |
| Author | Pinto, Eduardo Costa | |
| Author | Bozza, Fernando A. | |
| Author | Carvalho, Carlos Roberto Ribeiro | |
| Access date | 2019-04-05T14:43:27Z | |
| Available date | 2019-04-05T14:43:27Z | |
| Document date | 2016 | |
| Citation | ROTMAN, Vivian et al. Effects of the open lung concept following ARDSnet ventilation in patients with early ARDS. BMC Anesthesiology, v. 16, n. 1, p. 1-10, July 2016. | pt_BR |
| ISSN | 1471-2253 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/32395 | |
| Language | eng | pt_BR |
| Publisher | BMC | pt_BR |
| Rights | open access | pt_BR |
| Title | Effects of the open lung concept following ARDSnet ventilation in patients with early ARDS | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1186/s12871-016-0206-1 | |
| Abstract | Background: Ventilation with low tidal volume (VT) is well recognized as a protective approach to patients with
acute respiratory distress syndrome (ARDS), but the optimal level of positive end-expiratory pressure (PEEP) remains uncertain. This study aims to evaluate two protective ventilatory strategies sequentially applied in patients with early ARDS. Methods: In this prospective cohort study, fifteen patients were ventilated during 24 h with positive end-expiratory pressure (PEEP) adjusted according to the ARDSnet low-PEEP table (ARDSnet-24 h). During the next 24 h, nine patients with PaO2/FIO2 ratio below 350 mmHg were ventilated with PEEP titrated according to the Open Lung Concept protocol (ARDSnet + OLC). In the other six patients, regardless of their PaO2/FIO2 ratio, the ARDSnet remained for a further 24 h (ARDSnet-48 h). Ventilatory variables, arterial blood-gas and cytokine were obtained at baseline, 24 and 48 h. Additionally, whole-lung-computed tomography was acquired at 24 and 48 h. Results: A sustained improvement in PaO2/FIO2 ratio (P = 0.008) with a decrease in collapsed regions (P = 0.008) was observed in the ARDSnet + OLC group compared with the ARDSnet-24 h group. A reduction in IL-6 in plasma (P < 0.02) was observed throughout the protocol in the ARDSnet + OLC group. Compared with the ARDSnet-48 h group, the ARDSnet + OLC presented smaller amounts of collapsed areas (P = 0.018) without significant differences in hyperinflated regions and in driving and plateau pressures. Conclusions: In this set of patients with early ARDS, mechanical ventilation with an individually tailored PEEP sustained improved pulmonary function with better aeration, without significant increase in hyperinflated areas”. | pt_BR |
| Affilliation | Federal University of Rio de Janeiro. Internal Medicine Department. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Federal University of Rio de Janeiro. Instituto de Biofísica Carlos Chagas Filho. Laboratory of Respiration Physiology. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Federal University of Rio de Janeiro. Department of Radiology. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas., Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Copa D’Or Hospital. ICU. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of São Paulo. InCor-Hospital das Clinicas. Respiratory ICU. São Paulo, SP, Brazil. | pt_BR |
| Subject | Adult respiratory distress syndrome | pt_BR |
| Subject | Measurement techniques | pt_BR |
| Subject | Ventilation effects | pt_BR |
| Subject | Tomography | pt_BR |
| e-ISSN | 1471-2253 | |
