Abstract | PURPOSE: MATERIALS AND METHODS: Patients with severe ARDS and hypercapnia were studied. Esophageal balloon was inserted and mechanical ventilation was guided by assessment of transpulmonary pressures. Positive end expiratory pressure (PEEP) and inspiratory driving pressures were adjusted with the aim of achieving tidal volume of 6 to 8 mL/kg based on ideal body weight (IBW), while not exceeding end inspiratory transpulmonary (EITP) pressure of 25 cm H2O. RESULTS: Six patients with severe ARDS and hypercapnia were studied. Mean PaCO2 on enrollment was 108.33 ± 25.65 mmHg. One hour after adjustment of PEEP and inspiratory driving pressure guided by transpulmonary pressure, PaCO2 decreased to 64.5 ± 16.89 mmHg (P < 0.01). Tidal volume was 3.96 ± 0.92 mL/kg IBW before and increased to 7.07 ± 1.21 mL/kg IBW after intervention (P < 0.01). EITP pressure before intervention was low with a mean of 13.68 ± 8.69 cm H2O and remained low at 16.76 ± 4.76 cm H2O (P = 0.18) after intervention. Adjustment of PEEP and inspiratory driving pressures did not worsen oxygenation and did not affect cardiac output significantly. CONCLUSION:
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Authors | Arie Soroksky, Julia Kheifets, Zehava Girsh Solomonovich, Emad Tayem, Balmor Gingy Ronen, Boris Rozhavsky |
Journal | BioMed research international
(Biomed Res Int)
Vol. 2015
Pg. 385042
( 2015)
ISSN: 2314-6141 [Electronic] United States |
PMID | 25695069
(Publication Type: Clinical Trial, Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Cohort Studies
- Female
- Humans
- Hypercapnia
(physiopathology, therapy)
- Male
- Middle Aged
- Positive-Pressure Respiration
(methods)
- Respiration, Artificial
(methods)
- Respiratory Distress Syndrome
(physiopathology, therapy)
- Respiratory System
(physiopathology)
- Tidal Volume
(physiology)
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