Abstract | OBJECTIVE: DESIGN: Prospective study. SETTING: Medical intensive care unit of a university hospital in Créteil, France. PATIENTS: INTERVENTIONS:
Patent foramen ovale shunting was detected by using transesophageal echocardiography with modified gelatin contrast. Moderate-to-large shunting was defined as right-to-left passage of at least 10 bubbles through a valve-like structure within three cardiac cycles after complete opacification of the right atrium. In 85 patients without and 31 with shunting, the influence of the positive end-expiratory pressure level on shunting was studied. MEASUREMENTS AND RESULTS: The prevalence of moderate-to-large patent foramen ovale shunting was 19.2% (39 patients). Compared to those in the group without shunting, the patients in group with shunting had larger right ventricle dimensions, higher pulmonary artery systolic pressure, and a higher prevalence of cor pulmonale. Compared to patients without shunting, patients with shunting had a poorer Pa(O(2))/Fi(O(2)) ratio response to positive end-expiratory pressure, more often required prone positioning and nitric oxide as adjunctive interventions, and had fewer ventilator-free and intensive care unit-free days within the first 28 days. CONCLUSIONS:
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Authors | Armand Mekontso Dessap, Florence Boissier, Rusel Leon, Serge Carreira, Ferran Roche Campo, François Lemaire, Laurent Brochard |
Journal | Critical care medicine
(Crit Care Med)
Vol. 38
Issue 9
Pg. 1786-92
(Sep 2010)
ISSN: 1530-0293 [Electronic] United States |
PMID | 20601861
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Aged
- Echocardiography, Transesophageal
- Female
- Foramen Ovale, Patent
(complications)
- Heart Septal Defects, Atrial
(complications)
- Humans
- Hypertension, Pulmonary
(complications)
- Male
- Middle Aged
- Nitric Oxide
(administration & dosage)
- Positive-Pressure Respiration
(adverse effects)
- Prevalence
- Prognosis
- Prospective Studies
- Respiratory Distress Syndrome
(complications)
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