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Uneven distribution of ventilation in acute respiratory distress syndrome

INTRODUCTION: The aim of this study was to assess the volume of gas being poorly ventilated or non-ventilated within the lungs of patients treated with mechanical ventilation and suffering from acute respiratory distress syndrome (ARDS). METHODS: A prospective, descriptive study was performed of 25...

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Autores principales: Rylander, Christian, Tylén, Ulf, Rossi-Norrlund, Rauni, Herrmann, Peter, Quintel, Michael, Bake, Björn
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1175934/
https://www.ncbi.nlm.nih.gov/pubmed/15774050
http://dx.doi.org/10.1186/cc3058
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author Rylander, Christian
Tylén, Ulf
Rossi-Norrlund, Rauni
Herrmann, Peter
Quintel, Michael
Bake, Björn
author_facet Rylander, Christian
Tylén, Ulf
Rossi-Norrlund, Rauni
Herrmann, Peter
Quintel, Michael
Bake, Björn
author_sort Rylander, Christian
collection PubMed
description INTRODUCTION: The aim of this study was to assess the volume of gas being poorly ventilated or non-ventilated within the lungs of patients treated with mechanical ventilation and suffering from acute respiratory distress syndrome (ARDS). METHODS: A prospective, descriptive study was performed of 25 sedated and paralysed ARDS patients, mechanically ventilated with a positive end-expiratory pressure (PEEP) of 5 cmH(2)O in a multidisciplinary intensive care unit of a tertiary university hospital. The volume of poorly ventilated or non-ventilated gas was assumed to correspond to a difference between the ventilated gas volume, determined as the end-expiratory lung volume by rebreathing of sulphur hexafluoride (EELV(SF6)), and the total gas volume, calculated from computed tomography images in the end-expiratory position (EELV(CT)). The methods used were validated by similar measurements in 20 healthy subjects in whom no poorly ventilated or non-ventilated gas is expected to be found. RESULTS: EELV(SF6 )was 66% of EELV(CT), corresponding to a mean difference of 0.71 litre. EELV(SF6 )and EELV(CT )were significantly correlated (r(2 )= 0.72; P < 0.001). In the healthy subjects, the two methods yielded almost identical results. CONCLUSION: About one-third of the total pulmonary gas volume seems poorly ventilated or non-ventilated in sedated and paralysed ARDS patients when mechanically ventilated with a PEEP of 5 cmH(2)O. Uneven distribution of ventilation due to airway closure and/or obstruction is likely to be involved.
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spelling pubmed-11759342005-07-17 Uneven distribution of ventilation in acute respiratory distress syndrome Rylander, Christian Tylén, Ulf Rossi-Norrlund, Rauni Herrmann, Peter Quintel, Michael Bake, Björn Crit Care Research INTRODUCTION: The aim of this study was to assess the volume of gas being poorly ventilated or non-ventilated within the lungs of patients treated with mechanical ventilation and suffering from acute respiratory distress syndrome (ARDS). METHODS: A prospective, descriptive study was performed of 25 sedated and paralysed ARDS patients, mechanically ventilated with a positive end-expiratory pressure (PEEP) of 5 cmH(2)O in a multidisciplinary intensive care unit of a tertiary university hospital. The volume of poorly ventilated or non-ventilated gas was assumed to correspond to a difference between the ventilated gas volume, determined as the end-expiratory lung volume by rebreathing of sulphur hexafluoride (EELV(SF6)), and the total gas volume, calculated from computed tomography images in the end-expiratory position (EELV(CT)). The methods used were validated by similar measurements in 20 healthy subjects in whom no poorly ventilated or non-ventilated gas is expected to be found. RESULTS: EELV(SF6 )was 66% of EELV(CT), corresponding to a mean difference of 0.71 litre. EELV(SF6 )and EELV(CT )were significantly correlated (r(2 )= 0.72; P < 0.001). In the healthy subjects, the two methods yielded almost identical results. CONCLUSION: About one-third of the total pulmonary gas volume seems poorly ventilated or non-ventilated in sedated and paralysed ARDS patients when mechanically ventilated with a PEEP of 5 cmH(2)O. Uneven distribution of ventilation due to airway closure and/or obstruction is likely to be involved. BioMed Central 2005 2005-02-21 /pmc/articles/PMC1175934/ /pubmed/15774050 http://dx.doi.org/10.1186/cc3058 Text en Copyright © 2005 Rylander et al.; licensee BioMed Central Ltd.
spellingShingle Research
Rylander, Christian
Tylén, Ulf
Rossi-Norrlund, Rauni
Herrmann, Peter
Quintel, Michael
Bake, Björn
Uneven distribution of ventilation in acute respiratory distress syndrome
title Uneven distribution of ventilation in acute respiratory distress syndrome
title_full Uneven distribution of ventilation in acute respiratory distress syndrome
title_fullStr Uneven distribution of ventilation in acute respiratory distress syndrome
title_full_unstemmed Uneven distribution of ventilation in acute respiratory distress syndrome
title_short Uneven distribution of ventilation in acute respiratory distress syndrome
title_sort uneven distribution of ventilation in acute respiratory distress syndrome
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1175934/
https://www.ncbi.nlm.nih.gov/pubmed/15774050
http://dx.doi.org/10.1186/cc3058
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