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Ventilator-induced lung injury: lessons from experimental studies.
  • D. Dreyfuss, G. Saumon
  • Medicine, Engineering
    American journal of respiratory and critical care…
  • 1998
This paper presents experimental evidence for Increased Vascular Transmural Pressure Evidence for Alterations in Alveolar–Capillary Permeability Contributions of the Static and Dynamic Lung Volume Components to Ventilator-induced Edema High-volume Lung Edema Low Lung Volume Injury.
High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure.
To the authors' knowledge, this constitutes the first example of a protective effect of PEEP during permeability edema, which was markedly reduced by PEEP and preserved the normal ultrastructural aspect of the alveolar epithelium.
Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit.
In a trial involving critically ill patients with severe acute kidney injury, a delayed strategy averted the need for renal-replacement therapy in an appreciable number of patients and found no significant difference with regard to mortality.
Intermittent positive-pressure hyperventilation with high inflation pressures produces pulmonary microvascular injury in rats.
HIPPV edema presents all the features of high permeability edema and may be of concern in the ventilatory management of patients with acute respiratory failure in order to avoid additional damages induced by local overinflation.
Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. The Multicenter Trail Group on Tidal Volume reduction in ARDS.
It is concluded that no benefit could be observed with reduced VT titrated to reach plateau pressures around 25 cm H2O compared with a more conventional approach in which normocapnia was achieved with plateau pressures already below 35 cm H 2O.
The American-European Consensus Conference on ARDS, part 2: Ventilatory, pharmacologic, supportive therapy, study design strategies, and issues related to recovery and remodeling. Acute respiratory
The American-European Consensus Committee on ARDS was formed to re-evaluate the standards for the ICU care of patients with acute lung injury (ALI), with regard to ventilatory strategies, the more promising pharmacologic agents, and the definition and quantification of pathologic features of ALI that require resolution.
Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study
HFNC has a beneficial effect on clinical signs and oxygenation in ICU patients with acute respiratory failure, and favorable results constitute a prerequisite to launching a randomized controlled study to investigate whether HFNC reduces intubation in these patients.
Continuous versus Intermittent Infusion of Vancomycin in Severe Staphylococcal Infections: Prospective Multicenter Randomized Study
For comparable efficacy and tolerance, CIV may be a cost-effective alternative to IIV in severe hospital-acquired methicillin-resistant staphylococcal infections.
Use of High-Flow Nasal Cannula Oxygen Therapy to Prevent Desaturation During Tracheal Intubation of Intensive Care Patients With Mild-to-Moderate Hypoxemia*
High-flow nasal cannula oxygen significantly improved preoxygenation and reduced prevalence of severe hypoxemia compared with nonrebreathing bag reservoir facemask, and its use could improve patient safety during intubation.
Formal guidelines: management of acute respiratory distress syndrome
For three aspects of ARDS management (driving pressure, early spontaneous ventilation, and extracorporeal carbon dioxide removal), the experts concluded that no sound recommendation was possible given current knowledge.