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      Recruitment maneuvers with different pressure control levels in ARDS patients

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      1 , 1 , 1 , 1 , 1 , 1 , 1

      Critical Care

      BioMed Central

      First International Symposium on Intensive Care and Emergency Medicine for Latin America:

      26-29 June 2001

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          Abstract

          Background and objective Respiratory system PxV curves and recruitment maneuvers can improve oxygenation and survival when compared to the conventional ventilation in ARDS patients. Method In order to study the effects of recruiting the respiratory system with either 40 cmH2O plateau pressure or 60 cmH2O plateau pressures after the PEEP was set 2 cmH2O above the inflection point we studied 10 patients with ARDS criteria (less than 5 days of installation), with mean age of 66 ± 0.10 years and mean APACHE score of 21.8. After performing the PxV curve (random volumes) we set the PEEP 2 cmH2O above the Pflex and ventilated the patients with 6 ml/kg TV and RR of 20. Then we randomly assigned the patients to two groups. Group 1: three cycles of PCV with maximal pressure of 40, 40, 40 cmH2O for 6 s each; and Group 2: three cycles of PCV with maximal pressures of 40, 50 and 60 for 6 s each every 3 h during the first 24 h of mechanical ventilation. We measured the respiratory and hemodynamic parameters at baseline, after 1 and 6 h. Results See table. Table n = 10 Baseline After 1 h After 6 h PaO2/FiO2 Group 1 (5) 98 ± 50 107 ± 74 126 ± 85* PaO2/FiO2 Group 2 (5) 97 ± 22 145 ± 66* 202 ± 90† PaCO2 Group 1 (5) 43 ± 17 50 ± 12 52 ± 12 PaCO2 Group 2 (5) 33 ± 10 40 ± 14 45 ± 8 Cardiac index Group 1 (5) 4.5 ± 0.8 4.4 ± 0.8 4.1 ± 0.8 Cardiac index Group 2 (5) 4.3 ± 1.7 3.9 ± 1.3 4.4 ± 1.5 Conclusion Recruitment maneuvers with PCV of 60 cmH2O allowed a better oxygention compared to recruitment maneuver of PCV 40 mainly after 6 h in ARDS patients without hemodynamic impairments.

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          Author and article information

          Conference
          Crit Care
          Critical Care
          BioMed Central
          1364-8535
          1466-609X
          2001
          26 June 2001
          : 5
          : Suppl 3
          : P46
          Affiliations
          [1 ]ICU of Hospital Israelita Albert Einstein, São Paulo, Brazil
          Article
          cc1379
          10.1186/cc1379
          3300946
          First International Symposium on Intensive Care and Emergency Medicine for Latin America:
          São Paulo, Brazil
          26-29 June 2001
          Categories
          Meeting Abstract

          Emergency medicine & Trauma

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