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Title: Effects of the OLC following ARDSnet ventilation in patients with early ARDS      
dateReleased:
05-05-2016
privacy:
information not avaiable
aggregation:
instance of dataset
dateCreated:
05-05-2016
refinement:
raw
ID:
doi:10.5281/ZENODO.51049
creators:
Rotman, Vivian
Carvalho, Alysson Roncally
Rodrigues, Rosana Souza
Medeiros, Denise Machado
Pinto, Eduardo Costa
Bozza, Fernando Augusto
Carvalho, Carlos Roberto Ribeiro
availability:
available
types:
other
description:
Background: Ventilation with low tidal volume (VT) is well recognized as a protective approach to patients with acute respiratory distress syndrome (ARDS), but the optimal level of positive end-expiratory pressure (PEEP) remains uncertain. This study aims to evaluate two protective ventilatory strategies sequentially applied in patients with early ARDS. Methods: In this prospective cohort study, fifteen patients were ventilated during 24h with positive end-expiratory pressure (PEEP) adjusted according to the ARDSnet low-PEEP table (ARDSnet-24h). During the next 24h, nine patients with PaO2/FIO2 ratio below 350 mmHg were ventilated with PEEP titrated according to the Open Lung Concept protocol (ARDSnet+OLC). In the other six patients, regardless of their PaO2/FIO2 ratio, the ARDSnet remained for a further 24 h (ARDSnet-48h). Ventilatory variables, arterial bloodgas and cytokine were obtained at baseline, 24 and 48h. Additionally, whole-lungcomputed tomography was acquired at 24 and 48h. Results: A sustained improvement in PaO2/FIO2 ratio (P=0.008) with a decrease in collapsed regions (P=0.008) was observed in the ARDSnet+OLC group compared with the ARDSnet-24h group. A reduction in IL-6 in plasma (P<0.02) was observed throughout the protocol in the ARDSnet+OLC group. Compared with the ARDSnet-48h group, the ARDSnet+OLC presented smaller amounts of collapsed areas (P=0.018) without significant differences in hyperinflated regions and in driving and plateau pressures. Conclusions: In this set of patients with early ARDS, mechanical ventilation with an individually tailored PEEP sustained improved pulmonary function with better aeration, without significant increase in hyperinflated areas”
accessURL: https://doi.org/10.5281/ZENODO.51049
storedIn:
Zenodo
qualifier:
not compressed
format:
HTML
accessType:
landing page
authentication:
none
authorization:
none
abbreviation:
ZENODO
homePage: https://zenodo.org/
ID:
SCR:004129
name:
ZENODO

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