Respiratory system mechanics in acute respiratory distress syndrome

2003 ◽  
Vol 9 (3) ◽  
pp. 297-319 ◽  
Author(s):  
R KALLET ◽  
J KATZ
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Respiratory System ◽  
Distress Syndrome ◽  
Respiratory System Mechanics

scholarly journals Lung Mechanics in Type L CoVID-19 Pneumonia: A Pseudo-Normal ARDS.

2020 ◽  
Author(s):  
Lorenzo Viola ◽  
Emanuele Russo ◽  
Marco Benni ◽  
Emiliano Gamberini ◽  
Alessandro Circelli ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Respiratory System ◽  
Respiratory Insufficiency ◽  
Distress Syndrome ◽  
Lung Mechanics ◽  
Prone Positioning ◽  
Respiratory System Mechanics

Abstract Since its outbreak, in January, 2020, it has been clear that CoVID-19 pneumonia is atypical. Despite a full concordance to Berlin criteria for Acute Respiratory Distress Syndrome (ARDS), respiratory system mechanics is preserved [1]. Mechanical ventilation and muscular paralysis are recommended in worsening respiratory insufficiency [2]; in a substantial number of cases, prone positioning significantly improves oxygenation.

scholarly journals Respiratory effects of lung recruitment maneuvers depend on the recruitment-to-inflation ratio in patients with COVID-19-related acute respiratory distress syndrome

Critical Care ◽  
2022 ◽  
Vol 26 (1) ◽  
Author(s):  
Yoann Zerbib ◽  
Alexis Lambour ◽  
Julien Maizel ◽  
Loay Kontar ◽  
Bertrand De Cagny ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Respiratory System ◽  
Pulse Pressure ◽  
Distress Syndrome ◽  
Lung Recruitment ◽  
Respiratory System Compliance ◽  
Recruitment Maneuvers

Abstract Background In the context of acute respiratory distress syndrome (ARDS), the response to lung recruitment maneuvers (LRMs) varies considerably from one patient to another and so is difficult to predict. The aim of the study was to determine whether or not the recruitment-to-inflation (R/I) ratio could differentiate between patients according to the change in lung mechanics during the LRM. Methods We evaluated the changes in gas exchange and respiratory mechanics induced by a stepwise LRM at a constant driving pressure of 15 cmH2O during pressure-controlled ventilation. We assessed lung recruitability by measuring the R/I ratio. Patients were dichotomized with regard to the median R/I ratio. Results We included 30 patients with moderate-to-severe ARDS and a median [interquartile range] R/I ratio of 0.62 [0.42–0.83]. After the LRM, patients with high recruitability (R/I ratio ≥ 0.62) presented an improvement in the PaO2/FiO2 ratio, due to significant increase in respiratory system compliance (33 [27–42] vs. 42 [35–60] mL/cmH2O; p < 0.001). In low recruitability patients (R/I < 0.62), the increase in PaO2/FiO2 ratio was associated with a significant decrease in pulse pressure as a surrogate of cardiac output (70 [55–85] vs. 50 [51–67] mmHg; p = 0.01) but not with a significant change in respiratory system compliance (33 [24–47] vs. 35 [25–47] mL/cmH2O; p = 0.74). Conclusion After the LRM, patients with high recruitability presented a significant increase in respiratory system compliance (indicating a gain in ventilated area), while those with low recruitability presented a decrease in pulse pressure suggesting a drop in cardiac output and therefore in intrapulmonary shunt.

scholarly journals Effects of Anacardic Acid Monoene on the Respiratory System of Mice Submitted to Acute Respiratory Distress Syndrome

2021 ◽  
Author(s):  
Fladimir de Lima Gondim ◽  
Ruth Mesquita Ferreira ◽  
Tiago Rocha Nogueira ◽  
Daniel Silveira Serra ◽  
Maria Alexandra de Sousa Rios ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Respiratory System ◽  
Distress Syndrome ◽  
Anacardic Acid

scholarly journals Prevalence of Complete Airway Closure According to Body Mass Index in Acute Respiratory Distress Syndrome

2020 ◽  
Vol 133 (4) ◽  
pp. 867-878 ◽  
Author(s):  
Rémi Coudroy ◽  
Damien Vimpere ◽  
Nadia Aissaoui ◽  
Romy Younan ◽  
Clotilde Bailleul ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Respiratory System ◽  
Distress Syndrome ◽  
Respiratory Mechanics ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Airway Closure

Background Complete airway closure during expiration may underestimate alveolar pressure. It has been reported in cases of acute respiratory distress syndrome (ARDS), as well as in morbidly obese patients with healthy lungs. The authors hypothesized that complete airway closure was highly prevalent in obese ARDS and influenced the calculation of respiratory mechanics. Methods In a post hoc pooled analysis of two cohorts, ARDS patients were classified according to body mass index (BMI) terciles. Low-flow inflation pressure–volume curve and partitioned respiratory mechanics using esophageal manometry were recorded. The authors’ primary aim was to compare the prevalence of complete airway closure according to BMI terciles. Secondary aims were to compare (1) respiratory system mechanics considering or not considering complete airway closure in their calculation, and (2) and partitioned respiratory mechanics according to BMI. Results Among the 51 patients analyzed, BMI was less than 30 kg/m2 in 18, from 30 to less than 40 in 16, and greater than or equal to 40 in 17. Prevalence of complete airway closure was 41% overall (95% CI, 28 to 55; 21 of 51 patients), and was lower in the lowest (22% [3 to 41]; 4 of 18 patients) than in the highest BMI tercile (65% [42 to 87]; 11 of 17 patients). Driving pressure and elastances of the respiratory system and of the lung were higher when complete airway closure was not taken into account in their calculation. End-expiratory esophageal pressure (ρ = 0.69 [95% CI, 0.48 to 0.82]; P &lt; 0.001), but not chest wall elastance, was associated with BMI, whereas elastance of the lung was negatively correlated with BMI (ρ = −0.27 [95% CI, −0.56 to −0.10]; P = 0.014). Conclusions Prevalence of complete airway closure was high in ARDS and should be taken into account when calculating respiratory mechanics, especially in the most morbidly obese patients. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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