Impact of nursing care on lung functional residual capacity in acute respiratory distress syndrome patients

2021 ◽  
Author(s):  
Julien Burey ◽  
Pierre‐Gildas Guitard ◽  
Noémie Girard ◽  
Florence Cassiau ◽  
Benoît Veber ◽  
...  
2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092042
Author(s):  
Yu-Mei Wang ◽  
Xiu-Mei Sun ◽  
Yi-Min Zhou ◽  
Jing-Ran Chen ◽  
Kun-Ming Cheng ◽  
...  

Objective Measurement of positive end-expiratory pressure (PEEP)-induced recruitment lung volume using passive spirometry is based on the assumption that the functional residual capacity (FRC) is not modified by the PEEP changes. We aimed to investigate the influence of PEEP on FRC in different models of acute respiratory distress syndrome (ARDS). Methods A randomized crossover study was performed in 12 pigs. Pulmonary (n = 6) and extra-pulmonary (n = 6) ARDS models were established using an alveolar instillation of hydrochloric acid and a right atrium injection of oleic acid, respectively. Low (5 cmH2O) and high (15 cmH2O) PEEP were randomly applied in each animal. FRC and recruitment volume were determined using the nitrogen wash-in/wash-out technique and release maneuver. Results FRC was not significantly different between the two PEEP levels in either pulmonary ARDS (299 ± 92 mL and 309 ± 130 mL at 5 and 15 cmH2O, respectively) or extra-pulmonary ARDS (305 ± 143 mL and 328 ± 197 mL at 5 and 15 cmH2O, respectively). The recruitment volume was not significantly different between the two models (pulmonary, 341 ± 100 mL; extra-pulmonary, 351 ± 170 mL). Conclusions PEEP did not influence FRC in either the pulmonary or extra-pulmonary ARDS pig model.


2021 ◽  
Vol 4 (1) ◽  
pp. 44
Author(s):  
Fang Xie ◽  
Jiarong Zhang ◽  
Ming Zhang

Objective: experience in post-implantation care and pipeline maintenance in patients with acute respiratory distress syndrome. Methods:2020Admitted on 27 July1 Cases of severe pneumonia were transferred to severe ventilator on August 6 and to critical ECMO on August 10. Results: after active treatment, especially for the late stage of ECMO pipeline, the vital signs of the patients improved obviously and the condition gradually stabilized. Conclusion: The nursing care before and after the establishment of ECMO pipeline in patients with acute respiratory distress syndrome, the matters needing attention and the working experience after the establishment, It can provide a reference for the treatment of severe infectious diseases in the future.


Author(s):  
Terry Robinson ◽  
Jane Scullion

The incidence of describing acute respiratory distress syndrome (ARDS) is approximately 23% in mechanically ventilated patients. The diagnosis of ARDS varies widely; studies report a variation in the population diagnosed with ARDS, from 10 to 86 cases per 100,000. Complications of mechanical ventilation are common and include ventilator-associated pneumonia (VAP), barotrauma from excessive airway pressures, and volutrauma from excessive tidal volumes which may both worsen ARDS. Pneumothorax occurs in some patients, necessitating the placement of chest drains. This chapter starts with describing ARDS and the Berlin Definition, and its incidence. It also covers aetiology and physiology, then goes on to its treatment and general management. This includes respiratory support, position changes, and other treatments. Situation-dependent prognoses are outlined. Specific nursing care is also described.


2021 ◽  
Vol 6 (3) ◽  
pp. 116-122
Author(s):  
Farshid Rahimibashar ◽  
Mahmood Salesi ◽  
Amir Vahedian-Azimi ◽  
Masoum Khosh Fetrat

Background: The study of neuromuscular blocking agents (NMBAs) in the management of acute respiratory distress syndrome (ARDS) has provided conflicting results in terms of their effect on mortality. Objectives: The main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA. Methods: A retrospective secondary analysis of 4200 patients with ARDS was collected from two academic medical centers, Tehran, Iran. This study was performed to assess the impact of NMBAs use in ARDS patients with different subgroups including mild and moderate-to-severe ARDS, age more and less than 65 years, having medical turnover vs. not-having, and high acute nursing care vs. moderate to low nursing care. Results: Intensive care unit (ICU) mortality has occurred in 1169 (27.8%) participants. The mortality rate was 28.6% and 27.5% in patients with mild and moderate-to-severe ARDS, respectively. In the subjects without medical turnover, the moderate dose of NMBAs significantly reduces the mortality of patients (P=0.044). In patients who need high acute nursing care, increasing the NMBAs dose significantly reduces patients’ mortality (P=0.010). In addition, increasing the NMBAs doses significantly reduces ICU length of stay (LOS). Conclusion: This study provides evidence that the administration of different doses of NMBAs had no effect on patients’ mortality with mild or moderate-to-severe ARDS. However, higher doses of NMBAs than low doses increased the risk of mortality in patients over 80 years and can reduce the risk of death in patients less than 55 years.


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