scholarly journals Cardiac index and oxygen delivery during low and high tidal volume ventilation strategies in patients with acute respiratory distress syndrome: a crossover randomized clinical trial

Critical Care ◽  
2013 ◽  
Vol 17 (4) ◽  
pp. R146 ◽  
Author(s):  
Giuseppe Natalini ◽  
Cosetta Minelli ◽  
Antonio Rosano ◽  
Pierluigi Ferretti ◽  
Carmine R Militano ◽  
...  
2018 ◽  
Vol 15 (1) ◽  
pp. 527
Author(s):  
Neriman Temel Aksu ◽  
Abdullah Erdoğan

Acute respiratory distress syndrome is the greatest cause of acute respiratory failure. Progression of the syndrome causes short and long term complications such as increase in mortality rate, physical and cognitive impairment. Therefore, It is very important to recognize this syndrome earlier and start therapeutic applications. Despite the fact that pathophysiology is largely known, a well-accepted and definitive method of treatment is still undefined. The positive results of low tidal volume ventilation have been proven. In this article; current concepts for Acute respiratory distress syndrome are defined. In particular, new definitions of Acute respiratory distress syndrome, risk factors and recent validated ventilation strategies have been discussed.Extended English summary is in the end of Full Text PDF (TURKISH) file. ÖzetAkut solunum sıkıntısı sendromu akut solunum bozukluğunun en büyük nedenidir. Sendromun ilerlemesi mortalite hızında artışa,  fiziksel ve kognitif bozukluk gibi kısa ve uzun dönem komplikasyonlara neden olmaktadır. Buyüzden bu sendromun erken tanınması ve tedavi edici uygulamalara başvurmak oldukça önemlidir. Patofizyoloji büyük oranda bilinmesine rağmen kabul görmüş kesin bir tedavi yöntemi hala tanımlanamamıştır. Düşük tidal volüm ventilasyon uygulamasının olumlu sonuçları kanıtlanmıştır. Bu derlemede; Akut solunum sıkıntısı sendromu için yapılan güncel kavramlar tanımlanmıştır. Özellikle Akut solunum sıkıntısı sendromunun yeni tanımları, risk faktörleri ve son geçerli kabul görmüş ventilasyon uygulamaları tartışılmıştır. 


2021 ◽  
pp. 3-11
Author(s):  
Volodymyr Korsunov ◽  
Marine Georgiyants ◽  
Vita Skoryk

The aim. Determine hemodynamic status and its impact on oxygen transport, frequency of adverse events and outcomes in patients with severe SARS-CoV-2 associated with acute respiratory distress syndrome (ARDS). Materials and methods. A single-center prospective comparative study was conducted with 29 patients enrolled over the period of July—October 2020 who suffered a severe course of coronavirus disease and bilateral pneumonia associated with ARDS. Based on the estimated cardiac index (CI), patients were allocated to two groups: Group 1 included 14 patients with severe ARDS and CI 1.9 [1.5–2.5] L/min/m2, whereas Group 2 included 15 patients with CI 4.2 [3.2–8.1] L/min/m2 (p=0.001). Patient`s intensive care was regulated by the relevant orders of the Ministry of Health of Ukraine. Statistical analysis of the results was carried out using Statistica 10 software. Statistical significance of parameters was assessed using the non-parametric Wilcoxon criterion. Results were considered significant at p values <0.05. Data are presented as M [25–75]. Relative risk (RR) and odds ratio (OR) of adverse events were calculated. Results. The severe course of coronavirus disease is associated with significant oxygen transport disorders that increase with hypovolemia. Despite the increase in oxygen delivery in the group with normal CI its high tissue extraction remained, which may be a sign of development mitochondrial distress. Conclusions. Patients admitted to the ICU with severe COVID-19 may be in a state of hypovolemia and require individual assessment of hemodynamic status and the appointment of infusion therapy. Increased oxygen delivery in patients with normal cardiac index was associated with decreased adverse events rate and statistically significant decrease of mortality rate


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