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Intensive Care Medicine

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01-12-2006 | Original

Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome

Authors: Jérôme Aboab, Bjorn Jonson, Achille Kouatchet, Solenne Taille, Lisbet Niklason, Laurent Brochard

Published in: Intensive Care Medicine | Issue 12/2006

Abstract

Objective

High fractions of inspired oxygen (FIO₂) used in acute lung injury (ALI) may promote resorption atelectasis. The impact of derecruitment related to high FIO₂ in ALI is debated. We evaluated derecruitment with 100% vs. 60% FIO₂ at two levels of positive end-expiratory pressure (PEEP).

Patients

Fourteen consecutive patients with ALI were studied.

Interventions

Recruited volume at two PEEP levels was computed from two pressure-volume curves, recorded from PEEP and from zero end-expiratory pressure, using the sinusoidal flow modulation method. PEEP-induced recruitment was measured during prolonged expiration as the difference between the two curves at a given pressure. PaO₂/FIO₂ was also measured. PEEP was 5 ± 1 or 14 ± 3 cmH₂O and FIO₂ was 60% or 100%, yielding four combinations. We looked for differences between the beginning and end of a 30-min period with each combination.

Measurement and results

With low PEEP and 100% FIO₂, recruited volume decreased significantly from 68 ± 53 to 39 ± 43 ml and PaO₂/FIO₂ from 196 ± 104 to 153 ± 83 mmHg. With the three other combinations (low PEEP and 60% FIO₂ or high PEEP and 60% or 100% FIO₂) none of the parameters decreased significantly.

Conclusion

In mechanically ventilated patients with ALI the breathing of pure oxygen leads to derecruitment, which is prevented by high PEEP.

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Title: Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome
Authors: Jérôme Aboab
Bjorn Jonson
Achille Kouatchet
Solenne Taille
Lisbet Niklason
Laurent Brochard
Publication date: 01-12-2006
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 12/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-006-0382-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome

Abstract

Objective

Patients

Interventions

Measurement and results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Patients

Interventions

Measurement and results

Conclusion

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