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01-12-2006 | Original

Respiratory mechanics in brain-damaged patients

Authors: Antonia Koutsoukou, Helen Perraki, Asimina Raftopoulou, Nikolaos Koulouris, Christina Sotiropoulou, Anastasia Kotanidou, Stylianos Orfanos, Charis Roussos

Published in: Intensive Care Medicine | Issue 12/2006

Abstract

Objective

To assess respiratory mechanics on the 1st and 5th days of mechanical ventilation in a cohort of brain-damaged patients on positive end-expiratory pressure (PEEP) of 8 cmH₂O or zero PEEP (ZEEP).

Design and setting

Physiological study with randomized control trial design in a multidisciplinary intensive care unit of a university hospital.

Patients and measurements

Twenty-one consecutive mechanically ventilated patients with severe brain damage and no acute lung injury were randomly assigned to be ventilated with ZEEP (n = 10) or with 8 cmH₂O of PEEP (n = 11). Respiratory mechanics and arterial blood gases were assessed on days 1 and day 5 of mechanical ventilation.

Results

In the ZEEP group on day 1 static elastance and minimal resistance were above normal limits (18.9 ± 3.8 cmH₂O/l and 5.6 ± 2.2 cmH₂O/l per second, respectively); on day 5 static elastance and iso-CO₂ minimal resistance values were higher than on day 1 (21.2 ± 4.1 cmH₂O/l; 7.0 ± 1.9 cmH₂O/l per second, respectively). In the PEEP group these parameters did not change significantly. One of the ten patients on ZEEP developed acute lung injury. On day 5 there was a significant decrease in PaO₂/FIO₂ in both groups.

Conclusions

On day 1 of mechanical ventilation patients with brain damage exhibit abnormal respiratory mechanics. After 5 days of mechanical ventilation on ZEEP static elastance and minimal resistance increased significantly, perhaps reflecting “low lung volume” injury. Both could be prevented by administration of moderate levels of PEEP.

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Title: Respiratory mechanics in brain-damaged patients
Authors: Antonia Koutsoukou
Helen Perraki
Asimina Raftopoulou
Nikolaos Koulouris
Christina Sotiropoulou
Anastasia Kotanidou
Stylianos Orfanos
Charis Roussos
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/s00134-006-0406-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Respiratory mechanics in brain-damaged patients

Abstract

Objective

Design and setting

Patients and measurements

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Patients and measurements

Results

Conclusions

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