Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
THERAPEUTIC OPTIMIZATION INCLUDING INHALED NITRIC-OXIDE IN ADULT-RESPIRATORY-DISTRESS-SYNDROME IN A POLYVALENT INTENSIVE-CARE UNIT
Autore:
LEVY B; BOLLAERT PE; BAUER P; NACE L; AUDIBERT G; LARCAN A;
Indirizzi:
HOP CENT,POLYVALENT INTENS CARE UNIT,SERV REANIMAT POLYVALENTE,29 AVEMARECHAL LATTRE TASSIGNY F-54035 NANCY FRANCE
Titolo Testata:
The journal of trauma, injury, infection, and critical care
fascicolo: 3, volume: 38, anno: 1995,
pagine: 370 - 374
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONTINUOUS ARTERIOVENOUS HEMOFILTRATION; AIRWAY PRESSURE; MECHANICAL VENTILATION; PERMISSIVE HYPERCAPNIA; PULMONARY-EDEMA; FAILURE; OXYGENATION; IMPROVEMENT; INHALATION; MANAGEMENT;
Keywords:
ADULT RESPIRATORY DISTRESS SYNDROME; PERMISSIVE HYPERCAPNIA; NITRIC OXIDE; BAROTRAUMA; GAS INSUFFLATION; HEMOFILTRATION; BODY POSITION; MORTALITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
B. Levy et al., "THERAPEUTIC OPTIMIZATION INCLUDING INHALED NITRIC-OXIDE IN ADULT-RESPIRATORY-DISTRESS-SYNDROME IN A POLYVALENT INTENSIVE-CARE UNIT", The journal of trauma, injury, infection, and critical care, 38(3), 1995, pp. 370-374

Abstract

Objective: To investigate the effects of inhaled nitric oxide (NO) inadult respiratory distress syndrome (ARDS) associated with a therapeutic optimization strategy on oxygen parameters, barotrauma, and evolution in a medical and surgical intensive care unit. Design: Prospectivestudy. Materials and Methods: Twenty consecutive patients with ARDS were studied (Murray score 3.6 +/- 0.2). Eleven were surgical patients and nine were medical patients. All fulfilled the extracorporeal membrane oxygenation entry criteria. The APACHE II score predicted mortality was 39%. All were ventilated with FiO(2) 1 with positive end-expiratory pressure (PEEP) of 11 +/- 1 cm H2O. Therapeutic optimization included permissive hypercapnia, tracheal gas insufflation, prone position,continuous hemofiltration, treatment of infection, and pleural drainage. We used NO continuously inhaled at a concentration ranging from 5 to 10 ppm. Measurements and Main Results: After 1 hour, inhaled NO improved PaO2 in all patients except one (78 +/- 11 to 130 +/- 25 mm Hg)(p < 0.05), allowing a reduction of FiO(2) and PEEP. After 24 hours, mean pulmonary arterial pressure decreased from 31 +/- 3 to 25 +/- 2 mm Hg (p < 0.05). Systemic hemodynamics were unaffected. Oxygen delivery increased from 531 +/- 135 to 603 +/- 125 mL/minute/m(-2) (p < 0.05). Barotraumatic lesions were present in only one patient. Reversal of ARDS was obtained in 16 patients, of whom 14 (70%) were discharged. Conclusions: This study was shorter to demonstrate an improvement in the survival rate. Nevertheless, these preliminary results are encouraging. Because of its safety, effectiveness, and easy use, inhaled NO shouldbe used as a part of a therapeutic optimization protocol before considering more invasive and expensive procedures, such as extracorporeal respiratory support or intravascular oxygenation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/09/20 alle ore 11:58:05