Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure
Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whe...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Mentzelopoulos, Spyros D. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2010 |
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| Schlagwörter: |
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| Anmerkung: |
© © jointly held by Springer and ESICM 2010 |
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| Übergeordnetes Werk: |
Enthalten in: Intensive care medicine - Berlin : Springer, 1975, 36(2010), 5 vom: 16. März, Seite 810-816 |
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| Übergeordnetes Werk: |
volume:36 ; year:2010 ; number:5 ; day:16 ; month:03 ; pages:810-816 |
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| DOI / URN: |
10.1007/s00134-010-1822-8 |
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| Katalog-ID: |
SPR001209264 |
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| 041 | |a eng | ||
| 100 | 1 | |a Mentzelopoulos, Spyros D. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure |
| 264 | 1 | |c 2010 | |
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| 520 | |a Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. | ||
| 650 | 4 | |a Respiratory distress syndrome |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Adult |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Respiration |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Artificial |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a High-frequency ventilation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Thoracic wall compliance |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Pulmonary gas exchange |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Malachias, Sotiris |4 aut | |
| 700 | 1 | |a Kokkoris, Stelios |4 aut | |
| 700 | 1 | |a Roussos, Charis |4 aut | |
| 700 | 1 | |a Zakynthinos, Spyros G. |4 aut | |
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10.1007/s00134-010-1822-8 doi (DE-627)SPR001209264 (SPR)s00134-010-1822-8-e DE-627 ger DE-627 rakwb eng Mentzelopoulos, Spyros D. verfasserin aut Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © © jointly held by Springer and ESICM 2010 Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. Respiratory distress syndrome (dpeaa)DE-He213 Adult (dpeaa)DE-He213 Respiration (dpeaa)DE-He213 Artificial (dpeaa)DE-He213 High-frequency ventilation (dpeaa)DE-He213 Thoracic wall compliance (dpeaa)DE-He213 Pulmonary gas exchange (dpeaa)DE-He213 Malachias, Sotiris aut Kokkoris, Stelios aut Roussos, Charis aut Zakynthinos, Spyros G. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 36(2010), 5 vom: 16. März, Seite 810-816 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:36 year:2010 number:5 day:16 month:03 pages:810-816 https://dx.doi.org/10.1007/s00134-010-1822-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 36 2010 5 16 03 810-816 |
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10.1007/s00134-010-1822-8 doi (DE-627)SPR001209264 (SPR)s00134-010-1822-8-e DE-627 ger DE-627 rakwb eng Mentzelopoulos, Spyros D. verfasserin aut Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © © jointly held by Springer and ESICM 2010 Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. Respiratory distress syndrome (dpeaa)DE-He213 Adult (dpeaa)DE-He213 Respiration (dpeaa)DE-He213 Artificial (dpeaa)DE-He213 High-frequency ventilation (dpeaa)DE-He213 Thoracic wall compliance (dpeaa)DE-He213 Pulmonary gas exchange (dpeaa)DE-He213 Malachias, Sotiris aut Kokkoris, Stelios aut Roussos, Charis aut Zakynthinos, Spyros G. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 36(2010), 5 vom: 16. März, Seite 810-816 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:36 year:2010 number:5 day:16 month:03 pages:810-816 https://dx.doi.org/10.1007/s00134-010-1822-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 36 2010 5 16 03 810-816 |
| allfields_unstemmed |
10.1007/s00134-010-1822-8 doi (DE-627)SPR001209264 (SPR)s00134-010-1822-8-e DE-627 ger DE-627 rakwb eng Mentzelopoulos, Spyros D. verfasserin aut Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © © jointly held by Springer and ESICM 2010 Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. Respiratory distress syndrome (dpeaa)DE-He213 Adult (dpeaa)DE-He213 Respiration (dpeaa)DE-He213 Artificial (dpeaa)DE-He213 High-frequency ventilation (dpeaa)DE-He213 Thoracic wall compliance (dpeaa)DE-He213 Pulmonary gas exchange (dpeaa)DE-He213 Malachias, Sotiris aut Kokkoris, Stelios aut Roussos, Charis aut Zakynthinos, Spyros G. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 36(2010), 5 vom: 16. März, Seite 810-816 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:36 year:2010 number:5 day:16 month:03 pages:810-816 https://dx.doi.org/10.1007/s00134-010-1822-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 36 2010 5 16 03 810-816 |
| allfieldsGer |
10.1007/s00134-010-1822-8 doi (DE-627)SPR001209264 (SPR)s00134-010-1822-8-e DE-627 ger DE-627 rakwb eng Mentzelopoulos, Spyros D. verfasserin aut Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © © jointly held by Springer and ESICM 2010 Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. Respiratory distress syndrome (dpeaa)DE-He213 Adult (dpeaa)DE-He213 Respiration (dpeaa)DE-He213 Artificial (dpeaa)DE-He213 High-frequency ventilation (dpeaa)DE-He213 Thoracic wall compliance (dpeaa)DE-He213 Pulmonary gas exchange (dpeaa)DE-He213 Malachias, Sotiris aut Kokkoris, Stelios aut Roussos, Charis aut Zakynthinos, Spyros G. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 36(2010), 5 vom: 16. März, Seite 810-816 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:36 year:2010 number:5 day:16 month:03 pages:810-816 https://dx.doi.org/10.1007/s00134-010-1822-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 36 2010 5 16 03 810-816 |
| allfieldsSound |
10.1007/s00134-010-1822-8 doi (DE-627)SPR001209264 (SPR)s00134-010-1822-8-e DE-627 ger DE-627 rakwb eng Mentzelopoulos, Spyros D. verfasserin aut Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © © jointly held by Springer and ESICM 2010 Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. Respiratory distress syndrome (dpeaa)DE-He213 Adult (dpeaa)DE-He213 Respiration (dpeaa)DE-He213 Artificial (dpeaa)DE-He213 High-frequency ventilation (dpeaa)DE-He213 Thoracic wall compliance (dpeaa)DE-He213 Pulmonary gas exchange (dpeaa)DE-He213 Malachias, Sotiris aut Kokkoris, Stelios aut Roussos, Charis aut Zakynthinos, Spyros G. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 36(2010), 5 vom: 16. März, Seite 810-816 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:36 year:2010 number:5 day:16 month:03 pages:810-816 https://dx.doi.org/10.1007/s00134-010-1822-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 36 2010 5 16 03 810-816 |
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Respiratory distress syndrome Adult Respiration Artificial High-frequency ventilation Thoracic wall compliance Pulmonary gas exchange |
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Mentzelopoulos, Spyros D. @@aut@@ Malachias, Sotiris @@aut@@ Kokkoris, Stelios @@aut@@ Roussos, Charis @@aut@@ Zakynthinos, Spyros G. @@aut@@ |
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We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). 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Mentzelopoulos, Spyros D. |
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Mentzelopoulos, Spyros D. misc Respiratory distress syndrome misc Adult misc Respiration misc Artificial misc High-frequency ventilation misc Thoracic wall compliance misc Pulmonary gas exchange Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure |
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Mentzelopoulos, Spyros D. |
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1432-1238 |
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Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure Respiratory distress syndrome (dpeaa)DE-He213 Adult (dpeaa)DE-He213 Respiration (dpeaa)DE-He213 Artificial (dpeaa)DE-He213 High-frequency ventilation (dpeaa)DE-He213 Thoracic wall compliance (dpeaa)DE-He213 Pulmonary gas exchange (dpeaa)DE-He213 |
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misc Respiratory distress syndrome misc Adult misc Respiration misc Artificial misc High-frequency ventilation misc Thoracic wall compliance misc Pulmonary gas exchange |
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misc Respiratory distress syndrome misc Adult misc Respiration misc Artificial misc High-frequency ventilation misc Thoracic wall compliance misc Pulmonary gas exchange |
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misc Respiratory distress syndrome misc Adult misc Respiration misc Artificial misc High-frequency ventilation misc Thoracic wall compliance misc Pulmonary gas exchange |
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Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure |
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(DE-627)SPR001209264 (SPR)s00134-010-1822-8-e |
| title_full |
Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure |
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Mentzelopoulos, Spyros D. |
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Intensive care medicine |
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2010 |
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Mentzelopoulos, Spyros D. Malachias, Sotiris Kokkoris, Stelios Roussos, Charis Zakynthinos, Spyros G. |
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36 |
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Elektronische Aufsätze |
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Mentzelopoulos, Spyros D. |
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10.1007/s00134-010-1822-8 |
| title_sort |
comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure |
| title_auth |
Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure |
| abstract |
Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. © © jointly held by Springer and ESICM 2010 |
| abstractGer |
Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. © © jointly held by Springer and ESICM 2010 |
| abstract_unstemmed |
Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). Conclusions At the same Ptr level, HFO-TGI results in superior gas exchange compared with HFO. © © jointly held by Springer and ESICM 2010 |
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Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure |
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https://dx.doi.org/10.1007/s00134-010-1822-8 |
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Malachias, Sotiris Kokkoris, Stelios Roussos, Charis Zakynthinos, Spyros G. |
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10.1007/s00134-010-1822-8 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR001209264</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519070946.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201001s2010 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s00134-010-1822-8</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR001209264</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s00134-010-1822-8-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Mentzelopoulos, Spyros D.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Comparison of high-frequency oscillation and tracheal gas insufflation versus standard high-frequency oscillation at two levels of tracheal pressure</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2010</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© © jointly held by Springer and ESICM 2010</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Purpose In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) may improve oxygenation through a TGI-induced increase in mean tracheal pressure (Ptr). We compared standard HFO and HFO-TGI matched for Ptr, in order to determine whether TGI affects gas exchange independently from Ptr. Methods We conducted a prospective, randomized, crossover, physiological study in a 37-bed intensive care unit. Twenty-two patients with early acute lung injury (ALI) or ARDS were enrolled. On day 1, patients were ventilated with HFO, without (60 min) and combined with TGI (60 min) in random order. HFO/HFO-TGI sessions were repeated in inverse order within 7 h. HFO/HFO-TGI mean airway pressure (Paw) was titrated to a Ptr that was either equal to (low Paw) or 3 $ cmH_{2} $O higher than (high Paw) the Ptr of the preceding conventional mechanical ventilation. On day 2, the protocol was repeated at the alternative Ptr level relative to day 1. Results Gas exchange and hemodynamics were determined before, during, and after HFO/HFO-TGI sessions. HFO-TGI-high Paw versus HFO-high Paw resulted in significantly higher $ PaO_{2} $/inspired $ O_{2} $ fraction ($ FiO_{2} $) [mean ± standard error of the mean (SEM): 281.6 ± 15.1 versus 199.0 ± 15.0 mmHg; mean increase: 42%; P < 0.001]. HFO-TGI-low Paw, versus HFO-low Paw, resulted in significantly higher $ PaO_{2} $/$ FiO_{2} $ (222.8 ± 14.6 versus 141.3 ± 8.7 mmHg; mean increase: 58%; P < 0.001). $ PaCO_{2} $ was significantly lower during HFO-TGI-high Paw versus HFO-high $ P_{aw} $ (45.3 ± 1.6 versus 53.7 ± 1.9 mmHg; mean decrease: 16%; P = 0.037). 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