High survival rate in 122 ARDS patients managed according to a clinical algorithm including extracorporeal membrane oxygenation. beneficial effects of the 'Open Lung Approach' with low distending pressures in acute respiratory distress syndrome. Effect of protective-ventilation strategy on mortality in the acute respiratory distress syndrome. 6 The Acute Respiratory Distress Syndrome Network. V...

BACKGROUND Ventilation using low tidal volumes with permission of hypercapnia is recommended to protect the lung in acute respiratory distress syndrome. However, the most lung protective tidal volume in association with hypercapnia is unknown. The aim of this study was to assess the effects of different tidal volumes with associated hypercapnia on lung injury and gas exchange in a model for acu...

OBJECTIVES The present study was designed to identify the effect of positive end expiratory pressure (PEEP) and the ideal pulmonary tidal volume to ventilate animals with a surgically produced bronchopleural fistula, aiming to reduce fistula output without affecting gas exchange. METHODS Hemodynamic and respiratory assessment of gas exchange was obtained in five, healthy, young, mechanically ...

Introduction Ventilator strategies that use tidal volumes (TVs) limited to 6 ml/kg IBW (ideal body weight) have been shown to reduce mortality in patients with ARDS (acute respiratory distress syndrome). [1] It is suggested that using these same low tidal volumes in other critically ill patients may reduce the progression to ARDS. [2,3] An initial audit in the ICU at University Hospital Lewisha...

For a doctor to determine the most accurate diagnosis of diseases of the respiratory tract, it must be as accurate as possible insight into the problem. Imaging technology allows to look into the body, unfortunately for example lung is an organ, where without contrast agent does not buy the picture. Furthermore, the methods that can be used are whole body plethysmography or, a better option, sp...

It has been shown that mechanical ventilation by itself can cause lung injury and affect outcomes. Ventilator-induced lung injury is associated with high tidal volumes in lungs afflicted with ARDS. However, the question is: Do high tidal volumes have this same effect in normal lungs or lungs that have respiratory compromise stemming from something other than ARDS? Many clinicians believe that a...

Nineteen asthmatic volunteers underwent methacholine-induced asthma to the point when tightness in the chest was just sensed (threshold symptom). Changes in the following indices of lung function were measured--static lung volumes, forced expiratory volume in one second, and airways conductance. The increase in airways resistance necessary for threshold detection was at least double that previo...

Continuous ambulatory peritoneal dialysis (CAPD) produces a nearly continuous state of iatrogenic ascites which may interfere with respiratory excursions of the diaphragm and compromise ventilatory function. Sitting and supine studies of pulmonary function and arterial blood gas analyses done serially in 13 patients undergoing CAPD showed a significant decline in pulmonary volumes immediately a...

ACUTE LUNG INJURY IS A MAJOR cause of acute respiratory failure in patients who are critically ill and is associated with several clinical disorders, including sepsis, pneumonia, and aspiration. Although lifesaving, traditional ventilation strategies with higher tidal volumes and airway pressures can exacerbate lung inflammation and injury. Acute lung injury produces parenchymal lung damage tha...

To identify the best lung ventilation strategy for acute respiratory distress syndrome (ARDS), we performed a network meta-analysis. The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, CINAHL, and the Web of Science were searched, and 36 eligible articles were included. Compared with higher tidal volumes with FiO2-guided lower positive end-expiratory pressure [PEEP], the hazard...