We know that the reduction of tidal volume during mechanical ventilation in adults with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) affects outcome.1 Although, the optimal tidal volume, airway pressures and ventilator modalities are still controversial, it is clear that 12 ml/kg tidal volume increases mortality in ALI and ARDS patients [...]
Filed under: ARDS, PICU | No Comments »
A PaO2/FiO2 ratio of ≤ 300 and ≤ 200 are used in the diagnosis of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) for patients in acute hypoxic respiratory failure. The requirement for arterial blood gas analysis for diagnosis of ALI/ARDS and concerns about anemia, excessive blood draws may contribute to the underdiagnosis [...]
Filed under: ARDS | 1 Comment »
In partial liquid ventilation (PLV) the lungs are partially filled with plerfluorocarbon (PFC) and ventilation is provided with a standard mechanical ventilator. PFC is a clear inert liquid that improves gas exchange by recruiting dependent lung regions, clearing retained secretions and its antiinflammatory properties. In animal models PLV has been shown to decrease lung injury [...]
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In ARDS there is extensive ongoing tissue inflammation. Decreasing this inflammation in the lung would make a marked improvement in gas exchange allowing lower FiO2s, avoiding high tidal volumes and elevated ventilating pressures that may be the cause of additional lung injury and decreased survival. This lung inflammation would seem to be a promising target [...]
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Heat & moisture exchangers (HME) and heated humidifiers (HH) have long been compared in terms of adequate gas humidification, secretion accumulation and VAP incidence for example. A recent article in Intensive Care Medicine took a look on their effect on gas exchange and the respiratory system in acute lung injury (ALI) and acute respiratory [...]
Filed under: ARDS, Ventilators | 2 Comments »
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