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High-frequency percussive ventilation in severe acute respiratory distress syndrome: A single center experience.

Spapen H, Borremans M, Diltoer M, Gorp VV, Nguyen DN, Honoré PM - J Anaesthesiol Clin Pharmacol (2014)

Bottom Line: Ventilation and oxygenation were governed according to a predefined protocol.HFPV was continued until patients could be switched to conventional ventilation.Within 24 h, HFPV restored normal pH and PaCO2 and considerably improved oxygenation.

View Article: PubMed Central - PubMed

Affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.

ABSTRACT

Background: Few studies have investigated high-frequency percussive ventilation (HFPV) in adult patients with acute respiratory distress syndrome (ARDS).

Materials and methods: We retrospectively analyzed data from critically ill-patients with moderate and severe ARDS who received HFPV. Ventilation and oxygenation were governed according to a predefined protocol. HFPV was continued until patients could be switched to conventional ventilation.

Results: A total of 42 patients (20 with pneumonia-related ARDS and 22 non-septic ARDS cases) were evaluable. Baseline demographic characteristics, severity of illness, lung injury score; pH and respiratory variables were comparable between pneumonia and non-sepsis-related ARDS. Within 24 h, HFPV restored normal pH and PaCO2 and considerably improved oxygenation. Oxygenation improved more in non-septic than in pneumonia-related ARDS. Patients with pneumonia-induced ARDS also remained longer HFPV-dependent (7.0 vs. 4.9 days; P < 0.05). Mortality at 30 days was significantly higher in pneumonia-related than in non-sepsis-related ARDS (50% vs. 18%; P = 0.01).

Conclusions: HFPV caused rapid and sustained improvement of oxygenation and ventilation in patients with moderate to severe ARDS. Less improved oxygenation, longer ventilator dependency and worse survival were observed in pneumonia-related ARDS.

No MeSH data available.


Related in: MedlinePlus

Evolution of pH, PaCO2 and PaO2/FiO2 during high-frequency percussive ventilation treatment in patients with pneumonia-related acute respiratory distress syndrome (PR ARDS; red line) and patients with non-sepsis-related ARDS (NSR ARDS; black line). §P < 0.001;#P < 0.01;°P < 0.05
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Figure 4: Evolution of pH, PaCO2 and PaO2/FiO2 during high-frequency percussive ventilation treatment in patients with pneumonia-related acute respiratory distress syndrome (PR ARDS; red line) and patients with non-sepsis-related ARDS (NSR ARDS; black line). §P < 0.001;#P < 0.01;°P < 0.05

Mentions: The evolution of pH, PaCO2 and PaO2/FiO2 during HFPV was outlined in Figure 3 (all patients) and Figure 4 (pneumonia vs. non-septic patients). Data collection and comparison between patient groups were relevant for up to 6 days of HFPV treatment. Thereafter, the number of patients remaining on HFPV became too low to allow meaningful statistical evaluation.


High-frequency percussive ventilation in severe acute respiratory distress syndrome: A single center experience.

Spapen H, Borremans M, Diltoer M, Gorp VV, Nguyen DN, Honoré PM - J Anaesthesiol Clin Pharmacol (2014)

Evolution of pH, PaCO2 and PaO2/FiO2 during high-frequency percussive ventilation treatment in patients with pneumonia-related acute respiratory distress syndrome (PR ARDS; red line) and patients with non-sepsis-related ARDS (NSR ARDS; black line). §P < 0.001;#P < 0.01;°P < 0.05
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927295&req=5

Figure 4: Evolution of pH, PaCO2 and PaO2/FiO2 during high-frequency percussive ventilation treatment in patients with pneumonia-related acute respiratory distress syndrome (PR ARDS; red line) and patients with non-sepsis-related ARDS (NSR ARDS; black line). §P < 0.001;#P < 0.01;°P < 0.05
Mentions: The evolution of pH, PaCO2 and PaO2/FiO2 during HFPV was outlined in Figure 3 (all patients) and Figure 4 (pneumonia vs. non-septic patients). Data collection and comparison between patient groups were relevant for up to 6 days of HFPV treatment. Thereafter, the number of patients remaining on HFPV became too low to allow meaningful statistical evaluation.

Bottom Line: Ventilation and oxygenation were governed according to a predefined protocol.HFPV was continued until patients could be switched to conventional ventilation.Within 24 h, HFPV restored normal pH and PaCO2 and considerably improved oxygenation.

View Article: PubMed Central - PubMed

Affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.

ABSTRACT

Background: Few studies have investigated high-frequency percussive ventilation (HFPV) in adult patients with acute respiratory distress syndrome (ARDS).

Materials and methods: We retrospectively analyzed data from critically ill-patients with moderate and severe ARDS who received HFPV. Ventilation and oxygenation were governed according to a predefined protocol. HFPV was continued until patients could be switched to conventional ventilation.

Results: A total of 42 patients (20 with pneumonia-related ARDS and 22 non-septic ARDS cases) were evaluable. Baseline demographic characteristics, severity of illness, lung injury score; pH and respiratory variables were comparable between pneumonia and non-sepsis-related ARDS. Within 24 h, HFPV restored normal pH and PaCO2 and considerably improved oxygenation. Oxygenation improved more in non-septic than in pneumonia-related ARDS. Patients with pneumonia-induced ARDS also remained longer HFPV-dependent (7.0 vs. 4.9 days; P < 0.05). Mortality at 30 days was significantly higher in pneumonia-related than in non-sepsis-related ARDS (50% vs. 18%; P = 0.01).

Conclusions: HFPV caused rapid and sustained improvement of oxygenation and ventilation in patients with moderate to severe ARDS. Less improved oxygenation, longer ventilator dependency and worse survival were observed in pneumonia-related ARDS.

No MeSH data available.


Related in: MedlinePlus