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Intermittent recruitment with high-frequency oscillation/tracheal gas insufflation in acute respiratory distress syndrome
dc.creator | Mentzelopoulos, S. D. | en |
dc.creator | Malachias, S. | en |
dc.creator | Zintzaras, E. | en |
dc.creator | Kokkoris, S. | en |
dc.creator | Zakynthinos, E. | en |
dc.creator | Makris, D. | en |
dc.creator | Magira, E. | en |
dc.creator | Markaki, V. | en |
dc.creator | Roussos, C. | en |
dc.creator | Zakynthinos, S. G. | en |
dc.date.accessioned | 2015-11-23T10:39:22Z | |
dc.date.available | 2015-11-23T10:39:22Z | |
dc.date.issued | 2012 | |
dc.identifier | 10.1183/09031936.00158810 | |
dc.identifier.issn | 0903-1936 | |
dc.identifier.uri | http://hdl.handle.net/11615/30904 | |
dc.description.abstract | In acute respiratory distress syndrome (ARDS), recruitment sessions of high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) with short-lasting recruitment manoeuvres (RMs) may improve oxygenation and enable reduction of subsequent conventional mechanical ventilation (CMV) pressures. We determined the effect of adding HFO-TGI sessions to lung-protective CMV on early/severe ARDS outcome. We conducted a prospective clinical trial, subdivided into a first single-centre period and a second two-centre period. We enrolled 125 (first period, n=54) patients with arterial oxygen tension (Pa,O-2)/inspiratory oxygen fraction (FI,O-2) of < 150 mmHg for > 12 consecutive hours at an end-expiratory pressure of >= 8 cmH(2)O. Patients were randomly assigned to an HFO-TGI group (receiving HFO-TGI sessions with RMs, interspersed with lung-protective CMV; n=61) or CMV group (receiving lung-protective CMV and RMs; n=64). The primary outcome was survival to hospital discharge. Pre-enrolment ventilation duration was variable. During days 1-10 post-randomisation, Pa,O-2/FI,O-2, oxygenation index, plateau pressure and respiratory compliance were improved in the HFO-TGI group versus the CMV group (p < 0.001 for group x time). Within days 1-60, the HFO-TGI group had more ventilator-free days versus the CMV group (median (interquartile range) 31.0 (0.0-42.0) versus 0.0 (0.0-23.0) days; p < 0.001), and more days without respiratory, circulatory, renal, coagulation and liver failure (p <= 0.003). Survival to hospital discharge was higher in the HFO-TGI group versus the CMV group (38 (62.3%) out of 61 versus 23 (35.9%) out of 64 subjects; p=0.004). Intermittent recruitment with HFO-TGI and RMs may improve survival in early/severe ARDS. | en |
dc.source.uri | <Go to ISI>://WOS:000300883800019 | |
dc.subject | Adult | en |
dc.subject | clinical trial | en |
dc.subject | high-frequency ventilation | en |
dc.subject | respiratory distress | en |
dc.subject | syndrome | en |
dc.subject | ACUTE LUNG INJURY | en |
dc.subject | RANDOMIZED CONTROLLED-TRIAL | en |
dc.subject | END-EXPIRATORY PRESSURE | en |
dc.subject | OSCILLATORY VENTILATION | en |
dc.subject | MECHANICAL VENTILATION | en |
dc.subject | ADULT PATIENTS | en |
dc.subject | TIDAL | en |
dc.subject | VOLUMES | en |
dc.subject | ARDS | en |
dc.subject | MANEUVERS | en |
dc.subject | STRATEGY | en |
dc.subject | Respiratory System | en |
dc.title | Intermittent recruitment with high-frequency oscillation/tracheal gas insufflation in acute respiratory distress syndrome | en |
dc.type | journalArticle | en |
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