Verified Document

Lung Recruitability In Early ARDS Article Review

Related Topics:

Lung Recruitability in Early ARDS Lung Recruitment in ARDS

The symptoms of acute respiratory distress syndrome (ARDS) include cyanosis refractory to oxygen therapy, lower lung compliance, radiographic evidence of diffuse bilateral infiltrates, and PaO2/FiO2 ? 200 mmHg (reviewed by LaFollette, Norton, DiRocco, Carney, and Nieman, 2006). Problems arise when normal tidal volumes are used to ventilate ARDS lungs, because much of the lung tissue is refractory to recruitment. As a result, ventilator-induced lung injury (VILI) occurs due to lung distention. Mechanical ventilation of patients with ARDS therefore is associated with a high rate of mortality.

Awareness of the association between a poor prognosis and mechanical ventilation in ARDS is several decades old, yet considerable controversy remains concerning the optimal treatment approach (reviewed by de Matos et al., 2012). There is some consensus that positive end-expiratory pressure (PEEP) should be titrated during recruitment maneuvers, to minimize lung distention. Some clinicians have even argued for the efficacy of the so-called 'open-lung hypothesis', which states that collapsed lung tissue in early ARDS can be reclaimed with acceptable clinical costs. To date this hypothesis has received no empirical support, primarily...

The mean age of the study group was 50.7 years, with a range from 14 to 80 years of age. Most were suffering from primary ARDS (84%) and sepsis (71%).
MRS maneuvers were conducted while patients were being monitored live by computed tomography (CT) (de Matos et al., 2012, Figure 1). The recruitment phase involved pressure controlled ventilation that increased PEEP from 10 to 45 cmH2O in four steps, with each lasting two minutes. This was followed by a PEEP titration phase that decreased cmH2O from 25 to 10 in four steps. At the end of each end-expiratory pause, the lungs were imaged by CT. The only complications observed were transient decreases in blood pressure in two patients, which were not severe enough to interrupt MRS maneuvers.

The results of this study revealed that the median recruitable lung tissue was 45%, far higher than that revealed by previous studies (de Matos et al., 2012). Surprisingly, no evidence of barotrauma…

Sources used in this document:
References

de Matos, Gustavo F.J., Stanzani, Fabiana, Passos, Rogerio H., Fontana, Mauricio F., Albaladejo, Renata, Caserta, Raquel E. et al. (2012). How large is the lung recruitability in early ARDS: A prospective case series of patients monitored by CT. Critical Care, 16, 1-14.

Gattinoni, Luciano, Caironi, Pietro, Cressoni, Massimo, Chiumello, Davide, Ranieri, V. Marco, Quintel, Michael et al. (2006). Lung recruitment in patients with the acute respiratory distress syndrome. New England Journal of Medicine, 354, 1775-1786.

LaFollette, Ryan, Norton, Jillian, DiRocco, Joseph, Carney, David, and Nieman, Gary. (2006). Using pressure-volume curves to set proper PEEP in acute lung injury. Nursing in Critical Care, 12, 231-241.
Cite this Document:
Copy Bibliography Citation

Related Documents

Respiratory Therapy a Respiratory Therapist Is Someone
Words: 521 Length: 2 Document Type: Essay

Respiratory Therapy A respiratory therapist is someone who literally has the life of her patients in her hands. I have been fortunate this semester in being able to talk with people who chose this career. I even spent some time shadowing them at their job. I have known for a long time that I wanted a career in the health care field. Becoming a respiratory therapist sounded interesting. Now that I

Respiratory Therapist Professions of Caring Career Project:
Words: 830 Length: 2 Document Type: Term Paper

Respiratory Therapist Professions of caring career project: Where Am I Going? Part 2 Interview Why did you decide to work in this field? My grandmother had asthma, so I have always been acutely aware of the importance of the challenges some people experience with the simple act of breathing. Did you have another career before you went to school to become a ____? What was it like to change from one career to another? I

Respiratory Conditions
Words: 5082 Length: 15 Document Type: Research Paper

Respiratory Infections Respiratory Conditions Respiratory tract infections are highly infectious diseases that involve the respiratory tract. They are divided into upper (URTI or URI) and lower respiratory tract infections (LRTI or LRI). LRIs include pneumonia, bronchitis and influenza, and they tend to affect patients more seriously that URIs which include the common cold, tonsillitis, sinusitis and laryngitis. This research dwells on four respiratory infections which are bronchitis, bronchial asthma, exercise-induced bronchospasm and

Respiratory Syncytial Virus / Bronchiolitis
Words: 715 Length: 2 Document Type: Term Paper

Subtype a is the one that predominates in many of the outbreaks that are seen and presents much more severe clinical illness. It affects both the lower and the upper respiratory tract but is most prevalent in illnesses of the lower respiratory tract such as bronchiolitis and pneumonia. The obstruction of the airway in RSV can be very dangerous, and this is especially true of infants because their peripheral

Respiratory Syncytial Virus RSV Is
Words: 2800 Length: 10 Document Type: Term Paper

It has also been suggested that low-level viral replication associated with RSV may be a driver in chronic inflammation in some sufferers of chronic lung disease, although this is so far uncertain (Openshaw, 2005). It is estimated that infants who develop a wheeze as a result of RSV contraction develop a recurring wheeze in around two thirds of all cases. It is also estimated that around half of these children

Respiratory Drugs Respiratory System Drugs
Words: 1294 Length: 5 Document Type: Term Paper

Methylxanthines Yet another type of medication used to improve respiratory function is Methylxanthines. Some examples of these include Theophylline. These types of agents work similarly to bronchodilators which open the airway passage, in part by relaxing the bronchial or smooth muscles in the air passage ways. They also help promote greater circulation and engage the central nervous system so it can more actively work to provide oxygen throughout the body. Because

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now