Abstract
Improvement of oxygenation during acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) requires a high level of positive end-expiratory pressure (PEEP) to recruit nonaerated lung zones and decrease pulmonary shunt. However, monitoring of alveolar recruitment at the bedside is difficult, as neither the PaO2/FiO2 ratio, thoracopulmonary compliance or generation of pressure curve are indices of alveolar recruitment and avoidance of lung hyperinflation. Monitoring of the functional residual capacity (FRC) at the bedside may be useful to monitor directly lung recruitment and to optimize the PEEP level [1]. The aims of this study are to evaluate the FRC by a modified nitrogen multiple washout technique (NMBW) in ALI/ARDS patients, and to set PEEP levels on data of FRC values.
Highlights
There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients
In a logistic regression model, only sex and the dose/kg were significantly associated with the achievement of Cmax above 16 μg/ml
Results of this study show that early tracheostomy, if perioperative complications
Summary
There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients. Conclusions Our data demonstrate that critically ill patients may be exposed to a higher FiO2 than that required to maintain adequate oxygenation These results highlight an area of ICU care that has received little study, with no published clinical trials examining the effect of FiO2 on outcome. Results Age, sex, the underlying disease and tumour stage (TNM classification), type of previous anticancer treatment, performance status, severity scores (APACHE II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment), ICU and hospital mortalities and hospital outcome at 3, 6 and 12 months were analysed. Clinical data of 277 post-transplantation patients admitted to the ICU were collected at admission and the SAPS 3 and APACHE II score calculated with respective estimated mortality rates.
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