Abstract

There is great controversy concerning protective ventilatory strategy in ARDS. Recruitment maneuvers and PEEP titration sufficient to avoid collapse and tidal recruitment in the lung are the major goals of the maximal recruitment strategy (MRS) guided by computed tomography (CT).

Highlights

  • Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction

  • In previous work we demonstrated that platelet-derived attributed to bacterial translocation (BT), and the aggravation of microparticles (MP) can induce endothelial and vascular smooth sepsis is related to the increased vascular permeability state that muscle cell apoptosis in septic patients through NADPH oxidase- potentates the BT index

  • The aim of this study is to evaluate the effects of hypertonic saline (HSS) 7.5% and lactated Ringer’s (LR) solutions on intestinal BT in rats that underwent intestinal obstruction and ischaemia (IO)

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Summary

Introduction

Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction. The evolution of intensive care and its results related to the survival of very critically ill patients produce a group of survivors characterized by complex co-morbidities and prolonged dependence on mechanical ventilation (more than 21 days). Methods A prospective, nonrandomized, observational and comparative study that compares effects on PPV of the VC with another three PC ventilatory settings applied in sedated and mechanically ventilated critically ill patients with an arterial catheter in place. The APACHE II score (26.1 ± 9.5 vs 17.7 ± 6.0, P = 0.000), mean SOFA score (10.55 ± 3.41 vs 3.52 ± 2.29, P < 0.001), use of a central catheter (87.5% vs 60.7%, P = 0.001), dialysis (21.4% vs 5.4%, P = 0.013), mechanical ventilation (91.1% vs 35.7%, P < 0.001) and presence of septic shock (32.1% vs 8.9%, P = 0.002) were associated with worse prognosis. Several complications are possible, making it necessary to provide an immediate, specialized, postoperatory intensive care treatment

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