Lung recruitment in patients with the acute respiratory distress syndrome

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dc.contributor.authorGattinoni, L
dc.contributor.authorCaironi, P
dc.contributor.authorCressoni, M
dc.contributor.authorChiumello, D
dc.contributor.authorRanieri, VM
dc.contributor.authorQuintel, M
dc.contributor.authorRusso, S
dc.contributor.authorPatroniti, N
dc.contributor.authorCornejo, R
dc.contributor.authorBugedo, G
dc.date.accessioned2024-01-10T12:06:25Z
dc.date.available2024-01-10T12:06:25Z
dc.date.issued2006
dc.description.abstractBackground: In the acute respiratory distress syndrome (ARDS), positive end-expiratory pressure (PEEP) may decrease ventilator-induced lung injury by keeping lung regions open that otherwise would be collapsed. Since the effects of PEEP probably depend on the recruitability of lung tissue, we conducted a study to examine the relationship between the percentage of potentially recruitable lung, as indicated by computed tomography (CT), and the clinical and physiological effects of PEEP.
dc.description.abstractMethods: Sixty-eight patients with acute lung injury or ARDS underwent whole-lung CT during breath-holding sessions at airway pressures of 5, 15, and 45 cm of water. The percentage of potentially recruitable lung was defined as the proportion of lung tissue in which aeration was restored at airway pressures between 5 and 45 cm of water.
dc.description.abstractResults: The percentage of potentially recruitable lung varied widely in the population, accounting for a mean (+/-SD) of 13+/-11 percent of the lung weight, and was highly correlated with the percentage of lung tissue in which aeration was maintained after the application of PEEP (r(sup 2)=0.72, P < 0.001). On average, 24 percent of the lung could not be recruited. Patients with a higher percentage of potentially recruitable lung (greater than the median value of 9 percent) had greater total lung weights (P < 0.001), poorer oxygenation (defined as a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen) (P < 0.001) and respiratory-system compliance (P=0.002), higher levels of dead space (P=0.002), and higher rates of death (P=0.02) than patients with a lower percentage of potentially recruitable lung. The combined physiological variables predicted, with a sensitivity of 71 percent and a specificity of 59 percent, whether a patient's proportion of potentially recruitable lung was higher or lower than the median.
dc.description.abstractConclusions: In ARDS, the percentage of potentially recruitable lung is extremely variable and is strongly associated with the response to PEEP.
dc.fechaingreso.objetodigital2024-05-10
dc.format.extent12 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1056/NEJMoa052052
dc.identifier.eissn1533-4406
dc.identifier.issn0028-4793
dc.identifier.pubmedidMEDLINE:16641394
dc.identifier.urihttps://doi.org/10.1056/NEJMoa052052
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/76158
dc.identifier.wosidWOS:000237077100003
dc.information.autorucMedicina;Bugedo G;S/I;60490
dc.issue.numero17
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final1786
dc.pagina.inicio1775
dc.publisherMASSACHUSETTS MEDICAL SOC
dc.revistaNEW ENGLAND JOURNAL OF MEDICINE
dc.rightsregistro bibliográfico
dc.subjectEND-EXPIRATORY PRESSURES
dc.subjectMECHANICAL VENTILATION
dc.subjectPROTECTIVE-VENTILATION
dc.subjectFAILURE
dc.subjectMANEUVERS
dc.subjectMORTALITY
dc.subjectINJURY
dc.subjectARDS
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleLung recruitment in patients with the acute respiratory distress syndrome
dc.typeartículo
dc.volumen354
sipa.codpersvinculados60490
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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