Taipei Medical University

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Chen HI
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------>journal_name=J.Biomed Sci
------>paper_name=Acute respiratory distress syndrome
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------>fullAbstract=RATIONALE: The effects of high positive end-expiratory pressure (PEEP) strictly depend on lung recruitability, which widely varies during acute respiratory distress syndrome (ARDS). Unfortunately, increasing PEEP may lead to opposing effects on two main factors potentially worsening the lung injury, i.e., alveolar strain and intra-tidal opening and closing, being detrimental (increasing the former) or beneficial (decreasing the latter). OBJECTIVES: To investigate how lung recruitability influences alveolar strain and intra-tidal opening and closing after the application of high PEEP. METHODS: We analyzed data from a database of sixty-eight patients with acute lung injury or ARDS who underwent whole-lung computed tomography (CT) at 5, 15 and 45 cmH2O airway pressure. MEASUREMENTS AND MAIN RESULTS: End-inspiratory non-aerated lung tissue was estimated from CT pressure-volume curves. Alveolar strain and opening and closing lung tissue were computed at 5 and 15 cmH2O PEEP. In patients with a higher percentage of potentially recruitable lung, the increase of PEEP markedly reduced opening and closing lung tissue (p<0.001), while no differences were observed in patients with a lower percentage of potentially recruitable lung. In contrast, alveolar strain similarly increased in the two groups (p=0.89). Opening and closing lung tissue was mainly distributed in the dependent and hilar lung regions, and it appeared to be an independent risk factor for death (1.10 odds ratio for each 10 g-increase). CONCLUSIONS: In ARDS, especially in patients with higher lung recruitability, the beneficial impact of reducing intra-tidal alveolar opening and closing by increasing PEEP prevails on the effects of increasing alveolar strain.
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------>authors2=Kao SJ
------>authors3=Wang David
------>authors4=Lee RP
------>authors5=Su CF
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------>authors=Chen HI
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------>updateTitle=Lung Opening and Closing During Ventilation of Acute Respiratory Distress Syndrome.
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------>publish_year=2003
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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z