The Impact of PEEP on Ventilation Distribution in ARDS.

ICU electrical impedance tomography mechanical ventilation positive-pressure respiration respiratory distress syndrome

Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
16 Jul 2024
Historique:
medline: 17 7 2024
pubmed: 17 7 2024
entrez: 16 7 2024
Statut: aheadofprint

Résumé

The first aim of this study was to evaluate the capacity of electrical impedance tomography (EIT) to identify the effect of PEEP on regional ventilation distribution and the regional risk of collapse, overdistention, hypoventilation, and pendelluft in mechanically ventilated patients. The second aim was to evaluate the feasibility of EIT for estimating airway opening pressure (AOP). The EIT signal was recorded both during baseline cyclic ventilation and slow insufflation for one breath for 9 subjects with moderate-to-severe ARDS. From these data, the AOP and volumes insufflated to lung regions with or without the risk of either collapse, overdistention, hypoventilation, or pendelluft were assessed at 3 PEEP levels (5, 10, and 15 cm H The volume for which there was no specific risk significantly decreased at the highest PEEP from 55 ± 31% tidal volume (V Our results suggest that EIT could aid clinicians in making personalized and reasoned choices in setting the PEEP for subjects with ARDS.

Sections du résumé

BACKGROUND BACKGROUND
The first aim of this study was to evaluate the capacity of electrical impedance tomography (EIT) to identify the effect of PEEP on regional ventilation distribution and the regional risk of collapse, overdistention, hypoventilation, and pendelluft in mechanically ventilated patients. The second aim was to evaluate the feasibility of EIT for estimating airway opening pressure (AOP).
METHODS METHODS
The EIT signal was recorded both during baseline cyclic ventilation and slow insufflation for one breath for 9 subjects with moderate-to-severe ARDS. From these data, the AOP and volumes insufflated to lung regions with or without the risk of either collapse, overdistention, hypoventilation, or pendelluft were assessed at 3 PEEP levels (5, 10, and 15 cm H
RESULTS RESULTS
The volume for which there was no specific risk significantly decreased at the highest PEEP from 55 ± 31% tidal volume (V
CONCLUSIONS CONCLUSIONS
Our results suggest that EIT could aid clinicians in making personalized and reasoned choices in setting the PEEP for subjects with ARDS.

Identifiants

pubmed: 39013571
pii: respcare.11569
doi: 10.4187/respcare.11569
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 by Daedalus Enterprises.

Auteurs

Bruno Louis (B)

Institut Mondor de Recherches Biomédicales INSERM-UPEC U955 CNRS EMR7000, Créteil, France. bruno.louis@inserm.fr.

Martin Cour (M)

Médecine Intensive-Réanimation, Hôpital Edouard Herriot, Lyon, France.

Laurent Argaud (L)

Médecine Intensive-Réanimation, Hôpital Edouard Herriot, Lyon, France.

Claude Guérin (C)

Institut Mondor de Recherches Biomédicales INSERM-UPEC U955 CNRS EMR7000, Créteil, France; Médecine Intensive-Réanimation, Hôpital Edouard Herriot, Lyon, France; and Université de Lyon, Lyon, France.

Classifications MeSH