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[Mechanical ventilation therapy with permissive hypercapnia on ARDS].

L Xu1, M Gao, T Yao

  • 1Pulmonary Division, Anzhen Hospital, Beijing.

Zhonghua Jie He He Hu Xi Za Zhi = Zhonghua Jiehe He Huxi Zazhi = Chinese Journal of Tuberculosis and Respiratory Diseases
|April 1, 1997
PubMed
Summary
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Mechanical ventilation for acute respiratory distress syndrome (ARDS) using low tidal volume (VT) and allowing some respiratory acidosis improved survival. This approach may reduce lung injury in ARDS patients.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Respiratory Therapy

Background:

  • Acute respiratory distress syndrome (ARDS) presents significant challenges in mechanical ventilation (MV) management.
  • Traditional MV strategies aim to prevent hypercapnia, but may increase the risk of ventilator-induced lung injury (VILI).

Purpose of the Study:

  • To evaluate the efficacy and safety of a modified MV strategy in ARDS patients.
  • To assess the impact of low tidal volume (VT) and permissive hypercapnia on outcomes in ARDS.

Main Methods:

  • A cohort of ten ARDS patients received MV.
  • Low tidal volume (mean 6.5 ml/kg) was employed, permitting controlled respiratory acidosis based on renal compensation.
  • Low fraction of inspired oxygen (FiO2) and positive end-expiratory pressure (PEEP) were utilized to maintain adequate oxygenation while minimizing barotrauma.

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Main Results:

  • Seven out of ten patients survived the ARDS episode.
  • Three patients experienced respiratory acidosis, and two developed lung barotrauma during mechanical ventilation.
  • The strategy aimed to maintain PaO2 around 7.3 kPa.

Conclusions:

  • Employing lower tidal volumes and allowing permissive respiratory acidosis is a viable strategy in ARDS mechanical ventilation.
  • This approach warrants consideration for reducing lung injury and improving survival in ARDS patients.