Closed-loop mechanical ventilation for lung injury: a novel physiological-feedback mode following the principles of the open lung concept.
Adherence to low tidal volume (VT) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel full...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 32; no. 3; pp. 493 - 503 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129595139&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129595139 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Jun2018 vid: 32 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 129595139 129595139 NLM28653135 129595139 10.1007/s10877-017-0040-0 NLM28653135 129595139 ppf: 493 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Closed-loop mechanical ventilation for lung injury: a novel physiological-feedback mode following the principles of the open lung concept. aug: au: Schwaiberger, David Pickerodt, Philipp A. Pomprapa, Anake Tjarks, Onno Kork, Felix Boemke, Willehad Francis, Roland C. E. Leonhardt, Steffen Lachmann, Burkhard affil: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité -Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany sug: subj: Respiration, Artificial Methods Lung Injury Therapy Positive End-Expiratory Pressure Methods Pulmonary Gas Exchange Electric Impedance Lung Tomography Methods Monitoring, Physiologic Methods Respiration Tidal Volume Swine Computer Systems Animals Surface-Active Agents Human Funding Source ab: Adherence to low tidal volume (VT) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel fully closed-loop mechanical ventilation algorithm based on the "open lung" concept. Lung injury was induced by surfactant washout in pigs (n = 8). Animals were ventilated following the principles of the "open lung approach" (OLA) using a fully closed-loop physiological feedback algorithm for mechanical ventilation. Standard gas exchange, respiratory- and hemodynamic parameters were measured. Electrical impedance tomography was used to quantify regional ventilation distribution during mechanical ventilation. Automatized mechanical ventilation provided strict adherence to low VT-ventilation for 6 h in severely lung injured pigs. Using the "open lung" approach, tidal volume delivery required low lung distending pressures, increased recruitment and ventilation of dorsal lung regions and improved arterial blood oxygenation. Physiological feedback closed-loop mechanical ventilation according to the principles of the open lung concept is feasible and provides low tidal volume ventilation without human intervention. Of importance, the "open lung approach"-ventilation improved gas exchange and reduced lung driving pressures by opening atelectasis and shifting of ventilation to dorsal lung regions. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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