Lung computed tomography during a lung recruitment maneuver in patients with acute lung injury

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dc.catalogadorpau
dc.contributor.authorBugedo Tarraza, Guillermo
dc.contributor.authorBruhn, Alejandro
dc.contributor.authorHernández P., Glenn
dc.contributor.authorRojas Godoy, Gonzalo Andrés
dc.contributor.authorVarela Ubilla, Cristián Nacor
dc.contributor.authorTapia Vásquez, Juan Carlos
dc.contributor.authorCastillo Fuenzalida, Luis Benito
dc.date.accessioned2023-07-10T20:37:47Z
dc.date.available2023-07-10T20:37:47Z
dc.date.issued2003
dc.description.abstractObjective: To assess the acute effect of a lung recruitment maneuver (LRM) on lung morphology in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Patients: Ten patients with ALI/ARDS on mechanical ventilation. Design: Prospective clinical study. Setting: Computed tomography (CT) scan facility in a teaching hospital. Interventions: An LRM performed by stepwise increases in positive end-expiratory pressure (PEEP) of up to 30–40 cmH2O. Lung basal CT sections were taken at end-expiration (patients 1 to 5), and at end-expiration and end-inspiration (patients 6 to10). Arterial blood gases and static compliance (Cst) were measured before, during and after the LRM. Measurements and main results: Poorly aerated and non-aerated tissue at PEEP 10 cmH2O accounted for 60.0±29.1% of lung parenchyma, while only 1.1±1.8% was hyperinflated. Increasing PEEP to 20 and 30 cmH2O, compared to PEEP 10 cmH2O, decreased poorly aerated and non-aerated tissue by 16.2±28.0% and 33.4±13.8%, respectively (p<0.05). This was associated with an increase in PaO2 and a decrease in total static compliance. Inspiration increased alveolar recruitment at all PEEP levels. Hyperinflated tissue increased up to 2.9±4.0% with PEEP 30 cmH2O, and to a lesser degree with inspiration. No barotrauma or severe hypotension occurred. Conclusions: Lung recruitment maneuvers improve oxygenation by expanding collapsed alveoli without inducing too much hyperinflation in ALI/ARDS patients. An LRM during the CT scan gives morphologic and functional information that could be useful in setting ventilatory parameters.
dc.fechaingreso.objetodigital2023-07-10
dc.format.extent8 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1007/s00134-002-1618-6
dc.identifier.issn0342-4642
dc.identifier.urihttp://www.scopus.com/inward/record.url?eid=2-s2.0-0037302918&partnerID=MN8TOARS
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/74151
dc.identifier.wosidWOS:000181661600012
dc.information.autorucEscuela de Medicina ; Bugedo Tarraza, Guillermo ; 0000-0001-7527-6202 ; 103776
dc.information.autorucEscuela de Medicina ; Bruhn, Alejandro ; 0000-0001-8034-1937 ; 741
dc.information.autorucEscuela de Medicina ; Hernández P., Glenn ; S/I ; 98874
dc.information.autorucEscuela de Medicina ; Rojas Godoy, Gonzalo Andrés ; S/I ; 231711
dc.information.autorucEscuela de Medicina ; Varela Ubilla, Cristián Nacor ; S/I ; 87181
dc.information.autorucEscuela de Medicina ; Tapia Vásquez, Juan Carlos ; S/I ; 56867
dc.information.autorucEscuela de Medicina ; Castillo Fuenzalida, Luis Benito ; S/I ; 54397
dc.issue.numero2
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final225
dc.pagina.inicio218
dc.revistaIntensive Care Medicine
dc.rightsacceso abierto
dc.subjectAlveolar recruitment
dc.subjectComputed tomography (CT)
dc.subjectLung morphology
dc.subjectMechanical ventilation
dc.subjectAcute lung injury (ALI)
dc.subjectAcute respiratory distress syndrome (ARDS)
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleLung computed tomography during a lung recruitment maneuver in patients with acute lung injuryes_ES
dc.typeartículo
dc.volumen29
sipa.codpersvinculados103776
sipa.codpersvinculados741
sipa.codpersvinculados98874
sipa.codpersvinculados231711
sipa.codpersvinculados87181
sipa.codpersvinculados56867
sipa.codpersvinculados54397
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