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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | - |
dc.contributor.author | SANTOS, Arnoldo | - |
dc.contributor.author | GOMEZ-PENALVER, Eva | - |
dc.contributor.author | MONGE-GARCIA, M. Ignacio | - |
dc.contributor.author | RETAMAL, Jaime | - |
dc.contributor.author | BORGES, Joao Batista | - |
dc.contributor.author | TUSMAN, Gerardo | - |
dc.contributor.author | HEDENSTIERNA, Goran | - |
dc.contributor.author | LARSSON, Anders | - |
dc.contributor.author | SUAREZ-SIPMANN, Fernando | - |
dc.date.accessioned | 2018-03-06T15:25:59Z | - |
dc.date.available | 2018-03-06T15:25:59Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | CRITICAL CARE MEDICINE, v.45, n.11, p.E1157-E1164, 2017 | - |
dc.identifier.issn | 0090-3493 | - |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/25838 | - |
dc.description.abstract | Objectives: To compare the effects of two lung-protective ventilation strategies on pulmonary vascular mechanics in early acute respiratory distress syndrome. Design: Experimental study. Setting: University animal research laboratory. Subjects: Twelve pigs (30.8 +/- 2.5 kg). Interventions: Acute respiratory distress syndrome was induced by repeated lung lavages and injurious mechanical ventilation. Thereafter, animals were randomized to 4 hours ventilation according to the Acute Respiratory Distress Syndrome Network protocol or to an open lung approach strategy. Pressure and flow sensors placed at the pulmonary artery trunk allowed continuous assessment of pulmonary artery resistance, effective elastance, compliance, and reflected pressure waves. Respiratory mechanics and gas exchange data were collected. Measurements and Main Results: Acute respiratory distress syndrome led to pulmonary vascular mechanics deterioration. Four hours after randomization, pulmonary vascular mechanics was similar in Acute Respiratory Distress Syndrome Network and open lung approach: resistance (578 +/- 252 vs 626 +/- 153 dyn. s/cm(5); p = 0.714), effective elastance, (0.63 +/- 0.22 vs 0.58 +/- 0.17 mm Hg/mL; p = 0.710), compliance (1.19 +/- 0.8 vs 1.50 +/- 0.27 mL/mm Hg; p = 0.437), and reflection index (0.36 +/- 0.04 vs 0.34 +/- 0.09; p = 0.680). Open lung approach as compared to Acute Respiratory Distress Syndrome Network was associated with improved dynamic respiratory compliance (17.3 +/- 2.6 vs 10.5 +/- 1.3 mL/cm H2O; p < 0.001), driving pressure (9.6 +/- 1.3 vs 19.3 +/- 2.7 cm H2O; p < 0.001), and venous admixture (0.05 +/- 0.01 vs 0.22 +/- 0.03, p < 0.001) and lower mean pulmonary artery pressure (26 +/- 3 vs 34 +/- 7 mm Hg; p = 0.045) despite of using a higher positive endexpiratory pressure (17.4 +/- 0.7 vs 9.5 +/- 2.4 cm H2O; p < 0.001). Cardiac index, however, was lower in open lung approach (1.42 +/- 0.16 vs 2.27 +/- 0.48 L/min; p = 0.005). Conclusions: In this experimental model, Acute Respiratory Distress Syndrome Network and open lung approach affected pulmonary vascular mechanics similarly. The use of higher positive end-expiratory pressures in the open lung approach strategy did not worsen pulmonary vascular mechanics, improved lung mechanics, and gas exchange but at the expense of a lower cardiac index. | - |
dc.description.sponsorship | European Critical Care Research Network (ECCRN) | - |
dc.description.sponsorship | European Society of Intensive Care Medicine (ESICM), Basic Science Award | - |
dc.description.sponsorship | Swedish Heart and Lung foundation [K2015-99X-22731-01-4] | - |
dc.description.sponsorship | Swedish Research Council [K2015-99X-22731-01-4] | - |
dc.description.sponsorship | Fundacion Conchita Rabago, Madrid, Spain | - |
dc.description.sponsorship | Consejeria de Educacion, Juventud y Deporte of the Comunidad de Madrid | - |
dc.description.sponsorship | People Programme (Marie Curie Actions) of the ""European Union's Seventh Framework Programme"" (FP7) under Research Executive Agency grant [291820] | - |
dc.description.sponsorship | European Society of Intensive Care Medicine | - |
dc.description.sponsorship | Edwards Lifesciences | - |
dc.description.sponsorship | Deltex Medical | - |
dc.description.sponsorship | Swedish Research Council | - |
dc.description.sponsorship | Swedish Heart and Lung Foundation | - |
dc.description.sponsorship | Maquet Critical Care | - |
dc.description.sponsorship | Ministry of Economy, Industry and Competitiveness (MINECO) | - |
dc.description.sponsorship | Pro CNIC Foundation | - |
dc.description.sponsorship | Severo Ochoa Center of Excellence (MINECO award) [SEV-2015-0505] | - |
dc.language.iso | eng | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.relation.ispartof | Critical Care Medicine | - |
dc.rights | restrictedAccess | - |
dc.subject | ventricular dysfunction | - |
dc.subject | right | - |
dc.subject | respiratory distress syndrome | - |
dc.subject | adult | - |
dc.subject | hypertension | - |
dc.subject | pulmonary | - |
dc.subject | respiration | - |
dc.subject | artificial | - |
dc.subject | pulse wave analysis | - |
dc.subject.other | arterial system | - |
dc.subject.other | backward waves | - |
dc.subject.other | cor-pulmonale | - |
dc.subject.other | injury | - |
dc.subject.other | volume | - |
dc.subject.other | resistance | - |
dc.subject.other | inflation | - |
dc.subject.other | impedance | - |
dc.subject.other | ards | - |
dc.title | Effects on Pulmonary Vascular Mechanics of Two Different Lung-Protective Ventilation Strategies in an Experimental Model of Acute Respiratory Distress Syndrome | - |
dc.type | article | - |
dc.rights.holder | Copyright LIPPINCOTT WILLIAMS & WILKINS | - |
dc.identifier.doi | 10.1097/CCM.0000000000002701 | - |
dc.identifier.pmid | 28872540 | - |
dc.subject.wos | Critical Care Medicine | - |
dc.type.category | original article | - |
dc.type.version | publishedVersion | - |
hcfmusp.author.external | SANTOS, Arnoldo:Uppsala Univ, Sect Anaesthesiol & Crit Care, Dept Surg Sci, Hedenstierna Lab, Uppsala, Sweden; CIBER Enfermedades Resp CIBERES, Madrid, Spain; CNIC, Ctr Nacl Invest Cardiovasc Carlos 3, Madrid, Spain | - |
hcfmusp.author.external | GOMEZ-PENALVER, Eva:Hosp Gen Villalba, Intens Care Unit, Villalba, Spain | - |
hcfmusp.author.external | MONGE-GARCIA, M. Ignacio:Hosp SAS, Intens Care Unit, Jerez de la Frontera, Spain | - |
hcfmusp.author.external | RETAMAL, Jaime:Pontificia Univ Catolica Chile, Dept Med Intens, Santiago, Chile | - |
hcfmusp.author.external | TUSMAN, Gerardo:Hosp Privado Comunidad Mar Del Plata, Dept Anesthesia, Mar Del Plata, Buenos Aires, Argentina | - |
hcfmusp.author.external | HEDENSTIERNA, Goran:Uppsala Univ, Dept Med Sci, Clin Physiol, Uppsala, Sweden | - |
hcfmusp.author.external | LARSSON, Anders:Uppsala Univ, Sect Anaesthesiol & Crit Care, Dept Surg Sci, Hedenstierna Lab, Uppsala, Sweden | - |
hcfmusp.author.external | SUAREZ-SIPMANN, Fernando:Uppsala Univ, Sect Anaesthesiol & Crit Care, Dept Surg Sci, Hedenstierna Lab, Uppsala, Sweden; CIBER Enfermedades Resp CIBERES, Madrid, Spain | - |
hcfmusp.description.beginpage | E1157 | - |
hcfmusp.description.endpage | E1164 | - |
hcfmusp.description.issue | 11 | - |
hcfmusp.description.volume | 45 | - |
hcfmusp.origem | WOS | - |
hcfmusp.origem.id | 2-s2.0-85032163181 | - |
hcfmusp.origem.id | WOS:000417107000007 | - |
hcfmusp.publisher.city | PHILADELPHIA | - |
hcfmusp.publisher.country | USA | - |
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dc.description.index | MEDLINE | - |
dc.identifier.eissn | 1530-0293 | - |
hcfmusp.citation.scopus | 4 | - |
hcfmusp.scopus.lastupdate | 2024-04-12 | - |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - LIM/09 Artigos e Materiais de Revistas Científicas - ODS/03 |
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