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2015, Number 2

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Rev Cub Med Int Emerg 2015; 14 (2)

Recruitment alveolar sequential maneuver in patients with acute respiratory distress syndrome

San Martín EA, Triolet GA, Sánchez LM

Language: Spanish
References: 23
Page: 62-75
PDF size: 219.74 Kb.


ABSTRACT

Introduction: The mechanic ventilation to patients with acute respiratory distress syndrome constitutes a frequent practice and a challenge to the doctors that have to attend the handling of these sick persons and because of this the search of alternatives that to improve their presage should be incessant.
Objective: To evaluate the effectiveness of the recruitment alveolar sequential maneuver in patients with an acute respiratory distress syndrome in an early stage of evolution.
Method: A recruitment maneuver with growing values of PEEP and inspiratory pressure was carried out to 13 patients with early acute respiratory syndrome until the airway half pressure reached 40 mbar, a value previously defined in order to stop the increment of the PEEP and inspiratory pressure. The numeric variables were expressed as a half with their standard deviation. A significant statistic was considered with a p ‹ 0,05.
Results: After the maneuver, to equal values of controlled ventilation by pressure and PEEP, the elasticity of the breathing system got better (53,08 against 34.69 ml/mbar: p ‹ 0,001), the PaO2/ FiO2 (211,19 against 162.11 mmHg p ‹ 0,001) and the average volume increased (5,79 to 6.41 ml/ kg p ‹ 0,001). Four patients presented arterial hypotension during the alveolar recruitment maneuver (26,66%). Barotrauma was not detected in any patient.
Conclusions: The recruitment alveolar sequential maneuver applied to patient with acute respiratory distress syndrome is sure and beneficial in order to achieve a significant and lingering improvement of the oxygenation.


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