Reduction of ventilator settings allowed by intravenous oxygenator (IVOX) in ARDS patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1995-01

AUTHORS

J. P. Mira, F. Brunet, M. Belghith, O. Soubrane, J. L. Termignon, B. Renaud, I. Hamy, M. Monchi, E. Deslande, L. Fierobe, A. Brusset, J. F. Dhainaut

ABSTRACT

ObjectiveTo evaluate the possibility of reducing ventilator settings to “safe” levels by extrapulmonary gas exchange with IVOX in ARDS patients.DesignUncontrolled open clinical study.SettingMedical Intensive Care Unit of a University Hospital.Patients6 patients with ARDS who entered into IVOX phase II clinical trials.InterventionsThe end-point of this study was to reduce ventilator settings from the initial values, recorded on the day of inclusion, to the following: peak inspiratory pressure <40 cmH2O, mean airway pressure <25 cmH2O and tidal volume <10 ml/kg. Trials to achieve this goal were made on volume-controlled ventilation within the 24h before and after IVOX insertion. Comparison of the results achieved during these trials used wilcoxon test.ResultsBefore IVOX implantation reduction of ventilator settings was not possible in the 6 patients, despite a non-significant increase in PaO2/FIO2 was achieved. IVOX permitted significant decrease in PaCO2 (from 60.5±15 to 52±11 mmHg;p=0.02) before any modification of the ventilatory mode. After IVOX insertion, a significant decrease of the ventilator settings was performed: peak and mean airway pressures dropped from 44±10 to 36.8±6.7;p=0.02 and from 26.3±5.6 to 22.5±3.9 cmH2O;p=0.02, respectively. Concommitantly, PaCO2 remained unchanged and PaO2/FIO2 increased significantly from 93±28 to 117±52;p=0.04. The interruption of oxygen flow on IVOX was associated with a slight decrease of the oxygen variables. Tolerance of IVOX was satisfactory. However, a significant decrease both in cardiac index and in pulmonary wedge pressures (from 4.5±1.2 to 3.4±9;p=0.03 and from 16±5 to 11±2;p=0.04, respectively) was observed.ConclusionGas exchange achieved by IVOX allowed reduction of ventilator settings in 6 ARDS patients in whom previous attempts have failed. CO2 removal by the device, may explain these results. Efficacy of IVOX on arterial oxygenation was uncertain. More... »

PAGES

11-17

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf02425148

DOI

http://dx.doi.org/10.1007/bf02425148

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1028990066

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/7560467


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24 schema:description ObjectiveTo evaluate the possibility of reducing ventilator settings to “safe” levels by extrapulmonary gas exchange with IVOX in ARDS patients.DesignUncontrolled open clinical study.SettingMedical Intensive Care Unit of a University Hospital.Patients6 patients with ARDS who entered into IVOX phase II clinical trials.InterventionsThe end-point of this study was to reduce ventilator settings from the initial values, recorded on the day of inclusion, to the following: peak inspiratory pressure <40 cmH2O, mean airway pressure <25 cmH2O and tidal volume <10 ml/kg. Trials to achieve this goal were made on volume-controlled ventilation within the 24h before and after IVOX insertion. Comparison of the results achieved during these trials used wilcoxon test.ResultsBefore IVOX implantation reduction of ventilator settings was not possible in the 6 patients, despite a non-significant increase in PaO2/FIO2 was achieved. IVOX permitted significant decrease in PaCO2 (from 60.5±15 to 52±11 mmHg;p=0.02) before any modification of the ventilatory mode. After IVOX insertion, a significant decrease of the ventilator settings was performed: peak and mean airway pressures dropped from 44±10 to 36.8±6.7;p=0.02 and from 26.3±5.6 to 22.5±3.9 cmH2O;p=0.02, respectively. Concommitantly, PaCO2 remained unchanged and PaO2/FIO2 increased significantly from 93±28 to 117±52;p=0.04. The interruption of oxygen flow on IVOX was associated with a slight decrease of the oxygen variables. Tolerance of IVOX was satisfactory. However, a significant decrease both in cardiac index and in pulmonary wedge pressures (from 4.5±1.2 to 3.4±9;p=0.03 and from 16±5 to 11±2;p=0.04, respectively) was observed.ConclusionGas exchange achieved by IVOX allowed reduction of ventilator settings in 6 ARDS patients in whom previous attempts have failed. CO2 removal by the device, may explain these results. Efficacy of IVOX on arterial oxygenation was uncertain.
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32 ARDS patients
33 CO2 removal
34 ConclusionGas exchange
35 Efficacy of IVOX
36 FiO2
37 II clinical trials
38 IVOX implantation reduction
39 IVOX insertion
40 IVOX phase II clinical trials
41 ObjectiveTo
42 PaCO2
43 PaO2/FiO2
44 Patients6 patients
45 ResultsBefore IVOX implantation reduction
46 SettingMedical Intensive Care Unit
47 Tolerance of IVOX
48 University Hospital
49 Wilcoxon test
50 airway pressure
51 arterial oxygenation
52 attempt
53 cardiac index
54 care unit
55 clinical studies
56 clinical trials
57 cmH2O
58 comparison
59 day of inclusion
60 days
61 decrease
62 devices
63 efficacy
64 exchange
65 extrapulmonary gas exchange
66 flow
67 gas exchange
68 goal
69 hospital
70 implantation reduction
71 inclusion
72 increase
73 index
74 initial value
75 insertion
76 inspiratory pressure
77 intensive care unit
78 interruption
79 intravenous oxygenator
80 levels
81 mean airway pressure
82 mode
83 modification
84 non-significant increase
85 open clinical study
86 oxygen flow
87 oxygen variables
88 oxygenation
89 oxygenator
90 patients
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92 peak inspiratory pressure
93 phase II clinical trial
94 possibility
95 pressure
96 previous attempts
97 pulmonary wedge pressure
98 reduction
99 removal
100 results
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104 study
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108 trials
109 units
110 values
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