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10.1097/CCM.0000000000004640 http://scihub22266oqcxt.onion/10.1097/CCM.0000000000004640 32932346!ä!32932346 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Crit+Care+Med 2020 ; 48 (12): e1332-e1336 Nephropedia Template TP {{tp|p=32932346|t=2020. Effects of Positive End-Expiratory Pressure in "High Compliance" Severe Acute Respiratory Syndrome Coronavirus 2 Acute Respiratory Distress Syndrome |pdf=|usr=}}{{32932346}} gab.com Text Effects of Positive End-Expiratory Pressure in "High Compliance" Severe Acute Respiratory Syndrome Coronavirus 2 Acute Respiratory Distress Syndrome JO: Crit Care Med http://www.kidney.de/pget.php?&tw=1&pmid=32932346 #FOAvip OBJECTIVES: Clinical observation suggests that early acute respiratory distress syndrome induced by the severe acute respiratory syndrome coronavirus 2 may be "atypical" due to a discrepancy between a relatively unaffected static respiratory system compliance and a significant hypoxemia. This would imply an "atypical" response to the positive end-expiratory pressure. DESIGN: Single-center, unblinded, crossover study. SETTING: ICU of Bari Policlinico Academic Hospital (Italy), dedicated to care patients with confirmed diagnosis of novel coronavirus disease 2019. PATIENTS: Eight patients with early severe acute respiratory syndrome coronavirus 2 acute respiratory distress syndrome and static respiratory compliance higher than or equal to 50 mL/cm H2O. INTERVENTIONS: We compared a "lower" and a "higher" positive end-expiratory pressure approach, respectively, according to the intervention arms of the acute respiratory distress syndrome network and the positive end-expiratory pressure setting in adults with acute respiratory distress syndrome studies. MEASUREMENTS AND MAIN RESULTS: Patients were ventilated with the acute respiratory distress syndrome network and, subsequently, with the ExPress protocol. After 1 hour of ventilation, for each protocol, we recorded arterial blood gas, respiratory mechanics, alveolar recruitment, and hemodynamic variables. Comparisons were performed with analysis of variance for repeated measures or Friedman test as appropriate. Positive end-expiratory pressure was increased from 9 +/- 3.5 to 17.7 +/- 1.7 cm H2O (p < 0.01). Alveolar recruitment was 450 +/- 111 mL. Static respiratory system compliance decreased from 58.3 +/- 7.6 mL/cm H2O to 47.4 +/- 14.5 mL/cm H2O (p = 0.018) and the "stress index" increased from 0.97 +/- 0.03 to 1.22 +/- 0.07 (p < 0.001). The PaO2/FIO2 ratio increased from 131 +/- 22 to 207 +/- 41 (p < 0.001), and the PaCO2 increased from 45.9 +/- 12.7 to 49.8 +/- 13.2 mm Hg (p < 0.001). The cardiac index went from 3.6 +/- 0.4 to 2.9 +/- 0.6 L/min/m (p = 0.01). CONCLUSIONS: Our data suggest that the "higher" positive end-expiratory pressure approach in patients with severe acute respiratory syndrome coronavirus 2 acute respiratory distress syndrome and high compliance improves oxygenation and lung aeration but may result in alveolar hyperinflation and hemodynamic alterations. Twit Text FOAVip Effects of Positive End-Expiratory Pressure in "High Compliance" Severe Acute Respiratory Syndrome Coronavirus 2 Acute Respiratory Distress Syndrome ????Crit Care Med http://www.kidney.de/pget.php?&tw=1&pmid=32932346 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32932346 #FOAvip English Wikipedia <ref>{{Cite pmid|32932346}}</ref> Effects of Positive End-Expiratory Pressure in "High Compliance" Severe Acute Respiratory Syndrome Coronavirus 2 Acute Respiratory Distress Syndrome #MMPMID32932346 Grasso S; Mirabella L; Murgolo F; Di Mussi R; Pisani L; Dalfino L; Spadaro S; Rauseo M; Lamanna A; Cinnella G Crit Care Med 2020[Dec]; 48 (12): e1332-e1336 PMID32932346show ga OBJECTIVES: Clinical observation suggests that early acute respiratory distress syndrome induced by the severe acute respiratory syndrome coronavirus 2 may be "atypical" due to a discrepancy between a relatively unaffected static respiratory system compliance and a significant hypoxemia. This would imply an "atypical" response to the positive end-expiratory pressure. DESIGN: Single-center, unblinded, crossover study. SETTING: ICU of Bari Policlinico Academic Hospital (Italy), dedicated to care patients with confirmed diagnosis of novel coronavirus disease 2019. PATIENTS: Eight patients with early severe acute respiratory syndrome coronavirus 2 acute respiratory distress syndrome and static respiratory compliance higher than or equal to 50 mL/cm H2O. INTERVENTIONS: We compared a "lower" and a "higher" positive end-expiratory pressure approach, respectively, according to the intervention arms of the acute respiratory distress syndrome network and the positive end-expiratory pressure setting in adults with acute respiratory distress syndrome studies. MEASUREMENTS AND MAIN RESULTS: Patients were ventilated with the acute respiratory distress syndrome network and, subsequently, with the ExPress protocol. After 1 hour of ventilation, for each protocol, we recorded arterial blood gas, respiratory mechanics, alveolar recruitment, and hemodynamic variables. Comparisons were performed with analysis of variance for repeated measures or Friedman test as appropriate. Positive end-expiratory pressure was increased from 9 +/- 3.5 to 17.7 +/- 1.7 cm H2O (p < 0.01). Alveolar recruitment was 450 +/- 111 mL. Static respiratory system compliance decreased from 58.3 +/- 7.6 mL/cm H2O to 47.4 +/- 14.5 mL/cm H2O (p = 0.018) and the "stress index" increased from 0.97 +/- 0.03 to 1.22 +/- 0.07 (p < 0.001). The PaO2/FIO2 ratio increased from 131 +/- 22 to 207 +/- 41 (p < 0.001), and the PaCO2 increased from 45.9 +/- 12.7 to 49.8 +/- 13.2 mm Hg (p < 0.001). The cardiac index went from 3.6 +/- 0.4 to 2.9 +/- 0.6 L/min/m (p = 0.01). CONCLUSIONS: Our data suggest that the "higher" positive end-expiratory pressure approach in patients with severe acute respiratory syndrome coronavirus 2 acute respiratory distress syndrome and high compliance improves oxygenation and lung aeration but may result in alveolar hyperinflation and hemodynamic alterations. |Adult[MESH] |Aged[MESH] |Aged, 80 and over[MESH] |Blood Gas Analysis[MESH] |COVID-19/*complications[MESH] |Cross-Over Studies[MESH] |Female[MESH] |Humans[MESH] |Male[MESH] |Middle Aged[MESH] |Positive-Pressure Respiration/*methods[MESH] |Respiratory Distress Syndrome/*etiology/*therapy[MESH] |Respiratory Mechanics/physiology[MESH]Effects of Positive End-Expiratory Pressure in "High Compliance" Sever(epmc).pdf DeepDyve Pubget Overpricing