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5 papers 0 to 25 followers
https://www.readbyqxmd.com/read/28884313/endocan-as-an-early-biomarker-of-severity-in-patients-with-acute-respiratory-distress-syndrome
#1
Diego Orbegozo, Lokmane Rahmania, Marian Irazabal, Manuel Mendoza, Filippo Annoni, Daniel De Backer, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Plasma concentrations of endocan, a proteoglycan preferentially expressed in the pulmonary vasculature, may represent a biomarker of lung (dys)function. We sought to determine whether the measurement of plasma endocan levels early in the course of acute respiratory distress syndrome (ARDS) could help predict risk of death or of prolonged ventilation. METHODS: All patients present in the department of intensive care during a 150-day period were screened for ARDS (using the Berlin definition)...
September 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29175086/re-examining-permissive-hypercapnia-in-ards-a-narrative-review
#2
REVIEW
Tavish Barnes, Vasileios Zochios, Ken Parhar
Lung-protective ventilation (LPV) has become the cornerstone of management in patients with ARDS. A subset of patients is unable to tolerate LPV without significant CO2 elevation. In these patients, permissive hypercapnia is used. Although thought to be benign, it is becoming increasingly evident that elevated CO2 levels have significant physiological effects. In this narrative review, we highlight clinically relevant end-organ effects in both animal models and clinical studies. We also explore the association between elevated CO2 , acute cor pulmonale, and ICU mortality...
November 22, 2017: Chest
https://www.readbyqxmd.com/read/16714767/comparison-of-two-fluid-management-strategies-in-acute-lung-injury
#3
RANDOMIZED CONTROLLED TRIAL
Herbert P Wiedemann, Arthur P Wheeler, Gordon R Bernard, B Taylor Thompson, Douglas Hayden, Ben deBoisblanc, Alfred F Connors, R Duncan Hite, Andrea L Harabin
BACKGROUND: Optimal fluid management in patients with acute lung injury is unknown. Diuresis or fluid restriction may improve lung function but could jeopardize extrapulmonary-organ perfusion. METHODS: In a randomized study, we compared a conservative and a liberal strategy of fluid management using explicit protocols applied for seven days in 1000 patients with acute lung injury. The primary end point was death at 60 days. Secondary end points included the number of ventilator-free days and organ-failure-free days and measures of lung physiology...
June 15, 2006: New England Journal of Medicine
https://www.readbyqxmd.com/read/22797452/acute-respiratory-distress-syndrome-the-berlin-definition
#4
V Marco Ranieri, Gordon D Rubenfeld, B Taylor Thompson, Niall D Ferguson, Ellen Caldwell, Eddy Fan, Luigi Camporota, Arthur S Slutsky
The acute respiratory distress syndrome (ARDS) was defined in 1994 by the American-European Consensus Conference (AECC); since then, issues regarding the reliability and validity of this definition have emerged. Using a consensus process, a panel of experts convened in 2011 (an initiative of the European Society of Intensive Care Medicine endorsed by the American Thoracic Society and the Society of Critical Care Medicine) developed the Berlin Definition, focusing on feasibility, reliability, validity, and objective evaluation of its performance...
June 20, 2012: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/15269312/higher-versus-lower-positive-end-expiratory-pressures-in-patients-with-the-acute-respiratory-distress-syndrome
#5
RANDOMIZED CONTROLLED TRIAL
Roy G Brower, Paul N Lanken, Neil MacIntyre, Michael A Matthay, Alan Morris, Marek Ancukiewicz, David Schoenfeld, B Taylor Thompson
BACKGROUND: Most patients requiring mechanical ventilation for acute lung injury and the acute respiratory distress syndrome (ARDS) receive positive end-expiratory pressure (PEEP) of 5 to 12 cm of water. Higher PEEP levels may improve oxygenation and reduce ventilator-induced lung injury but may also cause circulatory depression and lung injury from overdistention. We conducted this trial to compare the effects of higher and lower PEEP levels on clinical outcomes in these patients. METHODS: We randomly assigned 549 patients with acute lung injury and ARDS to receive mechanical ventilation with either lower or higher PEEP levels, which were set according to different tables of predetermined combinations of PEEP and fraction of inspired oxygen...
July 22, 2004: New England Journal of Medicine
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