Abstract:
OBJECTIVE:To assess the safety and efficacy of sustained inflations (SI) as lung recruitment maneuvers (RMs) in ventilated pediatric intensive care unit (PICU) patients. DESIGN:Observational, prospective data collection. SETTING:Tertiary-care PICU. PATIENTS AND PARTICIPANTS:Thirty-two consecutive ventilated pediatric patients. INTERVENTIONS:An SI (30-40 cmH(2)O for 15-20 s) was performed following a ventilator disconnection, suctioning, hypoxemia, or routinely every 12 h. Physiologic variables were recorded for 6 h after each SI. All other management was at the attending physician's discretion. The change in variables from pre-SI to post-SI (at 2, 10, and 15 min, 1, 2, 3, 4, 5, and 6 h) was compared using mixed models to account for repeated measures in the same patient. MEASUREMENTS AND RESULTS:93 RMs were performed on 32 patients (ages 11 days to 14 years). RMs were done after suctioning (58/93, 62%), ventilator disconnect (5/93, 5%), desaturation (8/93, 9%), or routinely (22/93, 24%). Seven of 93 RMs (7.5%) were interrupted for patient agitation, and 2/93 (2.2%) for transient bradycardia. There was no evidence of statistically significant changes in systolic blood pressure, heart rate, or oxygen saturation as measured by pulse oximetry from pre-RM to post-RM, and there were no air leaks. In three patients with altered intracranial compliance, three of eight RM were associated with a spike of intracranial pressure. There was a sustained significant decrease in FiO(2) by 6.1% lasting up to 6 h post-RM. CONCLUSIONS:RMs (as SI) are safe in ventilated PICU patients and are associated with a significant reduction in oxygen requirements for the 6 h after the RM.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Duff JP,Rosychuk RJ,Joffe ARdoi
10.1007/s00134-007-0764-2subject
Has Abstractpub_date
2007-10-01 00:00:00pages
1778-86issue
10eissn
0342-4642issn
1432-1238journal_volume
33pub_type
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050290
更新日期:1997-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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journal_title:Intensive care medicine
pub_type: 指南,杂志文章,实务指引,评审
doi:10.1007/pl00003797
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:Growth hormone (GH) given to reverse muscle catabolism in critical illness increased mortality, illustrating the need for better understanding of the pathophysiology of the GH axis. We describe the relationship between changes in plasma insulin-like growth factor-I (IGF-I) and growth hormone-binding protein (...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000656
更新日期:2000-10-01 00:00:00
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journal_title:Intensive care medicine
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01687161
更新日期:1980-08-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 评论,社论
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更新日期:2008-04-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000843
更新日期:2001-03-01 00:00:00
abstract::Breathing pattern was studied non-invasively in 20 coronary artery bypass surgery patients before the operation and post-operatively after weaning from mechanical ventilation. Post-operatively minute ventilation (VE), breathing frequency (Fr) and mean inspiratory flow (VT/TI) increased (28%, 42%, 27%; p less than 0.01...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01716198
更新日期:1991-01-01 00:00:00
abstract::Production of beta-lactamases is the most important means of bacterial resistance to beta-lactam antibiotics. The traditional, plasmid-mediated beta-lactamases were initially confined to Enterobacteriaceae but have now spread to other genera and species including Pseudomonas aeruginosa, Haemophilus influenzae, and Nei...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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更新日期:1994-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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更新日期:2000-01-01 00:00:00
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doi:10.1007/s00134-013-2930-z
更新日期:2013-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2013-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1948-z
更新日期:2003-10-01 00:00:00
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更新日期:2003-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-03-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00273564
更新日期:1989-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
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更新日期:2008-09-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315379
更新日期:1986-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2006-02-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
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更新日期:2018-12-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2001-01-01 00:00:00