作者
Roberta De Santis Santiago, Maddalena Teggia Droghi, Jacopo Fumagalli, Francesco Marrazzo, Gaetano Florio, Luigi G Grassi, Susimeire Gomes, Caio CA Morais, Ozires PS Ramos, Maurizio Bottiroli, Riccardo Pinciroli, David A Imber, Aranya Bagchi, Kenneth Shelton, Abraham Sonny, Edward A Bittner, Marcelo BP Amato, Robert M Kacmarek, Lorenzo Berra
发表日期
2021/3/1
期刊
American Journal of Respiratory and Critical Care Medicine
卷号
203
期号
5
页码范围
575-584
出版商
American Thoracic Society
简介
Rationale: Obesity is characterized by elevated pleural pressure (Ppl) and worsening atelectasis during mechanical ventilation in patients with acute respiratory distress syndrome (ARDS).
Objectives: To determine the effects of a lung recruitment maneuver (LRM) in the presence of elevated Ppl on hemodynamics, left and right ventricular pressure, and pulmonary vascular resistance. We hypothesized that elevated Ppl protects the cardiovascular system against high airway pressure and prevents lung overdistension.
Methods: First, an interventional crossover trial in adult subjects with ARDS and a body mass index ≥ 35 kg/m2 (n = 21) was performed to explore the hemodynamic consequences of the LRM. Second, cardiovascular function was studied during low and high positive end-expiratory pressure (PEEP) in a model of swine with ARDS and high Ppl (n = 9) versus healthy swine with normal Ppl (n = 6 …
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R De Santis Santiago, M Teggia Droghi, J Fumagalli… - American Journal of Respiratory and Critical Care …, 2021
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