scholarly journals Sevoflurane improves respiratory mechanics and gas exchange in a case series of infants with severe bronchiolitis-induced acute respiratory distress syndrome

2018 ◽  
Vol 6 (5) ◽  
pp. 920-925 ◽  
Author(s):  
Mirco Nacoti ◽  
Jacopo Colombo ◽  
Oliviero Fochi ◽  
Daniele Bonacina ◽  
Francesco Fazzi ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Gas Exchange ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Respiratory Mechanics ◽  
Case Series

scholarly journals Correction to: Effect of PEEP decremental on respiratory mechanics, gas exchange, pulmonary regional ventilation, and hemodynamics in patients with SARS-Cov-2-associated Acute Respiratory Distress Syndrome

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Vincent Bonny ◽  
Vincent Janiak ◽  
Savino Spadaro ◽  
Andrea Pinna ◽  
Alexandre Demoule ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Gas Exchange ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Respiratory Mechanics ◽  
Regional Ventilation

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals Latent class analysis to predict intensive care outcomes in Acute Respiratory Distress Syndrome: a proposal of two pulmonary phenotypes

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Pedro D. Wendel Garcia ◽  
Alessio Caccioppola ◽  
Silvia Coppola ◽  
Tommaso Pozzi ◽  
Arianna Ciabattoni ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Respiratory Distress Syndrome ◽  
Gas Exchange ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Distress Syndrome ◽  
Respiratory Mechanics ◽  
Class Analysis

Abstract Background Acute respiratory distress syndrome remains a heterogeneous syndrome for clinicians and researchers difficulting successful tailoring of interventions and trials. To this moment, phenotyping of this syndrome has been approached by means of inflammatory laboratory panels. Nevertheless, the systemic and inflammatory expression of acute respiratory distress syndrome might not reflect its respiratory mechanics and gas exchange. Methods Retrospective analysis of a prospective cohort of two hundred thirty-eight patients consecutively admitted patients under mechanical ventilation presenting with acute respiratory distress syndrome. All patients received standardized monitoring of clinical variables, respiratory mechanics and computed tomography scans at predefined PEEP levels. Employing latent class analysis, an unsupervised structural equation modelling method, on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes at a PEEP level of 5cmH2O, distinct pulmonary phenotypes of acute respiratory distress syndrome were identified. Results Latent class analysis was applied to 54 respiratory mechanics, gas-exchange and CT-derived gas- and tissue-volume variables, and a two-class model identified as best fitting. Phenotype 1 (non-recruitable) presented lower respiratory system elastance, alveolar dead space and amount of potentially recruitable lung volume than phenotype 2 (recruitable). Phenotype 2 (recruitable) responded with an increase in ventilated lung tissue, compliance and PaO2/FiO2 ratio (p < 0.001), in addition to a decrease in alveolar dead space (p < 0.001), to a standardized recruitment manoeuvre. Patients belonging to phenotype 2 (recruitable) presented a higher intensive care mortality (hazard ratio 2.9, 95% confidence interval 1.7–2.7, p = 0.001). Conclusions The present study identifies two ARDS phenotypes based on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes. These phenotypes are characterized by distinctly diverse responses to a standardized recruitment manoeuvre and by a diverging mortality. Given multicentre validation, the simple and rapid identification of these pulmonary phenotypes could facilitate enrichment of future prospective clinical trials addressing mechanical ventilation strategies in ARDS.

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