tailieunhanh - Báo cáo y học: "A recruitment maneuver increases oxygenation after intubation of hypoxemic intensive care unit patients: a randomized controlled study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: A recruitment maneuver increases oxygenation after intubation of hypoxemic intensive care unit patients: a randomized controlled study. | Constantin et al. Critical Care 2010 14 R76 http content 14 2 R76 c CRITICAL CARE RESEARCH Open Access A recruitment maneuver increases oxygenation after intubation of hypoxemic intensive care unit patients a randomized controlled study Jean-Michel Constantin 1 Emmanuel Futier1 Anne-Laure Cherprenet1 Gérald Chanques2 Renaud Guerin1 Sophie Cayot-Constantin1 Mathieu Jabaudon1 Sebastien Perbet1 Christian Chartier1 Boris Jung2 Dominique Guelon3 Samir Jaber2 and Jean-Etienne Bazin1 Abstract Introduction Tracheal intubation and anaesthesia promotes lung collapse and hypoxemia. In acute lung injury patients recruitment maneuvers RMs increase lung volume and oxygenation and decrease atelectasis. The aim of this study was to evaluate the efficacy and safety of RMs performed immediately after intubation. Methods This randomized controlled study was conducted in two 16-bed medical-surgical intensive care units within the same university hospital. Consecutive patients requiring intubation for acute hypoxemic respiratory failure were included. Patients were randomized to undergo a RM immediately within 2 minutes after intubation consisting of a continuous positive airway pressure CPAP of 40 cmH2O over 30 seconds RM group or not control group . Blood gases were sampled and blood samples taken for culture before within 2 minutes 5 minutes and 30 minutes after intubation. Haemodynamic and respiratory parameters were continuously recorded throughout the study. Positive end expiratory pressure PEEP was set at 5 cmH2O throughout. Results The control n 20 and RM n 20 groups were similar in terms of age disease severity diagnosis at time of admission and PaO2 obtained under 10-15 L min oxygen flow immediately before 81 15 vs 83 35 mmHg P and within 2 minutes after intubation under 100 FiO2 81 15 vs 83 35 mmHg P . Five minutes after intubation PaO2 obtained under 100 FiO2 was significantly higher in the RM group compared with the control group 93 36 vs 236 117 mmHg P