tailieunhanh - Báo cáo khoa học: " Hypercapnic acidosis in ARDS: A tolerated side effect or an important therapeutic modality"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Hypercapnic acidosis in ARDS: A tolerated side effect or an important therapeutic modality? | Available online at http content 11 1 304 University of Pittsburgh Department of Critical Care Medicine Evidence-Based Medicine Journal Club EBM Journal Club Section Editor Eric B. Milbrandt MD MPH Journal club critique Hypercapnic acidosis in ARDS A tolerated side effect or an important therapeutic modality Adrian A. Salmon1 and John R. Hotchkiss2 1 Clinical Fellow Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA 2 Assistant Professor Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA Published online 16 February 2007 This article is online at http content 11 1 304 2007 BioMed Central Ltd Critical Care 2007 11 304 DOI 101186 cc5677 Expanded Abstract Citation Kregenow DA Rubenfeld GD Hudson LD Swenson ER. Hypercapnic acidosis and mortality in acute lung injury. Crit Care Med 2006 34 1-7 1 . Background Evidence suggests that hypercapnic acidosis may be beneficial in patients with acute lung injury though studies have not separated the effects of HA from the effects of changes in mechanical ventilation. Methods Objective We tested the hypothesis that hypercapnic acidosis is associated with reduced mortality rate in patients with acute lung injury independent of changes in mechanical ventilation. Design Secondary analysis of randomized clinical trial data using hypothesis-driven multivariate logistic regression. Setting Randomized multiple-center trial comparing 12 mL kg to 6 mL kg predicted body weight PBW tidal volumes previously published by the National Institutes of Health Acute Respiratory Distress Syndrome ARDS Network. Subjects 861 acute lung injury patients enrolled in a randomized multiple-center trial. Intervention None. Measurements and main results The adjusted odds ratio and 95 confidence intervals CI for 28-day mortality rate associated with hypercapnic acidosis defined as day 1 pH and PaCO2 45 mm Hg were .