Adult Respiratory Distress Syndrome
Conditions
Interventions
Fifteen patients were initially ventilated according to the ARDSnet protocol. During the next 24h,patients were divided in 2 groups. Group 1 with nine patients who were ventilated according to the Ope
Other
Sponsors
Universidade de São Paulo
Hospital Copa Dor
Eligibility
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Patients with the diagnosis of Distress Respiratory Syndrome presenting PaO2/FIO2 lower than 300 mmHg after 30 min of mechanical ventilation with a PEEP of 5 cmH2O and an FIO2 of 1.0 and a VT ranging from 8 to 10 mL/kg of ideal body weight along with hemodynamically stable parameters (mean arterial pressures higher than 65 mmHg and arterial lactates lower than 3 mg/dL) over the preceding 6 hours.
Exclusion criteria
Exclusion criteria: Patients with the diagnosis of Adult Distress Syndrome for more than 48 h. Diagnosis of pneumothorax. Diagnosis of pneumomediastinum. Bronchopleural fistula. Subpleural blebs. Increased intracranial pressure. Body weight greater than 140 kg. Pregnancy. Coexistent disease with an expected 6-month mortality risk exceeding 50%.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expected endpoint - Improvement of pulmonar aeration when ventilation with the concept of open lung was applied, in comparison with ventilation according ARDSnet protocol Observed endpoint - A higher fraction of normally aerated regions(P=0.015), with a lower fraction of collapsed regions (P=0.018), were observed with the Open Lung Concept when compared with ARDSnet protocol. No significant differences in hyperinflated regions were observed (P=0.179) among groups. ;Expected endpoint - Improvement of respiratory function (PaO2/FIO2)when ventilation with the concept of open lung was applied, in comparison with ventilation according ARDSnet protocol Observed endpoint - Significant improvement of respiratory function with ventilation according to open lung concept in comparison with ventilation according ARDSnet protocol(median of PaO2/FIO2=270 mmHg vs 177 mmHg, respectively). | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected endpoint - Stable serum levels of inflamatory markers when ventilation with the concept of open lung was applied, in comparison with ventilation according ARDSnet protocol Observed endpoint - Stable inflammatory markers with ventilation according to open lung concept were observed. | — |
Countries
Brazil
Contacts
Public ContactVivian Rotman
Universidade Federal do Rio de Janeiro
Outcome results
None listed