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Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome

Aboab, Jerome; Jonson, Bjorn; Kouatchet, Achille; Taille, Solenne; Niklason, Lisbet LU and Brochard, Laurent (2006) In Intensive Care Medicine 32(12). p.1979-1986
Abstract
Objective: High fractions of inspired oxygen (FIO2) used in acute lung injury (ALI) may promote resorption atelectasis. The impact of derecruitment related to high FIO2 in ALI is debated. We evaluated derecruitment with 100% vs. 60% FIO2 at two levels of positive end-expiratory pressure (PEEP). Patients: Fourteen consecutive patients with ALI were studied. Interventions: Recruited volume at two PEEP levels was computed from two pressure-volume curves, recorded from PEEP and from zero end-expiratory pressure, using the sinusoidal flow modulation method. PEEP-induced recruitment was measured during prolonged expiration as the difference between the two curves at a given pressure. PaO2/FIO2 was also measured. PEEP was 5 +/- 1 or 14 +/- 3... (More)
Objective: High fractions of inspired oxygen (FIO2) used in acute lung injury (ALI) may promote resorption atelectasis. The impact of derecruitment related to high FIO2 in ALI is debated. We evaluated derecruitment with 100% vs. 60% FIO2 at two levels of positive end-expiratory pressure (PEEP). Patients: Fourteen consecutive patients with ALI were studied. Interventions: Recruited volume at two PEEP levels was computed from two pressure-volume curves, recorded from PEEP and from zero end-expiratory pressure, using the sinusoidal flow modulation method. PEEP-induced recruitment was measured during prolonged expiration as the difference between the two curves at a given pressure. PaO2/FIO2 was also measured. PEEP was 5 +/- 1 or 14 +/- 3 cmH(2)O and FIO2 was 60% or 100%, yielding four combinations. We looked for differences between the beginning and end of a 30-min period with each combination. Measurement and results: With low PEEP and 100% FIO2, recruited volume decreased significantly from 68 +/- 53 to 39 +/- 43 ml and PaO2/FIO2 from 196 +/- 104 to 153 +/- 83 mmHg. With the three other combinations (low PEEP and 60% FIO2 or high PEEP and 60% or 100% FIO2) none of the parameters decreased significantly. Conclusion: In mechanically ventilated patients with ALI the breathing of pure oxygen leads to derecruitment, which is prevented by high PEEP. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
oxygen inhalation, atelectasis, acute respiratory distress syndrome, acute lung injury, oxygen toxicity
in
Intensive Care Medicine
volume
32
issue
12
pages
1979 - 1986
publisher
Springer
external identifiers
  • wos:000242361900013
  • scopus:33751520468
ISSN
0342-4642
DOI
10.1007/s00134-006-0382-4
language
English
LU publication?
yes
id
5b249bb2-f7ff-45ec-bd2e-97dee23e49c7 (old id 685523)
date added to LUP
2007-12-20 09:47:54
date last changed
2019-04-07 03:31:26
@article{5b249bb2-f7ff-45ec-bd2e-97dee23e49c7,
  abstract     = {Objective: High fractions of inspired oxygen (FIO2) used in acute lung injury (ALI) may promote resorption atelectasis. The impact of derecruitment related to high FIO2 in ALI is debated. We evaluated derecruitment with 100% vs. 60% FIO2 at two levels of positive end-expiratory pressure (PEEP). Patients: Fourteen consecutive patients with ALI were studied. Interventions: Recruited volume at two PEEP levels was computed from two pressure-volume curves, recorded from PEEP and from zero end-expiratory pressure, using the sinusoidal flow modulation method. PEEP-induced recruitment was measured during prolonged expiration as the difference between the two curves at a given pressure. PaO2/FIO2 was also measured. PEEP was 5 +/- 1 or 14 +/- 3 cmH(2)O and FIO2 was 60% or 100%, yielding four combinations. We looked for differences between the beginning and end of a 30-min period with each combination. Measurement and results: With low PEEP and 100% FIO2, recruited volume decreased significantly from 68 +/- 53 to 39 +/- 43 ml and PaO2/FIO2 from 196 +/- 104 to 153 +/- 83 mmHg. With the three other combinations (low PEEP and 60% FIO2 or high PEEP and 60% or 100% FIO2) none of the parameters decreased significantly. Conclusion: In mechanically ventilated patients with ALI the breathing of pure oxygen leads to derecruitment, which is prevented by high PEEP.},
  author       = {Aboab, Jerome and Jonson, Bjorn and Kouatchet, Achille and Taille, Solenne and Niklason, Lisbet and Brochard, Laurent},
  issn         = {0342-4642},
  keyword      = {oxygen inhalation,atelectasis,acute respiratory distress syndrome,acute lung injury,oxygen toxicity},
  language     = {eng},
  number       = {12},
  pages        = {1979--1986},
  publisher    = {Springer},
  series       = {Intensive Care Medicine},
  title        = {Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome},
  url          = {http://dx.doi.org/10.1007/s00134-006-0382-4},
  volume       = {32},
  year         = {2006},
}