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Do periodic hyperinflations improve gas exchange in patients with hypoxemic respiratory failure?

Novak, RA and Shumaker, L and Snyder, JV and Pinsky, MR (1987) Do periodic hyperinflations improve gas exchange in patients with hypoxemic respiratory failure? Critical Care Medicine, 15 (12). 1081 - 1085. ISSN 0090-3493

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Abstract

Prolonged artificial ventilation may result in worsening gas exchange and pulmonary compliance in patients with otherwise normal lungs. Prolonged hyperinflations to 40 cm H2O can completely reverse deterioration of gas exchange and compliance in such patients. Similar efforts have effectively recruited atelectatic lung regions in critically ill patients. Less aggressive hyperinflations have not improved lung function in patients with abnormal lungs with hypoxemia. However, sustained exaggerated hyperinflations may successfully open collapsed lung units in these patients when standard recruitment techniques fail. We compared periodic hyperinflations of 40 cm H2O lasting 15 to 30 sec associated with body positioning (directed recruitment [DR]) to standard bag-sigh-suctioning (BSS) for their effects on gas exchange and pulmonary compliance in 16 stable surgical ICU patients with hypoxemic respiratory failure of 24-h duration or longer. Patients were sequentially alternated between DR and BSS (group 1, BSS followed by DR; group 2, DR followed by BSS). Neither technique, alone or in sequence, resulted in a sustained (≥5 min) improvement or deterioration in either gas exchange or pulmonary compliance. We conclude that neither BSS nor DR reliably affects gas exchange or compliance in patients with established hypoxemic respiratory failure.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Novak, RA
Shumaker, L
Snyder, JV
Pinsky, MRpinsky@pitt.eduPINSKY
Date: 1 January 1987
Date Type: Publication
Journal or Publication Title: Critical Care Medicine
Volume: 15
Number: 12
Page Range: 1081 - 1085
DOI or Unique Handle: 10.1097/00003246-198712000-00001
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0090-3493
Date Deposited: 24 Feb 2012 16:09
Last Modified: 04 Feb 2019 15:56
URI: http://d-scholarship.pitt.edu/id/eprint/11025

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