| Title |
Bedside assessment of the effects of positive end-expiratory pressure on lung inflation and recruitment by the helium dilution technique and electrical impedance tomography
|
|---|---|
| Published in |
Intensive Care Medicine, August 2016
|
| DOI | 10.1007/s00134-016-4467-4 |
| Pubmed ID | |
| Authors |
Tommaso Mauri, Nilde Eronia, Cecilia Turrini, Marta Battistini, Giacomo Grasselli, Roberto Rona, Carlo Alberto Volta, Giacomo Bellani, Antonio Pesenti |
| Abstract |
Higher positive end-expiratory pressure might induce lung inflation and recruitment, yielding enhanced regional lung protection. We measured positive end-expiratory pressure-related lung volume changes by electrical impedance tomography and by the helium dilution technique. We also used electrical impedance tomography to assess the effects of positive end-expiratory pressure on regional determinants of ventilator-induced lung injury. A prospective randomized crossover study was performed on 20 intubated adult patients: 12 with acute hypoxemic respiratory failure and 8 with acute respiratory distress syndrome. Each patient underwent protective controlled ventilation at lower (7 [7, 8] cmH2O) and higher (12 [12, 13] cmH2O) positive end-expiratory pressures. At the end of each phase, we collected ventilation, helium dilution, and electrical impedance tomography data. Positive end-expiratory pressure-induced changes in lung inflation and recruitment measured by electrical impedance tomography and helium dilution showed close correlations (R (2) = 0.78, p < 0.001 and R (2) = 0.68, p < 0.001, respectively) but with relatively variable limits of agreement. At higher positive end-expiratory pressure, recruitment was evident in all lung regions (p < 0.01) and heterogeneity of tidal ventilation distribution was reduced by increased tidal volume distending the dependent lung (p < 0.001); in the non-dependent lung, on the other hand, compliance decreased (p < 0.001) and tidal hyperinflation significantly increased (p < 0.001). In the subgroup of ARDS patients (but not in the whole study population) tidal hyperinflation in the dependent lung regions decreased at higher positive end-expiratory pressure (p = 0.05), probably indicating higher potential for recruitment. Close correlations exist between bedside assessment of positive end-expiratory pressure-induced changes in lung inflation and recruitment by the helium dilution and electrical impedance tomography techniques. Higher positive end-expiratory pressure exerts mixed effects on the regional determinants of ventilator-induced lung injury; these merit close monitoring. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Argentina | 2 | 29% |
| France | 1 | 14% |
| Spain | 1 | 14% |
| Italy | 1 | 14% |
| Unknown | 2 | 29% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 71% |
| Science communicators (journalists, bloggers, editors) | 1 | 14% |
| Scientists | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 162 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | <1% |
| Unknown | 161 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 18 | 11% |
| Researcher | 18 | 11% |
| Student > Bachelor | 12 | 7% |
| Student > Master | 10 | 6% |
| Student > Ph. D. Student | 8 | 5% |
| Other | 31 | 19% |
| Unknown | 65 | 40% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 76 | 47% |
| Nursing and Health Professions | 6 | 4% |
| Engineering | 5 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 1% |
| Social Sciences | 2 | 1% |
| Other | 5 | 3% |
| Unknown | 66 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 August 2016.
All research outputs
#7,235,787
of 25,477,125 outputs
Outputs from Intensive Care Medicine
#2,971
of 5,425 outputs
Outputs of similar age
#112,303
of 369,404 outputs
Outputs of similar age from Intensive Care Medicine
#25
of 76 outputs
Altmetric has tracked 25,477,125 research outputs across all sources so far. This one has received more attention than most of these and is in the 71st percentile.
So far Altmetric has tracked 5,425 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 29.6. This one is in the 45th percentile – i.e., 45% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 369,404 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 76 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.