Posttraumatisches akutes Lungenversagen: Behandlung durch drucklimitierte Beatmung und kontinuierlichen Lagewechsel [Acute posttraumatic lung failure. Its treatment through pressure-limited respiration and continuous postural change]

DOI to cite this document:

10.5283/epub.14724 Copy

Schlitt, Hans-Jürgen ; Werner, U. ; Schandelmaier, P. ; Krettek, C. ; Dreinhöfer, K. ; Hauss, J. ; Pichlmayr, R.

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Date of publication of this fulltext: 10 May 2010 12:20

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Details

Item type:	Article
Journal or Publication Title:	Deutsche medizinische Wochenschrift (1946)
Publisher:	Thieme
Volume:	116
Number of Issue or Book Chapter:	34
Page Range:	pp. 1257-1264
Date:	23 August 1991
Institutions:	Medicine > Lehrstuhl für Chirurgie
Identification Number:	Value Type 1874128 PubMed ID 10.1055/s-2008-1063744 DOI
Classification:	Notation Type Adult MESH Beds MESH Combined Modality Therapy MESH Female MESH Humans MESH Lung Compliance MESH Male MESH Middle Aged MESH Positive-Pressure Respiration/methods MESH Posture MESH Prognosis MESH Respiratory Distress Syndrome, Adult/therapy MESH Time Factors MESH Wounds and Injuries/complications MESH
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Unknown
Created at the University of Regensburg:	Unknown
Item ID:	14724

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Abstract

Nine patients (4 women and 5 men; mean age 31 [20-48] years) with severe posttraumatic adult respiratory distress syndrome (ARDS) were treated with continuous postural change (kinetic bed) and pressure-limited ventilation. Seven patients survived; only one patient died as a result of pulmonary insufficiency. As compliance was markedly reduced (less than 20 ml/cm H2O), low stroke volumes (up to ...

Abstract

Nine patients (4 women and 5 men; mean age 31 [20-48] years) with severe posttraumatic adult respiratory distress syndrome (ARDS) were treated with continuous postural change (kinetic bed) and pressure-limited ventilation. Seven patients survived; only one patient died as a result of pulmonary insufficiency. As compliance was markedly reduced (less than 20 ml/cm H2O), low stroke volumes (up to 380 ml) and high respiratory rate (up to 45/min) were employed to keep airway peak pressure below 40 mmHg. Kinetic treatment lasted for a mean of 14 (2-28) days; artificial ventilation was maintained for 31 (9-49) days. Practical problems of the method are the intensive nursing care required for the kinetic bed and the risk of decubitus ulcers, as well as disconnection of infusion tubing. The results indicate that kinetic treatment with pressure-limited ventilation constitutes a low-risk and, in many cases, effective treatment of severe ARDS.

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