Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://repositorio.unifesp.br/handle/11600/54582 http://dx.doi.org/10.1016/j.bjane.2015.10.002 |
Resumo: | Objective: The aim of this study was to evaluate the impact of increased positive end-expiratory pressure on the sublingual microcirculation. Methods: Adult patients who were sedated, under mechanical ventilation, and had a diagnosis of circulatory shock and acute respiratory distress syndrome were included. The positive end expiratory pressure level was settled to obtain a plateau pressure of 30 cm H2O and then maintained at this level for 20 minutes. Microcirculatory (obtained by videomicroscopy) and hemodynamic variables were collected at baseline and compared with those at the end of 20 min. Results: Twelve patients were enrolled. Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, there was considerable interindividual variability. There was a negative, moderate correlation between the changes in the De Backer score (r = -0.58, p = 0.048), total vessel density (r = -0.60, p = 0.039) and baseline values. The changes in total vessel density (r = 0.54, p = 0.07) and per fused vessel density (r = 0.52, p = 0.08) trended toward correlating with the changes in the mean arterial pressure. Conclusion: Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, at individual level, such response was heterogeneous. The changes in the microcirculation parameters could be correlated with the baseline values and changes in the mean arterial pressure. (C) 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. |
id |
UFSP_ad31169aa70674447f9fc6d212d3332b |
---|---|
oai_identifier_str |
oai:repositorio.unifesp.br:11600/54582 |
network_acronym_str |
UFSP |
network_name_str |
Repositório Institucional da UNIFESP |
repository_id_str |
3465 |
spelling |
Nunes, Nathaly Fonseca [UNIFESP]Bafi, Antonio Tonete [UNIFESP]Pacheco, Eduardo Souza [UNIFESP]Pontes de Azevedo, Luciano Cesar [UNIFESP]Machado, Flavia Ribeiro [UNIFESP]Rezende Freitas, Flavio Geraldo [UNIFESP]2020-07-13T11:53:23Z2020-07-13T11:53:23Z2017Revista Brasileira De Anestesiologia. New York, v. 67, n. 3, p. 278-283, 2017.0034-7094https://repositorio.unifesp.br/handle/11600/54582http://dx.doi.org/10.1016/j.bjane.2015.10.002WOS000401600800009.pdf10.1016/j.bjane.2015.10.002WOS:000401600800009Objective: The aim of this study was to evaluate the impact of increased positive end-expiratory pressure on the sublingual microcirculation. Methods: Adult patients who were sedated, under mechanical ventilation, and had a diagnosis of circulatory shock and acute respiratory distress syndrome were included. The positive end expiratory pressure level was settled to obtain a plateau pressure of 30 cm H2O and then maintained at this level for 20 minutes. Microcirculatory (obtained by videomicroscopy) and hemodynamic variables were collected at baseline and compared with those at the end of 20 min. Results: Twelve patients were enrolled. Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, there was considerable interindividual variability. There was a negative, moderate correlation between the changes in the De Backer score (r = -0.58, p = 0.048), total vessel density (r = -0.60, p = 0.039) and baseline values. The changes in total vessel density (r = 0.54, p = 0.07) and per fused vessel density (r = 0.52, p = 0.08) trended toward correlating with the changes in the mean arterial pressure. Conclusion: Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, at individual level, such response was heterogeneous. The changes in the microcirculation parameters could be correlated with the baseline values and changes in the mean arterial pressure. (C) 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo - FAPESPUniv Fed Sao Paulo UNIFESP, Hosp Sao Paulo, Disciplina Anestesiol Dor & Terapia Intens, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Hosp Sao Paulo, Disciplina Anestesiol Dor & Terapia Intens, Sao Paulo, SP, BrazilFAPESP: 2010/50096-6Web of Science278-283engElsevier Science IncRevista Brasileira De AnestesiologiaAdult respiratorydistress syndromePositive end-expiratory pressureMicrocirculationHemodynamicsShockMechanicalventilatorsEffects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndromeinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleNew York673info:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/545822021-10-05 22:05:35.999metadata only accessoai:repositorio.unifesp.br:11600/54582Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652021-10-06T01:05:35Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome |
title |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome |
spellingShingle |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome Nunes, Nathaly Fonseca [UNIFESP] Adult respiratory distress syndrome Positive end-expiratory pressure Microcirculation Hemodynamics Shock Mechanical ventilators |
title_short |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome |
title_full |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome |
title_fullStr |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome |
title_full_unstemmed |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome |
title_sort |
Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome |
author |
Nunes, Nathaly Fonseca [UNIFESP] |
author_facet |
Nunes, Nathaly Fonseca [UNIFESP] Bafi, Antonio Tonete [UNIFESP] Pacheco, Eduardo Souza [UNIFESP] Pontes de Azevedo, Luciano Cesar [UNIFESP] Machado, Flavia Ribeiro [UNIFESP] Rezende Freitas, Flavio Geraldo [UNIFESP] |
author_role |
author |
author2 |
Bafi, Antonio Tonete [UNIFESP] Pacheco, Eduardo Souza [UNIFESP] Pontes de Azevedo, Luciano Cesar [UNIFESP] Machado, Flavia Ribeiro [UNIFESP] Rezende Freitas, Flavio Geraldo [UNIFESP] |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Nunes, Nathaly Fonseca [UNIFESP] Bafi, Antonio Tonete [UNIFESP] Pacheco, Eduardo Souza [UNIFESP] Pontes de Azevedo, Luciano Cesar [UNIFESP] Machado, Flavia Ribeiro [UNIFESP] Rezende Freitas, Flavio Geraldo [UNIFESP] |
dc.subject.eng.fl_str_mv |
Adult respiratory distress syndrome Positive end-expiratory pressure Microcirculation Hemodynamics Shock Mechanical ventilators |
topic |
Adult respiratory distress syndrome Positive end-expiratory pressure Microcirculation Hemodynamics Shock Mechanical ventilators |
description |
Objective: The aim of this study was to evaluate the impact of increased positive end-expiratory pressure on the sublingual microcirculation. Methods: Adult patients who were sedated, under mechanical ventilation, and had a diagnosis of circulatory shock and acute respiratory distress syndrome were included. The positive end expiratory pressure level was settled to obtain a plateau pressure of 30 cm H2O and then maintained at this level for 20 minutes. Microcirculatory (obtained by videomicroscopy) and hemodynamic variables were collected at baseline and compared with those at the end of 20 min. Results: Twelve patients were enrolled. Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, there was considerable interindividual variability. There was a negative, moderate correlation between the changes in the De Backer score (r = -0.58, p = 0.048), total vessel density (r = -0.60, p = 0.039) and baseline values. The changes in total vessel density (r = 0.54, p = 0.07) and per fused vessel density (r = 0.52, p = 0.08) trended toward correlating with the changes in the mean arterial pressure. Conclusion: Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, at individual level, such response was heterogeneous. The changes in the microcirculation parameters could be correlated with the baseline values and changes in the mean arterial pressure. (C) 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017 |
dc.date.accessioned.fl_str_mv |
2020-07-13T11:53:23Z |
dc.date.available.fl_str_mv |
2020-07-13T11:53:23Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Revista Brasileira De Anestesiologia. New York, v. 67, n. 3, p. 278-283, 2017. |
dc.identifier.uri.fl_str_mv |
https://repositorio.unifesp.br/handle/11600/54582 http://dx.doi.org/10.1016/j.bjane.2015.10.002 |
dc.identifier.issn.none.fl_str_mv |
0034-7094 |
dc.identifier.file.none.fl_str_mv |
WOS000401600800009.pdf |
dc.identifier.doi.none.fl_str_mv |
10.1016/j.bjane.2015.10.002 |
dc.identifier.wos.none.fl_str_mv |
WOS:000401600800009 |
identifier_str_mv |
Revista Brasileira De Anestesiologia. New York, v. 67, n. 3, p. 278-283, 2017. 0034-7094 WOS000401600800009.pdf 10.1016/j.bjane.2015.10.002 WOS:000401600800009 |
url |
https://repositorio.unifesp.br/handle/11600/54582 http://dx.doi.org/10.1016/j.bjane.2015.10.002 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Revista Brasileira De Anestesiologia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
278-283 |
dc.coverage.none.fl_str_mv |
New York |
dc.publisher.none.fl_str_mv |
Elsevier Science Inc |
publisher.none.fl_str_mv |
Elsevier Science Inc |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
_version_ |
1802764144326213632 |