Articles: respiratory-distress-syndrome.
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Am. Rev. Respir. Dis. · May 1992
Randomized Controlled Trial Clinical TrialImproved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization.
We performed a randomized, prospective trial to evaluate whether fluid management that emphasized diuresis and fluid restriction in patients with pulmonary edema could affect the development or resolution of extravascular lung water (EVLW), as well as time on mechanical ventilation and time in the intensive care unit (ICU), in critically ill patients requiring pulmonary artery catheterization (PAC). PAC was performed on 101 patients. A total of 52 patients were randomized to an EVLW management group using a protocol based on bedside indicator-dilution measurements of EVLW. ⋯ EVLW decreased significantly, and ventilator-days and ICU days were significantly shorter only in patients from the EVLW group. No clinically significant adverse effect occurred as a result of following the EVLW group algorithm. Thus, a lower positive fluid balance, especially in patients with pulmonary edema regardless of cause, is associated with reduced EVLW, ventilator-days, and ICU days.
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Neonatal Intensive Care · May 1992
Volume-controlled ventilation for severe neonatal respiratory failure.
Volume-controlled ventilation was utilized as a rescue modality in six newborn infants with severe respiratory failure. Infants were switched from time-cycled, pressure-limited ventilation to volume-controlled ventilation at 10-12 mL/kg using the VIP-Bird infant ventilator. ⋯ Preliminary analysis of pulmonary function during volume-controlled ventilation suggests differences in the patterns of delivery of tidal volume and minute ventilation, which are more consistent. This may improve stabilization of lung volume and decrease ventilation-perfusion mismatch.