SrdaDecubitusV1, Main, Exploration, bibRecord, 000433

High-frequency oscillatory ventilation and adjunctive therapies: inhaled nitric oxide and prone positioning.

Identifieur interne : 000433 ( Main/Exploration ); précédent : 000432; suivant : 000434

High-frequency oscillatory ventilation and adjunctive therapies: inhaled nitric oxide and prone positioning.

Auteurs : Eddy Fan [Canada] ; Sangeeta Mehta

Source :

Critical care medicine [ 0090-3493 ] ; 2005.

RBID : pubmed:15753726

Descripteurs français

KwdFr :
- Administration par inhalation (MeSH), Adulte (MeSH), Association thérapeutique (MeSH), Décubitus ventral (MeSH), Humains (MeSH), Monoxyde d'azote (administration et posologie), Syndrome de détresse respiratoire de l'adulte (thérapie), Thérapie de rattrapage (MeSH), Ventilation à haute fréquence (MeSH).
MESH :
- administration et posologie : Monoxyde d'azote.
- thérapie : Syndrome de détresse respiratoire de l'adulte.
- Administration par inhalation, Adulte, Association thérapeutique, Décubitus ventral, Humains, Thérapie de rattrapage, Ventilation à haute fréquence.

English descriptors

KwdEn :
- Administration, Inhalation (MeSH), Adult (MeSH), Combined Modality Therapy (MeSH), High-Frequency Ventilation (MeSH), Humans (MeSH), Nitric Oxide (administration & dosage), Prone Position (MeSH), Respiratory Distress Syndrome, Adult (therapy), Salvage Therapy (MeSH).
MESH :
- chemical , administration & dosage : Nitric Oxide.
- therapy : Respiratory Distress Syndrome, Adult.
- Administration, Inhalation, Adult, Combined Modality Therapy, High-Frequency Ventilation, Humans, Prone Position, Salvage Therapy.

Abstract

OBJECTIVE

To review the use of high-frequency oscillatory ventilation (HFOV) with adjunctive therapies (inhaled nitric oxide [iNO] and prone positioning [PP]) in adult patients with acute respiratory distress syndrome (ARDS).

DATA SOURCES

Published studies evaluating the use of iNO, PP, and HFOV in adult patients with ARDS.

DATA SUMMARY

Despite ongoing preclinical and clinical research, the therapeutic armamentarium for ARDS remains limited. Although a pressure- and volume-limited strategy aimed at mitigating ventilator-associated lung injury has demonstrated mortality benefit, patients with severe ARDS may still develop life-threatening hypoxemia. As a result, various salvage therapies aimed at improving oxygenation, including HFOV, iNO, and PP alone or in combination, have been evaluated in patients with refractory ARDS. Although the few preclinical and clinical trials of combination therapy to date have shown promising improvements in oxygenation and other physiological variables, with few adverse clinical events, the impact on survival awaits the performance of large randomized trials.

CONCLUSIONS

There is limited clinical data to recommend the widespread use of combination therapy in patients with ARDS. In the subset of patients with life-threatening hypoxemia from refractory ARDS, combination therapy is safe and may be considered for salvage therapy. More rigorous randomized, controlled trials are needed to help delineate the therapeutic role of combination therapy in adults with ARDS.

DOI: 10.1097/01.ccm.0000155927.54034.34
PubMed: 15753726

Affiliations:

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Le document en format XML

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<author><name sortKey="Fan, Eddy" sort="Fan, Eddy" uniqKey="Fan E" first="Eddy" last="Fan">Eddy Fan</name>
<affiliation wicri:level="4"><nlm:affiliation>Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Interdepartmental Division of Critical Care, University of Toronto, Toronto</wicri:regionArea>
<placeName><settlement type="city">Toronto</settlement>
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<orgName type="university">Université de Toronto</orgName>
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<author><name sortKey="Mehta, Sangeeta" sort="Mehta, Sangeeta" uniqKey="Mehta S" first="Sangeeta" last="Mehta">Sangeeta Mehta</name>
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<term>Combined Modality Therapy (MeSH)</term>
<term>High-Frequency Ventilation (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Nitric Oxide (administration & dosage)</term>
<term>Prone Position (MeSH)</term>
<term>Respiratory Distress Syndrome, Adult (therapy)</term>
<term>Salvage Therapy (MeSH)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Administration par inhalation (MeSH)</term>
<term>Adulte (MeSH)</term>
<term>Association thérapeutique (MeSH)</term>
<term>Décubitus ventral (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Monoxyde d'azote (administration et posologie)</term>
<term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term>
<term>Thérapie de rattrapage (MeSH)</term>
<term>Ventilation à haute fréquence (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Nitric Oxide</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Monoxyde d'azote</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Respiratory Distress Syndrome, Adult</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Syndrome de détresse respiratoire de l'adulte</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Administration, Inhalation</term>
<term>Adult</term>
<term>Combined Modality Therapy</term>
<term>High-Frequency Ventilation</term>
<term>Humans</term>
<term>Prone Position</term>
<term>Salvage Therapy</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Administration par inhalation</term>
<term>Adulte</term>
<term>Association thérapeutique</term>
<term>Décubitus ventral</term>
<term>Humains</term>
<term>Thérapie de rattrapage</term>
<term>Ventilation à haute fréquence</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To review the use of high-frequency oscillatory ventilation (HFOV) with adjunctive therapies (inhaled nitric oxide [iNO] and prone positioning [PP]) in adult patients with acute respiratory distress syndrome (ARDS).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DATA SOURCES</b>
</p>
<p>Published studies evaluating the use of iNO, PP, and HFOV in adult patients with ARDS.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DATA SUMMARY</b>
</p>
<p>Despite ongoing preclinical and clinical research, the therapeutic armamentarium for ARDS remains limited. Although a pressure- and volume-limited strategy aimed at mitigating ventilator-associated lung injury has demonstrated mortality benefit, patients with severe ARDS may still develop life-threatening hypoxemia. As a result, various salvage therapies aimed at improving oxygenation, including HFOV, iNO, and PP alone or in combination, have been evaluated in patients with refractory ARDS. Although the few preclinical and clinical trials of combination therapy to date have shown promising improvements in oxygenation and other physiological variables, with few adverse clinical events, the impact on survival awaits the performance of large randomized trials.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>There is limited clinical data to recommend the widespread use of combination therapy in patients with ARDS. In the subset of patients with life-threatening hypoxemia from refractory ARDS, combination therapy is safe and may be considered for salvage therapy. More rigorous randomized, controlled trials are needed to help delineate the therapeutic role of combination therapy in adults with ARDS.</p>
</div>
</front>
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<Title>Critical care medicine</Title>
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<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To review the use of high-frequency oscillatory ventilation (HFOV) with adjunctive therapies (inhaled nitric oxide [iNO] and prone positioning [PP]) in adult patients with acute respiratory distress syndrome (ARDS).</AbstractText>
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<AbstractText Label="DATA SUMMARY" NlmCategory="METHODS">Despite ongoing preclinical and clinical research, the therapeutic armamentarium for ARDS remains limited. Although a pressure- and volume-limited strategy aimed at mitigating ventilator-associated lung injury has demonstrated mortality benefit, patients with severe ARDS may still develop life-threatening hypoxemia. As a result, various salvage therapies aimed at improving oxygenation, including HFOV, iNO, and PP alone or in combination, have been evaluated in patients with refractory ARDS. Although the few preclinical and clinical trials of combination therapy to date have shown promising improvements in oxygenation and other physiological variables, with few adverse clinical events, the impact on survival awaits the performance of large randomized trials.</AbstractText>
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High-frequency oscillatory ventilation and adjunctive therapies: inhaled nitric oxide and prone positioning.

High-frequency oscillatory ventilation and adjunctive therapies: inhaled nitric oxide and prone positioning.

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki