Articles: respiratory-distress-syndrome.
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Ultra-protective ventilation is the combination of low airway pressures and tidal volume (Vt) combined with extra corporeal carbon dioxide removal (ECCO2R). A recent large study showed no benefit of ultra-protective ventilation compared to standard ventilation in ARDS (Acute Respiratory Distress Syndrome) patients. However, the reduction in Vt failed to achieve the objective of less than or equal to 3 ml/kg predicted body weight (PBW). The main objective of our study was to assess the feasibility of the ultra-low volume ventilation (Vt ≤ 3 ml/kg PBW) facilitated by ECCO2R in acute respiratory failure patients. ⋯ Ultra-low volume ventilation (≤ 3 ml/kg PBW) was feasible in 18 out of 45 sessions. Higher blood flow rates were associated with the success of ultra-low volume ventilation.
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Observational Study
Early pulmonary rehabilitation in ARDS patients: Effects on respiratory function and long-term outcomes: A retrospective study.
This retrospective cohort study, conducted at People's Hospital of Wenjiang Chengdu (January 2018 to January 2022), aimed to evaluate the effects of early pulmonary rehabilitation (PR) on respiratory function in acute respiratory distress syndrome patients after discontinuing invasive mechanical ventilation in the intensive care unit. Patients were divided into PR and control groups based on an offline training protocol. Outcome measures included short physical performance battery scores, respiratory muscle strength, and pulmonary function indicators at discharge and 3 months post-discharge, including peak expiratory flow, forced expiratory volume in 1 second/forced vital capacity, and vital capacity. ⋯ The number of sputum aspirations in the PR group significantly decreased (P < .05), and intensive care unit stays after weaning were significantly shorter (P < .05). Kaplan-Meier survival analysis revealed that the cumulative survival rate at 6 months post-discharge was significantly higher in the PR group compared to the control group (hazard ratio = 0.660, 95% CI: 0.472-0.922, P = .014). These findings suggest that early PR significantly enhances respiratory function recovery, reduces complications, and improves survival outcomes in acute respiratory distress syndrome patients after invasive ventilation.
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The lactate-to-albumin ratio (LAR) is predictive of disease prognosis in some cases. However, the clinical significance of LAR in patients with influenza A virus-induced acute respiratory distress syndrome (ARDS) has yet to be explored. This study aims to investigate whether LAR can be used as a predictor of influenza A virus-induced ARDS. ⋯ LAR strongly predicted ARDS development in patients with influenza A virus pneumonia. It showed a significant correlation with disease severity and provided promising predictive efficiency for extrapulmonary complications and 28-day mortality in patients with influenza A virus-induced ARDS.