Tracheal Gas Insufflation as an alternative therapy to hypercapnia in ARDS
DOI:
https://doi.org/10.34024/rnc.2010.v18.8463Keywords:
Acute Respiratory Distress Syndrome, Hypercapnia, Mechanical VentilationAbstract
Introduction. The Acute Respiratory Distress Syndrome (ARDS) is characterized as a hypoxemic acute respiratory failure generated by an intense pulmonary inflammatory response. The tracheal gas insufflation (TGI) is one of the alternative therapies for the treatment of the hypercapnia in ARDS. Method. To realize this literature review, it was utilized pneumology books and articles from the databases Bireme, Scielo and Pudmed, from 1992 to 2006, with the following key-words: Acute Respiratory Distress Syndrome, tracheal gas insufflation, permissive hypercapnia and their similar in Portuguese. Conclusion. Previous studies about the technique points to positive results in the reduction or stabilization of PaCO2 , however the lack of a secure protocol and concerns about the deleterious effects still surrounds TGI. TGI is seeing as a secondary technique, but effective in the treatment of hyopercapnia in patients under protective ventilation in ARDS. Therefore, researches can still explore this technique, assisting its development and looking for better understanding of it’s benefits
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References
Galhardo FPL, Martinez JAB. Síndrome do Desconforto Respiratório Agudo. Med Ribeirão Preto 2003;36:248-56.
Antoniazzi P, Júnior GAP, Marson F, Abeid M, Baldisserotto S, BasileFilho A. Síndrome da Angústia Respiratória Aguda (SARA). Med Ribeirão Preto 1998;31:493-506.
Coimbra R, Silverio CC. Novas Estratégias de Ventilação Mecânica na Lesão Pulmonar Aguda e na Síndrome da Angústia Respiratória Aguda. Assoc Med Bras 2001;47:358-64.
Piantados CA, Sshwartz DA. The Acute Respiratory Distress Syndrome. Annals of Inter Med 2004;141:460-70.
Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. Acute Respiratory Distress Syndrome Caused by Pulmonary and Extrapulmonary Disease. Am J Respir Crit Care Med 1998;158:3-11.
Rubenfeld GD. Epidemiology of Acute Lung Injury. Crit Care Med 2003;31:S276-84.
Bersten AD, Ediban C, Hunt T, Moran J. Incidence and Mortality of Acute Lung Injury and The Acute Respiratory Distress Syndrome in Three Australian States. Am J Respir Crit Care Med 2002;165:443-8.
Scanlan CL, Wilkins RL, Stoller JK. Fundamentos da Terapia Respiratória de EGAN. São Paulo: Editora Manole, 2000, p.1291.
Hudson LD, Milberg JA, Anardi D, Maunder RJ. Clinical Risks for Development of the Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 1995;151:293-301.
Esteban A, Alia I, Gordo F, de Pablo R, Suarez J, Gonzalez G, et al. Prospective Randomized Trial Comparing Pressure-Controlled Ventilation and Volume-Controlled Ventilation in ARDS. Chest 2000;117:1690-6.
Ware LB, Matthay MA. The Acute Respiratory Distress Syndrome. N Engl J Med 2000;342:1334-49.
Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American-European Consensus Conference on ARDS. Definition, Mechanisms, Relevant Outcomes and Clinical Trial Coordination. Am J Respir Crit Care Med 1994;149:818-24.
Mcconnell R, Macintyre NR. Tracheal gas insufflation. Semin Respir Crit Care Med 2000;21:211-4.
Nahum A. Tracheal gas insufflation as an adjunct to mechanical ventilation. Respir Care Clin N Am 2002;8:171-85.
Nakos G, Zakinthinos S, Kotanidou A, Tsagaris H, Roussos C. Tracheal gas insufflation reduces the tidal volume while PaCO2 is maintained constant. Inten Care Med 1994;20:407-13.
Ravenscraft SA, Burke WC, Nahum A, Adams AB, Nakos G, Marcy TW, et al. Tracheal gas insufflation augments CO2 clearance during mechanical ventilation. Am Rev Respir Dis 1993;148:345-51.
Tzou WS, Korcarz CE, Aeschlimann SE, Morgan BT, Skatrub JB, Stein JH. Coronary flow velocity changes in response to hypercapnia: assessment by transthoracic Doppler echocardiography. J Am Soc Echocardiogr 2007; 20:241-6
Nahum A, Ravenscraft SA, Nakos G, Burke WC, Adams AB, Marcy TW, et al. Tracheal gas insufflation during pressure-control ventilation. Effect of catheter position, diameter, and flow rate. Am Rev Respir Dis 1992;146: 1411-8.
Adams AB. Catheters for tracheal gas insufflation. Respir Care 2001;46:177-84.
Hoffman LA, Miro AM, Tasota FJ, Delgado E, Zullo TG, Lutz J, et al. Tracheal gas insufflation. Limits of efficacy in adults with acute respiratory distress syndrome. Am J Respir Crit Care Med 2000;162(2 Pt 1):387-92.
Carter C, Adams AB, Stone M, Bliss P, HotchkiIss JR, Marini JJ. Tracheal gas insufflation during late exhalation efficiently reduces PaCO(2) in experimental acute lung injury. Inten Care Med 2002;28:504-8.
Belghith M, Fierobe L, Brunet F, Monchi M, Mira JP. Is tracheal gas insufflation an alternative to extrapulmonary gas exchangers in severe ARDS? Chest 1995;107:1416-9.
Piinsky MR, Delgado E, Hete B. The effect of tracheal gas insufflation on gas exchange efficiency. Anesth Analg 2006;103:1213-8.
Myers TR, Macintyre NR. Does airway pressure release ventilation offer important new advantages in mechanical ventilation support? Respir Care 2007;52:452-8.
Tomicic FV, Molina BJ, Graf SJ, Espinoza RM, Antunez RM, Errazuric CI, et al. Mechanical ventilatory parameters guided by the low flow pressure-volume curve in patients with acute lung injury/acute respiratory distress sindrome. Rev Med Chil 2007;135:307-16.
