Respiratory drive in the acute respiratory distress syndrome: pathophysiology, monitoring, and therapeutic interventions
Elena Spinelli,Tommaso Mauri,Tommaso Mauri,Jeremy R. Beitler,Antonio Pesenti,Antonio Pesenti,Daniel Brodie +6 more
Reads0
Chats0
TLDR
The main determinants of neural respiratory drive and the mechanisms involved in its potentiation, in health and ARDS are summarized.Abstract:
Neural respiratory drive, i.e., the activity of respiratory centres controlling breathing, is an overlooked physiologic variable which affects the pathophysiology and the clinical outcome of acute respiratory distress syndrome (ARDS). Spontaneous breathing may offer multiple physiologic benefits in these patients, including decreased need for sedation, preserved diaphragm activity and improved cardiovascular function. However, excessive effort to breathe due to high respiratory drive may lead to patient self-inflicted lung injury (P-SILI), even in the absence of mechanical ventilation. In the present review, we focus on the physiological and clinical implications of control of respiratory drive in ARDS patients. We summarize the main determinants of neural respiratory drive and the mechanisms involved in its potentiation, in health and ARDS. We also describe potential and pitfalls of the available bedside methods for drive assessment and explore classical and more “futuristic” interventions to control drive in ARDS patients.read more
Citations
More filters
Journal ArticleDOI
Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS.
Carlos Ferrando,Fernando Suarez-Sipmann,Ricard Mellado-Artigas,María Hernández,Alfredo Gea,Egoitz Arruti,Cesar Aldecoa,Graciela Martínez-Pallí,Miguel Ángel Martínez-González,Arthur S. Slutsky,Jesús Villar,Jesús Villar +11 more
TL;DR: In this large series, COVID-19 ARDS patients have features similar to other causes of ARDS, compliance with lung-protective ventilation was high, and the risk of 28-day mortality increased with the degree of AR DS severity.
Journal ArticleDOI
High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure.
Ricard Mellado-Artigas,Bruno L. Ferreyro,Bruno L. Ferreyro,Federico Angriman,Federico Angriman,María L. Hernández-Sanz,Egoitz Arruti,Antoni Torres,Jesús Villar,Jesús Villar,Laurent Brochard,Laurent Brochard,Carlos Ferrando +12 more
TL;DR: In this paper, the authors conducted a multicentre cohort study using a prospectively collected database of patients with COVID-19 associated acute respiratory failure admitted to 36 Spanish and Andorran intensive care units (ICUs).
Journal ArticleDOI
Extracorporeal life support for adults with acute respiratory distress syndrome.
Alain Combes,Matthieu Schmidt,Carol L. Hodgson,Eddy Fan,Niall D. Ferguson,John F. Fraser,Samir Jaber,Antonio Pesenti,Marco Ranieri,Kathryn M Rowan,Kiran Shekar,Arthur S. Slutsky,Daniel Brodie,Daniel Brodie +13 more
TL;DR: A narrative review summarizes physiological concepts related to ECLS, as well as the rationale and evidence supporting ECMO and ECCO2R for the treatment of ARDS, and discusses future key research questions and challenges for this technology.
Journal ArticleDOI
Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS.
Domenico Luca Grieco,Salvatore Maurizio Maggiore,Oriol Roca,Elena Spinelli,Bhakti K. Patel,Arnaud W. Thille,Carmen Silvia Valente Barbas,Carmen Silvia Valente Barbas,Marina Garcia de Acilu,Salvatore Lucio Cutuli,Filippo Bongiovanni,Marcelo B. P. Amato,Jean Pierre Frat,Tommaso Mauri,John P. Kress,Jordi Mancebo,Massimo Antonelli +16 more
TL;DR: The role of non-invasive respiratory support (high-flow nasal oxygen and noninvasive ventilation) in the management of acute hypoxemic respiratory failure and acute respiratory distress syndrome is debated as mentioned in this paper.
Journal ArticleDOI
Awake prone positioning in patients with hypoxemic respiratory failure due to COVID-19: the PROFLO multicenter randomized clinical trial.
Jacob Rosén,Erik von Oelreich,Erik von Oelreich,Diddi Fors,Malin Jonsson Fagerlund,Malin Jonsson Fagerlund,Knut Taxbro,Paul Skorup,Ludvig Eby,Francesca Campoccia Jalde,Francesca Campoccia Jalde,Niclas Johansson,Niclas Johansson,Gustav Bergström,Peter Frykholm +14 more
TL;DR: In this paper, the effect of awake prone positioning on intubation rates is not established and the aim of this trial was to investigate if a protocol for awake prone position reduces the rate of endo...
References
More filters
Journal ArticleDOI
A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation
Karl L. Yang,Martin J. Tobin +1 more
TL;DR: Two new indexes are developed: the first quantitates rapid shallow breathing as the ratio of respiratory frequency to tidal volume (f/VT), and the second is termed CROP, because it integrates thoracic compliance, respiratory ṟate, arterial oxygenation, and P1max.
Journal ArticleDOI
Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure
TL;DR: It is argued that application of a lung-protective ventilation, today best applied with sedation and endotracheal intubation, might be considered a prophylactic therapy, rather than just a supportive therapy, to minimize the progression of lung injury from a form of patient self-inflicted lung injury.
Journal ArticleDOI
Occlusion pressure as a measure of respiratory center output in conscious man.
TL;DR: It is concluded that measurements of P0.1 represent a useful index of the output of the respiratory centers, independent of mechanisms that alter the respiratory pattern by affecting inspiratory duration, in particular the vagal volume-related inspiratory-inhibitory reflex.
Journal ArticleDOI
On the regulation of depth and rate of breathing
F. J. Clark,C. von Euler +1 more
TL;DR: The relationships between the depth of a breath and the durations of the inspiratory and expiratory phases have been studied in cat and in man during rebreathing, and in cat using artificial inflations of different magnitudes and timings.
Related Papers (5)
Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries
Giacomo Bellani,John G. Laffey,John G. Laffey,Tài Pham,Tài Pham,Eddy Fan,Eddy Fan,Laurent Brochard,Laurent Brochard,Andrés Esteban,Luciano Gattinoni,Frank van Haren,Anders Larsson,Daniel F. McAuley,Marco Ranieri,Gordon D. Rubenfeld,Gordon D. Rubenfeld,B. Taylor Thompson,Hermann Wrigge,Arthur S. Slutsky,Antonio Pesenti +20 more
High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure.
Jean-Pierre Frat,Arnaud W. Thille,Alain Mercat,Christophe Girault,Stéphanie Ragot,Sébastien Perbet,Gwenaël Prat,Thierry Boulain,Elise Morawiec,Alice Cottereau,Jérôme Devaquet,Saad Nseir,Keyvan Razazi,Jean-Paul Mira,Laurent Argaud,Jean-Charles Chakarian,Jean-Damien Ricard,Xavier Wittebole,Stéphanie Chevalier,Alexandre Herbland,Muriel Fartoukh,Jean-Michel Constantin,Jean-Marie Tonnelier,Marc Pierrot,Armelle Mathonnet,Gaetan Beduneau,Celine Deletage-Metreau,Jean-Christophe M. Richard,Laurent Brochard,René Robert +29 more