Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome

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dc.citation.issue3
dc.citation.volume67
dc.contributor.authorNunes, Nathaly Fonseca [UNIFESP]
dc.contributor.authorBafi, Antonio Tonete [UNIFESP]
dc.contributor.authorPacheco, Eduardo Souza [UNIFESP]
dc.contributor.authorPontes de Azevedo, Luciano Cesar [UNIFESP]
dc.contributor.authorMachado, Flavia Ribeiro [UNIFESP]
dc.contributor.authorRezende Freitas, Flavio Geraldo [UNIFESP]
dc.coverageNew York
dc.date.accessioned2020-07-13T11:53:23Z
dc.date.available2020-07-13T11:53:23Z
dc.date.issued2017
dc.description.abstractObjective: The aim of this study was to evaluate the impact of increased positive end-expiratory pressure on the sublingual microcirculation. Methods: Adult patients who were sedated, under mechanical ventilation, and had a diagnosis of circulatory shock and acute respiratory distress syndrome were included. The positive end expiratory pressure level was settled to obtain a plateau pressure of 30 cm H2O and then maintained at this level for 20 minutes. Microcirculatory (obtained by videomicroscopy) and hemodynamic variables were collected at baseline and compared with those at the end of 20 min. Results: Twelve patients were enrolled. Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, there was considerable interindividual variability. There was a negative, moderate correlation between the changes in the De Backer score (r = -0.58, p = 0.048), total vessel density (r = -0.60, p = 0.039) and baseline values. The changes in total vessel density (r = 0.54, p = 0.07) and per fused vessel density (r = 0.52, p = 0.08) trended toward correlating with the changes in the mean arterial pressure. Conclusion: Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, at individual level, such response was heterogeneous. The changes in the microcirculation parameters could be correlated with the baseline values and changes in the mean arterial pressure. (C) 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.en
dc.description.affiliationUniv Fed Sao Paulo UNIFESP, Hosp Sao Paulo, Disciplina Anestesiol Dor & Terapia Intens, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo UNIFESP, Hosp Sao Paulo, Disciplina Anestesiol Dor & Terapia Intens, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo - FAPESP
dc.description.sponsorshipIDFAPESP: 2010/50096-6
dc.format.extent278-283
dc.identifierhttp://dx.doi.org/10.1016/j.bjane.2015.10.002
dc.identifier.citationRevista Brasileira De Anestesiologia. New York, v. 67, n. 3, p. 278-283, 2017.
dc.identifier.doi10.1016/j.bjane.2015.10.002
dc.identifier.fileWOS000401600800009.pdf
dc.identifier.issn0034-7094
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54582
dc.identifier.wosWOS:000401600800009
dc.language.isoeng
dc.publisherElsevier Science Inc
dc.relation.ispartofRevista Brasileira De Anestesiologia
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAdult respiratoryen
dc.subjectdistress syndromeen
dc.subjectPositive end-expiratory pressureen
dc.subjectMicrocirculationen
dc.subjectHemodynamicsen
dc.subjectShocken
dc.subjectMechanicalen
dc.subjectventilatorsen
dc.titleEffects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndromeen
dc.typeinfo:eu-repo/semantics/article
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