Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS
Objective. Tracheal intubation and positive-pressure ventilation as the current standard of care for the adult respiratory distress syndrome (ARDS) seem to have reached their limit in terms of a further relevant reduction of the still very high mortality. Case Presentation. A 75-year-old male patien...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2015/714902 |
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| author | Konstantinos Raymondos Jörg Ahrens Ulrich Molitoris |
| author_facet | Konstantinos Raymondos Jörg Ahrens Ulrich Molitoris |
| author_sort | Konstantinos Raymondos |
| collection | DOAJ |
| description | Objective. Tracheal intubation and positive-pressure ventilation as the current standard of care for the adult respiratory distress syndrome (ARDS) seem to have reached their limit in terms of a further relevant reduction of the still very high mortality. Case Presentation. A 75-year-old male patient developed ARDS after abscess drainage with deteriorating oxygenation, despite positive end-expiratory pressure (PEEP) values above 15 cm H2O. We applied external negative-pressure ventilation with a chamber respirator using −33 cm H2O at inspiration and −15 cm H2O at expiration, combined with conventional pressure support using a PEEP of about 8 cm H2O and a pressure support of 4–12 cm H2O. Alveolar infiltrates disappeared rapidly and PaO2/FiO2 values surpassed 300 mmHg after the first application and 500 mmHg after the second. Negative-pressure ventilation was used for 6–18 hours/day over five days. Now, 13 years later, the patient is still alive and has a good quality of life. Conclusion. Using this or similar concepts, not only in intubated patients but also as a noninvasive approach in patients with ARDS, offers new options that may genuinely differ from the present therapeutic approaches and may, therefore, have the potential to decrease the present high mortality from ARDS. |
| format | Article |
| id | doaj-art-2d2b8bb9e3ff474e930fa4f248226d9f |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-2d2b8bb9e3ff474e930fa4f248226d9f2025-08-20T03:55:17ZengWileyCase Reports in Critical Care2090-64202090-64392015-01-01201510.1155/2015/714902714902Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDSKonstantinos Raymondos0Jörg Ahrens1Ulrich Molitoris2Anaesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, GermanyAnaesthesiology and Intensive Care Medicine, Klinikum Links der Weser, 28277 Bremen, GermanyCardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyObjective. Tracheal intubation and positive-pressure ventilation as the current standard of care for the adult respiratory distress syndrome (ARDS) seem to have reached their limit in terms of a further relevant reduction of the still very high mortality. Case Presentation. A 75-year-old male patient developed ARDS after abscess drainage with deteriorating oxygenation, despite positive end-expiratory pressure (PEEP) values above 15 cm H2O. We applied external negative-pressure ventilation with a chamber respirator using −33 cm H2O at inspiration and −15 cm H2O at expiration, combined with conventional pressure support using a PEEP of about 8 cm H2O and a pressure support of 4–12 cm H2O. Alveolar infiltrates disappeared rapidly and PaO2/FiO2 values surpassed 300 mmHg after the first application and 500 mmHg after the second. Negative-pressure ventilation was used for 6–18 hours/day over five days. Now, 13 years later, the patient is still alive and has a good quality of life. Conclusion. Using this or similar concepts, not only in intubated patients but also as a noninvasive approach in patients with ARDS, offers new options that may genuinely differ from the present therapeutic approaches and may, therefore, have the potential to decrease the present high mortality from ARDS.http://dx.doi.org/10.1155/2015/714902 |
| spellingShingle | Konstantinos Raymondos Jörg Ahrens Ulrich Molitoris Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS Case Reports in Critical Care |
| title | Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS |
| title_full | Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS |
| title_fullStr | Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS |
| title_full_unstemmed | Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS |
| title_short | Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS |
| title_sort | combined negative and positive pressure ventilation for the treatment of ards |
| url | http://dx.doi.org/10.1155/2015/714902 |
| work_keys_str_mv | AT konstantinosraymondos combinednegativeandpositivepressureventilationforthetreatmentofards AT jorgahrens combinednegativeandpositivepressureventilationforthetreatmentofards AT ulrichmolitoris combinednegativeandpositivepressureventilationforthetreatmentofards |