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Puybasset, Louis; Rouby, Jean‐Jacques

doi:10.1186/cc118

Cited by 8 publications

(2 citation statements)

References 20 publications

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“…Initiate inhaled NO at 1 ppm and titrate up every 30 minutes until an improvement in oxygenation is observed, but not to exceed 10 ppm. [35] If there is no immediate response, gradually discontinue its use. If there is a response, the dose should be decreased daily to the lowest dose necessary to maintain the target oxygenation and not used for longer than 4 days.…”

Section: Therapeutic Strategiesmentioning

confidence: 99%

Therapeutic strategies for severe acute lung injury

Dı́az¹,

Brower²,

Calfee³

et al. 2010

Critical Care Medicine

156

122

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Objective In the management of patients with severe Acute Lung Injury and the Acute Respiratory Distress Syndrome (ALI/ARDS), clinicians are sometimes challenged to maintain acceptable gas exchange while avoiding harmful mechanical ventilation practices. In some of these patients, physicians may consider the use of “rescue therapies” to sustain life. Our goal is to provide a practical, evidence-based review to assist critical care physicians’ care for patients with severe ALI/ARDS. Data Sources and Study Selection We searched the Pub Med database for clinical trials examining the use of the following therapies in ALI/ARDS: recruitment maneuvers, high positive end expiratory pressure, prone position, high frequency oscillatory ventilation, glucocorticoids, inhaled nitric oxide, buffer therapy and extracorporeal life support. Study selection All clinical trials that included patients with severe ALI/ARDS were included in the review. Data Synthesis The primary author reviewed the aforementioned trials in depth and then disputed findings and conclusions with other authors until consensus was achieved. Conclusions This article is designed to: a) provide clinicians with a simple, bedside definition for the diagnosis of severe ARDS; b) describe several therapies that can be used in severe ARDS with an emphasis on the potential risks as well as the indications and benefits; and c) to offer practical guidelines for implementation of these therapies.

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Section: Therapeutic Strategiesmentioning

confidence: 99%

Therapeutic strategies for severe acute lung injury

Dı́az¹,

Brower²,

Calfee³

et al. 2010

Critical Care Medicine

156

122

View full text Add to dashboard Cite

show abstract

“…Ionization-based NO delivery technology generates NO from air and delivers NO into the inspiratory limb of a ventilator circuit based on breathing circuit flow. Several studies using flow-based NO delivery systems with anesthesia machines have concluded that NO delivery to the patient is accurate only when FGF is equal to or greater than MV [17][18][19]. Because flow-based NO delivery systems do not account for recirculating gases in semi-closed circuits on an anesthesia machine, the many benefits of low-flow anesthesia are negated.…”

Section: Introductionmentioning

confidence: 99%

A novel, cassette-based nitric oxide delivery system with an advanced feedback control algorithm accurately delivers nitric oxide via the anesthesia machine independent of fresh gas flow rate and volatile anesthetic agent

Twite,

Roebuck,

Anderson

2024

J Clin Monit Comput

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Nitric oxide (NO), a selective pulmonary vasodilator, can be delivered via conventional ICU and anesthesia machine ventilators. Anesthesia machines are designed for rebreathing of circulating gases, reducing volatile anesthetic agent quantity used. Current cylinder- and ionizing-based NO delivery technologies use breathing circuit flow to determine NO delivery and do not account for recirculated gases; therefore, they cannot accurately dose NO at FGF below patient minute ventilation (MV). A novel, cassette-based NO delivery system (GENOSYL® DS, Vero Biotech Inc.) uses measured NO concentration in the breathing circuit as an input to an advanced feedback control algorithm, providing accurate NO delivery regardless of FGF and recirculation of gases. This study evaluated GENOSYL® DS accuracy with different anesthesia machines, ventilation parameters, FGFs, and volatile anesthetics. GENOSYL® DS was tested with GE Aisys and Dräger Fabius anesthesia machines to determine NO dose accuracy with FGF < patient MV, and with a Getinge Flow-i anesthesia machine to determine NO dose accuracy when delivering various volatile anesthetic agents. Neonatal and adult mechanical ventilation parameters and circuits were used. GENOSYL® DS maintained accurate NO delivery with all three anesthesia machines, at low FGF with recirculation of gases, and with all volatile anesthetic agents at different concentrations. Measured NO2 levels remained acceptable at ≤ 1 ppm with set NO dose ≤ 40 ppm. GENOSYL® DS, with its advanced feedback control algorithm, is the only NO delivery system capable of accurately dosing NO with anesthesia machines with rebreathing ventilation parameters (FGF < MV) regardless of anesthetic agent.

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Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS)

Ostwani

Shanley

2014

Pediatric Critical Care Medicine

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Untitled

Cited by 8 publications

References 20 publications

Therapeutic strategies for severe acute lung injury

Therapeutic strategies for severe acute lung injury

A novel, cassette-based nitric oxide delivery system with an advanced feedback control algorithm accurately delivers nitric oxide via the anesthesia machine independent of fresh gas flow rate and volatile anesthetic agent

Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS)

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