دورية أكاديمية
Cardiopulmonary Resuscitation-associated Lung Edema (CRALE). A Translational Study.
| العنوان: | Cardiopulmonary Resuscitation-associated Lung Edema (CRALE). A Translational Study. |
|---|---|
| المؤلفون: | Magliocca A; Dipartimento di Medicina Cardiovascolare, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy.; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Rezoagli E; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Zani D; Department of Veterinary Medicine, University of Milan, Lodi, Italy., Manfredi M; Department of Veterinary Medicine, University of Milan, Lodi, Italy., De Giorgio D; Dipartimento di Medicina Cardiovascolare, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy., Olivari D; Dipartimento di Medicina Cardiovascolare, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy., Fumagalli F; Dipartimento di Medicina Cardiovascolare, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy., Langer T; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Avalli L; Department of Emergency and Intensive Care, San Gerardo Hospital, Monza, Italy., Grasselli G; Department of Medical Physiopathology and Transplants, University of Milan, Milano, Italy; and.; Dipartimento di Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy., Latini R; Dipartimento di Medicina Cardiovascolare, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy., Pesenti A; Department of Medical Physiopathology and Transplants, University of Milan, Milano, Italy; and.; Dipartimento di Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy., Bellani G; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.; Department of Emergency and Intensive Care, San Gerardo Hospital, Monza, Italy., Ristagno G; Department of Medical Physiopathology and Transplants, University of Milan, Milano, Italy; and.; Dipartimento di Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy. |
| المصدر: | American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2021 Feb 15; Vol. 203 (4), pp. 447-457. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Thoracic Society Country of Publication: United States NLM ID: 9421642 Publication Model: Print Cited Medium: Internet ISSN: 1535-4970 (Electronic) Linking ISSN: 1073449X NLM ISO Abbreviation: Am J Respir Crit Care Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2000- : New York, NY : American Thoracic Society Original Publication: New York, NY : American Lung Association, c1994- |
| مواضيع طبية MeSH: | Cardiopulmonary Resuscitation/*adverse effects , Cardiopulmonary Resuscitation/*methods , Lung Injury/*etiology , Out-of-Hospital Cardiac Arrest/*therapy , Pressure/*adverse effects , Pulmonary Edema/*etiology, Aged ; Female ; Humans ; Male ; Middle Aged ; Translational Research, Biomedical |
| مستخلص: | Rationale: Cardiopulmonary resuscitation is the cornerstone of cardiac arrest (CA) treatment. However, lung injuries associated with it have been reported. Objectives: To assess 1 ) the presence and characteristics of lung abnormalities induced by cardiopulmonary resuscitation and 2 ) the role of mechanical and manual chest compression (CC) in its development. Methods: This translational study included 1 ) a porcine model of CA and cardiopulmonary resuscitation ( n = 12) and 2 ) a multicenter cohort of patients with out-of-hospital CA undergoing mechanical or manual CC ( n = 52). Lung computed tomography performed after resuscitation was assessed qualitatively and quantitatively along with respiratory mechanics and gas exchanges. Measurements and Main Results: The lung weight in the mechanical CC group was higher compared with the manual CC group in the experimental (431 ± 127 vs. 273 ± 66, P = 0.022) and clinical study (1,208 ± 630 vs. 837 ± 306, P = 0.006). The mechanical CC group showed significantly lower oxygenation ( P = 0.043) and respiratory system compliance ( P < 0.001) compared with the manual CC group in the experimental study. The variation of right atrial pressure was significantly higher in the mechanical compared with the manual CC group (54 ± 11 vs. 31 ± 6 mm Hg, P = 0.001) and significantly correlated with lung weight ( r = 0.686, P = 0.026) and respiratory system compliance ( r = -0.634, P = 0.027). Incidence of abnormal lung density was higher in patients treated with mechanical compared with manual CC (37% vs. 8%, P = 0.018). Conclusions: This study demonstrated the presence of cardiopulmonary resuscitation-associated lung edema in animals and in patients with out-of-hospital CA, which is more pronounced after mechanical as opposed to manual CC and correlates with higher swings of right atrial pressure during CC. |
| التعليقات: | Comment in: Am J Respir Crit Care Med. 2021 Feb 15;203(4):405-406. (PMID: 32966750) Comment in: Am J Respir Crit Care Med. 2021 Sep 15;204(6):740-741. (PMID: 34181867) Comment in: Am J Respir Crit Care Med. 2021 Sep 15;204(6):741-743. (PMID: 34181870) |
| فهرسة مساهمة: | Keywords: acute lung injury; cardiac arrest; cardiopulmonary resuscitation; chest compression; intrathoracic pressure |
| تواريخ الأحداث: | Date Created: 20200908 Date Completed: 20210308 Latest Revision: 20211204 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1164/rccm.201912-2454OC |
| PMID: | 32897758 |
| قاعدة البيانات: | MEDLINE |
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