Optimal Positive End-expiratory Pressure Levels in Tuberculosis-associated Acute Respiratory Distress Syndrome
International Journal of Mycobacteriology, cilt.13, sa.3, ss.247-251, 2024 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 13 Sayı: 3
- Basım Tarihi: 2024
- Doi Numarası: 10.4103/ijmy.ijmy_136_24
- Dergi Adı: International Journal of Mycobacteriology
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
- Sayfa Sayıları: ss.247-251
- Anahtar Kelimeler: Acute respiratory distress syndrome, electrical impedance tomography, lung compliance, positive end-expiratory pressure, tuberculosis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: The objective is to assess lung compliance and identify the optimal positive end-expiratory pressure (PEEP) levels in patients with tuberculosis-associated Acute Respiratory Distress Syndrome (TB-ARDS) compared to non-TB-ARDS patients. Methods: This observational case-control study utilized electrical impedance tomography to evaluate lung mechanics in 20 TB-ARDS and 20 non-TB-ARDS patients. Participants underwent PEEP titration from 23 to 5 cm H2O in 2 cm H2O decrements. Lung compliance and the rates of hyperdistention and collapse were assessed at each PEEP level. Results: Delta impedance values showed higher amounts in a PEEP range of 11-17 cm H2O and in patients with TB-ARDS (P > 0.05). In addition, both hyperdistention and collapse rates were nonsignificantly higher in TB-ARDS patients (P > 0.05), and the compromised levels of hyperdistention and collapse rates were at 15-17 cm H2O, indicating the most favorable PEEP level. Conclusions: The observed patterns of hyperdistention and collapse rates across various PEEP levels provide valuable insights into the susceptibility of TB-ARDS patients to barotrauma. Notably, the identified optimal PEEP range between 15 and 17 cm H2O may guide ventilator management strategies in mitigating both hyperdistention and collapse; nonetheless, due to the high variability of lung compliances within groups, we strongly recommend individualized consideration for tailored respiratory support and evaluation.