Chest
Clinical Investigations in Critical CareEffect of Bronchodilators on Lung Mechanics in the Acute Respiratory Distress Syndrome (ARDS)
Section snippets
Patient Selection
We studied eight patients who had ARDS and who were in the intensive care units of Vanderbilt University Medical Center. Patients who had an illness known to be associated with ARDS and who met all the following criteria were eligible for study: (1) arterial blood gases revealing a partial pressure of arterial oxygen of (PaO2) ≤70 mm Hg while they were breathing at least 40% oxygen or a ratio of partial pressure of arterial oxygen to partial pressure of alveolar oxygen (PaO2/PAO2) of ≤0.3
Results
Eight patients with ARDS from the intensive care units at Vanderbilt University Hospital were studied, including two men and six women with a mean age of 51 ± 7 years. Although two of the eight patients were smokers prior to hospitalization, neither had physical evidence, laboratory findings, or a history of previously existing lung disease. As Table 1 shows, physiologic variables were similar at the beginning of the metaproterenol and placebo portions of the trial, precluding a carryover
Discussion
Reduced lung or thoracic compliance, more specifically static compliance, is usually considered the primary disorder of lung mechanics in ARDS. The contribution of airflow resistance to lung mechanics and gas exchange abnormalities in ARDS had not been extensively studied until recently.12,13,30 In a previous study, we were able to show that resistance to airflow across the lung was significantly greater in 12 patients with ARDS than normal controls, 6.15 ± 0.08 vs 0.88 ± 0.08 H2O/L/s,
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This work was supported by NHLBI grant HL-19153 (Special Center of Research in Pulmonary Diseases), HL-07123 (Training Grant), the Bernard Werthan Sr. Fund for Pulmonary Research, and a grant from Boerhinger-Ingleheim Inc.