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Journal Articles Chest Year : 2020

Impact of Respiratory Rate and Dead Space in the Current Era of Lung Protective Mechanical Ventilation

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Abstract

Protective ventilation should potentially be applied in most or all patients undergoing invasive mechanical ventilation.1,2 Reduction of tidal volume (VT) has progressively been incorporated over the years.3 Protective ventilation is not limited to VT reduction, however, but needs a combination of ventilator settings and associated procedures.1,4 The progressive reduction of VT has necessitated to increase the respiratory rate (RR), but no clear recommendation for setting the rate exists. In addition, the impact of dead space, including instrumental dead space (VDinstr), became highly relevant. Reducing the VDinstr should be recommended as part of lung protective ventilation,4 especially for patients requiring VT ≤ 6 mL/kg of predicted body weight (PBW).5 In this report, we reviewed data from the literature of the last 20 years to try to offer some clues to physicians on the questions of rate setting and the impact of dead space.

Dates and versions

hal-02945939 , version 1 (22-09-2020)

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François Lellouche, Mathieu Delorme, Laurent Brochard. Impact of Respiratory Rate and Dead Space in the Current Era of Lung Protective Mechanical Ventilation. Chest, 2020, 158 (1), pp.45-47. ⟨10.1016/j.chest.2020.02.033⟩. ⟨hal-02945939⟩
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