Lung UltraSound Targeted Recruitment (LUSTR) : A Novel Protocol to Optimize Open Lung Ventilation in Critically Ill Neonates
This study investigated the effectiveness of an original Lung UltraSound Targeted Recruitment (LUSTR) protocol to improve the success of lung recruitment maneuvers (LRMs), which are performed as a rescue approach in critically ill neonates. All the LUSTR maneuvers, performed on infants with an oxygen saturation/fraction of inspired oxygen (S/F) ratio below 200, were included in this case-control study (LUSTR-group). The LUSTR-group was matched by the initial S/F ratio and underlying respiratory disease with a control group of lung recruitments performed following the standard oxygenation-guided procedure (Ox-group). The primary outcome was the improvement of the S/F ratio (Delta S/F) throughout the LRM. Secondary outcomes included the rate of air leaks. Each group was comprised of fourteen LRMs. As compared to the standard approach, the LUSTR protocol was associated with a higher success of the procedure in terms of Delta S/F (110 ± 47.3 vs. 64.1 ± 54.6, p = 0.02). This result remained significant after adjusting for confounding variables through multiple linear regressions. The incidence of pneumothorax was lower, although not reaching statistical significance, in the LUSTR-group (0 vs. 14.3%, p = 0.15). The LUSTR protocol may be a more effective and safer option than the oxygenation-based procedure to guide open lung ventilation in neonates, potentially improving ventilation and reducing the impact of ventilator-induced lung injury.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Children (Basel, Switzerland) - 9(2022), 7 vom: 12. Juli |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chioma, Roberto [VerfasserIn] |
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| Links: |
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| Themen: |
Intensive care |
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| Anmerkungen: |
Date Revised 31.07.2022 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/children9071035 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344038114 |
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| 100 | 1 | |a Chioma, Roberto |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Lung UltraSound Targeted Recruitment (LUSTR) |b A Novel Protocol to Optimize Open Lung Ventilation in Critically Ill Neonates |
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| 500 | |a Date Revised 31.07.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a This study investigated the effectiveness of an original Lung UltraSound Targeted Recruitment (LUSTR) protocol to improve the success of lung recruitment maneuvers (LRMs), which are performed as a rescue approach in critically ill neonates. All the LUSTR maneuvers, performed on infants with an oxygen saturation/fraction of inspired oxygen (S/F) ratio below 200, were included in this case-control study (LUSTR-group). The LUSTR-group was matched by the initial S/F ratio and underlying respiratory disease with a control group of lung recruitments performed following the standard oxygenation-guided procedure (Ox-group). The primary outcome was the improvement of the S/F ratio (Delta S/F) throughout the LRM. Secondary outcomes included the rate of air leaks. Each group was comprised of fourteen LRMs. As compared to the standard approach, the LUSTR protocol was associated with a higher success of the procedure in terms of Delta S/F (110 ± 47.3 vs. 64.1 ± 54.6, p = 0.02). This result remained significant after adjusting for confounding variables through multiple linear regressions. The incidence of pneumothorax was lower, although not reaching statistical significance, in the LUSTR-group (0 vs. 14.3%, p = 0.15). The LUSTR protocol may be a more effective and safer option than the oxygenation-based procedure to guide open lung ventilation in neonates, potentially improving ventilation and reducing the impact of ventilator-induced lung injury | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a intensive care | |
| 650 | 4 | |a mechanical ventilation | |
| 650 | 4 | |a neonatal | |
| 650 | 4 | |a point-of-care diagnostics | |
| 650 | 4 | |a respiratory distress syndrome | |
| 650 | 4 | |a respiratory insufficiency | |
| 650 | 4 | |a ventilator-induced lung injury | |
| 700 | 1 | |a Amabili, Lorenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Ciarmoli, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Copetti, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Villani, Pier Giorgio |e verfasserin |4 aut | |
| 700 | 1 | |a Natile, Miria |e verfasserin |4 aut | |
| 700 | 1 | |a Vento, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Storti, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Pierro, Maria |e verfasserin |4 aut | |
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