Publications by authors named "B Pavlovsky"

Electrical impedance tomography (EIT) is an emerging technology for the non-invasive monitoring of regional distribution of ventilation and perfusion, offering real-time and continuous data that can greatly enhance our understanding and management of various respiratory conditions and lung perfusion. Its application may be especially beneficial for critically ill mechanically ventilated patients. Despite its potential, clear evidence of clinical benefits is still lacking, in part due to a lack of standardization and transparent reporting, which is essential for ensuring reproducible research and enhancing the use of EIT for personalized mechanical ventilation.

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Article Synopsis
  • - Blood flow rate during venovenous ECMO impacts mixed venous oxygenation (Sv), which can influence pulmonary circulation and right heart function in patients with severe acute respiratory distress syndrome (ARDS).
  • - A study evaluated the physiological effects of varying ECMO blood flow levels on Sv in 20 ARDS patients, revealing that higher blood flow rates led to decreased cardiac output, pulmonary artery pressure, and right ventricular workload.
  • - The results showed an inverse relationship between cardiac output and mixed venous oxygenation, indicating that as ECMO blood flow increased, overall cardiac efficiency and workload on the right heart decreased without affecting mismatching measures significantly.
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Background: Various Positive End-Expiratory Pressure (PEEP) titration strategies have been proposed to optimize ventilation in patients with acute respiratory distress syndrome (ARDS). We aimed to compare PEEP titration strategies based on electrical impedance tomography (EIT) to methods derived from respiratory system mechanics with or without esophageal pressure measurements, in terms of PEEP levels and association with recruitability.

Methods: Nineteen patients with ARDS were enrolled.

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Background: Respiratory mechanics is a key element to monitor mechanically ventilated patients and guide ventilator settings. Besides the usual basic assessments, some more complex explorations may allow to better characterize patients' respiratory mechanics and individualize ventilation strategies. These advanced respiratory mechanics assessments including esophageal pressure measurements and complete airway closure detection may be particularly relevant in critically ill obese patients.

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Defining lung recruitability is needed for safe positive end-expiratory pressure (PEEP) selection in mechanically ventilated patients. However, there is no simple bedside method including both assessment of recruitability and risks of overdistension as well as personalized PEEP titration. To describe the range of recruitability using electrical impedance tomography (EIT), effects of PEEP on recruitability, respiratory mechanics and gas exchange, and a method to select optimal EIT-based PEEP.

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