Respiratory effects of lung recruitment maneuvers depend on the recruitment-to-inflation ratio in patients with COVID-19-related acute respiratory distress syndrome.

Background: In the context of acute respiratory distress syndrome (ARDS), the response to lung recruitment maneuvers (LRMs) varies considerably from one patient to another and so is difficult to predict. The aim of the study was to determine whether or not the recruitment-to-inflation (R/I) ratio could differentiate between patients according to the change in lung mechanics during the LRM.

Methods: We evaluated the changes in gas exchange and respiratory mechanics induced by a stepwise LRM at a constant driving pressure of 15 cmHO during pressure-controlled ventilation.

Doppler Echocardiographic Indices Are Specific But Not Sensitive to Predict Pulmonary Artery Occlusion Pressure in Critically Ill Patients Under Mechanical Ventilation.

Objectives: The objective of this study was to prospectively evaluate the ability of transthoracic echocardiography to assess pulmonary artery occlusion pressure in mechanically ventilated critically ill patients.

Design: In a prospective observational study.

Setting: Amiens University Hospital Medical ICU.

Transthoracic echocardiography: an accurate and precise method for estimating cardiac output in the critically ill patient.

Background: Cardiac output (CO) monitoring is a valuable tool for the diagnosis and management of critically ill patients. In the critical care setting, few studies have evaluated the level of agreement between CO estimated by transthoracic echocardiography (CO-TTE) and that measured by the reference method, pulmonary artery catheter (CO-PAC). The objective of the present study was to evaluate the precision and accuracy of CO-TTE relative to CO-PAC and the ability of transthoracic echocardiography to track variations in CO, in critically ill mechanically ventilated patients.

Residents learning ultrasound-guided catheterization are not sufficiently skilled to use landmarks.

Introduction: Ultrasound-guided (UG) technique is the recommended procedure for central venous catheterization (CVC). However, as ultrasound may not be available in emergency situations, guidelines also propose that physicians remain skilled in landmark (LM) placement. We conducted this prospective observational study to determine the learning curve of the LM technique in residents only learning the UG technique.

Ultrasound evaluation of central veinsin the intensive care unit:effects of dynamic manoeuvres.

Objective: To determine: (1) the proportion of small (<5 mm) or thrombosed internal jugular veins (IJV) and femoral veins (FV) in which catheter placement would be difficult without ultrasound guidance; (2) which position increases central vein sizes and may facilitate cannulation of these vessels.

Design: Prospective study.

Setting: Twelve-bed adult medical intensive care unit.