MINERVA ANESTESIOLOGICA EDIZIONI MINERVA MEDICA This provisional PDF corresponds to the article as it appeared upon acceptance. A copyedited and fully formatted version will be made available soon. The final version may contain major or minor changes.
Friday night ventilation A safety starting tool kit for mechanically ventilated patients Luciano GATTINONI, Eleonora CARLESSO, Luca BRAZZI, Massimo CRESSONI, Simone ROSSEAU, Stefan KLUGE, Armin KALENKA, Martin BACHMANN, Lars TOEPFER, Hermann WRIGGE, Fabrizio REDAELLI, Christoph VETTER, Marc WYSOCKI Minerva Anestesiol 2014 May 21 [Epub ahead of print]
MINERVA ANESTESIOLOGICA Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva pISSN 0375-9393 - eISSN 1827-1596 Article type: Experts' opinion and Point of view The online version of this article is located at http://www.minervamedica.it
Subscription: Information about subscribing to Minerva Medica journals is online at: http://www.minervamedica.it/en/how-to-order-journals.php Reprints and permissions: For information about reprints and permissions send an email to:
[email protected] -
[email protected] -
[email protected]
COPYRIGHT© 2014 EDIZIONI MINERVA MEDICA
4 EDIZIONI MINERVA MEDICA COPYRIGHT© 2013
!
Friday night ventilation A safety starting tool kit for mechanically ventilated patients 1,2
Luciano Gattinoni, 2Eleonora Carlesso, 3Luca Brazzi, 2Massimo Cressoni, 4Simone Rosseau, 5Stefan Kluge, 6Armin Kalenka, 7Martin Bachmann, 8Lars Toepfer, 9Hermann Wrigge, 10Fabrizio Redaelli, 11
Christoph Vetter, 12Marc Wysocki.
1
Dipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy. 2 Dipartimento di Fisiopatologia MedicoChirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy. 3 Dipartimento di Scienze Chirurgiche, Microchirurgiche e Mediche, Università degli Studi di Sassari, Sassari, Italia; Unità Operativa di Anestesia e Rianimazione, AOU Sassari, Sassari, Italia 4 Medizinische Klinik m.S. Infektiologie und Pneumologie, CharitèUniversitätsmedizin Berlin, Germany. 5 Department of Intensive Care Medicine, University Medical Center HamburgEppendorf, Martinistr 52,20246 Hamburg, Germany. 6 Anästhesie und Intensivmedizin, Kreiskrankenhaus Bergstraße gemeinnützige, 64646 Heppenheim, Germany. 7 Sektion Pneumologische Intensiv und Beatmungsmedizin, Asklepios Klinik Harburg, Eißendorfer Pferdeweg 52, 21079 Hamburg Germany. 8 Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus VirchowKlinikum, Charité – Universitätsmedizin Berlin, Campus VirchowKlinikum, Augustenburger Platz 1, 13353 Berlin, Germany. 9 Department of Anesthesiology and Intensive Care Medicine, University of Leipzig, Germany. 10 GE Healthcare, Buc, France 11 GE Healthcare, Germany 12 GE Healthcare, Buc, France and Research Center, CHU SainteJustine Hospital, 3175 Chemin de la CôteSainteCatherine, Montreal, QC H3T 1C5, Canada 7KLVVWXG\ZDVVXSSRUWHGE\*(+HDOWKFDUH Corresponding author and address for reprints Luciano Gattinoni Dipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122 Milan, Italy. Phone: +390255033232 Fax: +390255033230 Email:
[email protected]
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher.
1
!
4 EDIZIONI MINERVA MEDICA COPYRIGHT© 2013
!
Abstract We wish to report here a practical approach to an ARDS patient as devised by a group of intensivists with different expertise. The referral scenario is an intensive care unit of a Community Hospital with limited technology, where a young doctor, alone, must deal with this complicate syndrome during the night. The knowledge of pulse oximetry at room air and at 100% oxygen allows to estimate the PaO2 and the cause of hypoxemia, shunt vs. VA/Q maldistribution. The ARDS severity (mild (200
