{"created":"2023-05-15T16:49:27.970454+00:00","id":26933,"links":{},"metadata":{"_buckets":{"deposit":"9b11829a-ea85-469b-9144-db6555e60f20"},"_deposit":{"created_by":6,"id":"26933","owners":[6],"pid":{"revision_id":0,"type":"depid","value":"26933"},"status":"published"},"_oai":{"id":"oai:nagasaki-u.repo.nii.ac.jp:00026933","sets":["8:9"]},"author_link":["119816","119822","119820","119824","119829","119817","119819","119828","119826","119818","119827","119823","119821","119825"],"item_2_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2021-09-10","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"36","bibliographicPageStart":"e27199","bibliographicVolumeNumber":"100","bibliographic_titles":[{"bibliographic_title":"Medicine"}]}]},"item_2_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"To avoid ventilator-associated lung injury in acute respiratory distress syndrome (ARDS) treatment, respiratory management should be performed at a low tidal volume of 6 to 8 mL/kg and plateau pressure of ≤30 cmH2O. However, such lung-protective ventilation often results in hypercapnia, which is a risk factor for poor outcomes. The purpose of this study was to retrospectively evaluate the effectiveness and safety of the removal of a catheter mount (CM) and using heated humidifiers (HH) instead of a heat-and-moisture exchanger (HME) for reducing the mechanical dead space created by the CM and HME, which may improve hypercapnia in patients with ARDS.\nThis retrospective observational study included adult patients with ARDS, who developed hypercapnia (PaCO2 > 45 mm Hg) during mechanical ventilation, with target tidal volumes between 6 and 8 mL/kg and a plateau pressure of ≤30 cmH2O, and underwent stepwise removal of CM and HME (replaced with HH). The PaCO2 values were measured at 3 points: ventilator circuit with CM and HME (CM + HME) use, with HME (HME), and with HH (HH), and the overall number of accidental extubations was evaluated. Ventilator values (tidal volume, respiratory rate, minutes volume) were evaluated at the same points.\nA total of 21 patients with mild-to-moderate ARDS who were treated under deep sedation were included. The values of PaCO2 at HME (52.7 ± 7.4 mm Hg, P < .0001) and HH (46.3 ± 6.8 mm Hg, P < .0001) were significantly lower than those at CM + HME (55.9 ± 7.9 mm Hg). Measured ventilator values were similar at CM + HME, HME, and HH. There were no cases of reintubation due to accidental extubation after the removal of CM.\nThe removal of CM and HME reduced PaCO2 values without changing the ventilator settings in deeply sedated patients with mild-to-moderate ARDS on lung-protective ventilation. Caution should be exercised, as the removal of a CM may result in circuit disconnection or accidental extubation. Nevertheless, this intervention may improve hypercapnia and promote lung-protective ventilation.","subitem_description_type":"Abstract"}]},"item_2_description_63":{"attribute_name":"引用","attribute_value_mlt":[{"subitem_description":"Medicine, 100(36), art. no. e27199; 2021","subitem_description_type":"Other"}]},"item_2_publisher_33":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"Wolters Kluwer Health, Inc."}]},"item_2_relation_12":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"10.1097/MD.0000000000027199","subitem_relation_type_select":"DOI"}}]},"item_2_rights_13":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"© 2021 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0"}]},"item_2_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0025-7974","subitem_source_identifier_type":"ISSN"}]},"item_2_version_type_16":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"Shimoda, Takaya"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Sekino, Motohiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Higashijima, Ushio"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Matsumoto, Sojiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Sato, Shuntaro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Yano, Rintaro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Egashira, Takashi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Araki, Hiroshi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Naoya, Iwasaki"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Miki, Suzumura"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Koyanagi, Ryo"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Hayashi, Makoto"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Kurihara, Shintaro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Hara, Tetsuya"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2021-12-10"}],"displaytype":"detail","filename":"Medicine100_e27199.pdf","filesize":[{"value":"403.9 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"Medicine100_e27199.pdf","url":"https://nagasaki-u.repo.nii.ac.jp/record/26933/files/Medicine100_e27199.pdf"},"version_id":"205e3ace-cc02-454b-bff0-1a6607968cbe"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"acute respiratory distress syndrome","subitem_subject_scheme":"Other"},{"subitem_subject":"dead space","subitem_subject_scheme":"Other"},{"subitem_subject":"heat-and-moisture exchanger","subitem_subject_scheme":"Other"},{"subitem_subject":"carbon dioxide","subitem_subject_scheme":"Other"},{"subitem_subject":"permissive hypercapnia","subitem_subject_scheme":"Other"},{"subitem_subject":"ventilation","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Removal of a catheter mount and heat-and-moisture exchanger improves hypercapnia in patients with acute respiratory distress syndrome","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Removal of a catheter mount and heat-and-moisture exchanger improves hypercapnia in patients with acute respiratory distress syndrome"}]},"item_type_id":"2","owner":"6","path":["9"],"pubdate":{"attribute_name":"公開日","attribute_value":"2021-12-10"},"publish_date":"2021-12-10","publish_status":"0","recid":"26933","relation_version_is_last":true,"title":["Removal of a catheter mount and heat-and-moisture exchanger improves hypercapnia in patients with acute respiratory distress syndrome"],"weko_creator_id":"6","weko_shared_id":-1},"updated":"2023-05-15T20:05:45.618075+00:00"}