A specialized Lung Rescue Team established by clinicians at Massachusetts General Hospital (MGH) to evaluate and treat patients with obesity receiving mechanical ventilation [MV] due to acute respiratory failure (ARF) has significantly reduced the risk of mortality compared to standard treatment. In a paper published in the journal Critical Care , MGH investigators reported that by individualized treatment for patients in the intensive care unit the Lung Rescue Team reduced by half the risk of death for up to a year in patients with acute respiratory failure.
Our extensive research over the past 10 years has shown that standard protocols for treating patients with obesity and acute respiratory failure requiring ventilator support were inadequate to provide oxygenation because excessive tissue increased pressure on the lungs, resulting in their failure to expand. The Lung Rescue Team carefully assesses the respiratory, pulmonary and cardiac physiology of each patient. And based on those findings, it's able to implement a ventilation titration strategy that counteracts the detrimental effects of increased pleural pressure, resulting in lung re-expansion." Lorenzo Berra, MD, investigator in the Department of Anesthesia, Critical Care and Pain Medicine at MGH, and corresponding author of the study
The Lung Rescue Team was created in 2014 as a joint effort between MGH Respiratory Care Services and critical care physicians. The dedicated team consists of a critical care physician and two critical care fellows trained in cardio-pulmonary physiology who are asked to consult on cases involving patients with obesity and ARF within 24 hours of ICU admission. The intervention tools they employ include esophageal manometry to determine the intrapleural pressure inside the chest; trans-thoracic echocardiography to determine cardiac function during mechanical ventilation manipulation; and electrical impedance tomography (EIT) to measure the regional distribution of ventilation and assess the degree of lung collapse and overdistension. Related Stories
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