». En, élimination des AVH FlurAbsorb (Sedana Medical AB) n'entrainait pas d'augmentation du ?VT par rapport à l'absence de filtre (21,57±8,74 vs 18,62±5,07 mL, p=0,22) en cas de VT à 300mL. Par contre, avec un plus grand VT (500mL) on notait une hausse du ?VT

, De même, le circuit cocotte entrainait une hausse du ?VT par rapport au circuit standard pour un VT à 500mL (34,47±11,91 vs 37,50±12,61 mL, p<0,001) et pour un VT à 300mL, vol.82

R. D. Branson, The effects of inadequate humidity, Respir Care Clin N Am. juin, vol.4, issue.2, pp.199-214, 1998.

B. Misset, B. Escudier, D. Rivara, B. Leclercq, and G. Nitenberg, Heat and Moisture Exchanger vs Heated Humidifier during Long-Term Mechanical Ventilation: A Prospective Randomized Study, CHEST. 1 juill, vol.100, issue.1, pp.160-163, 1991.

I. L. Cohen, P. F. Weinberg, I. A. Fein, and G. S. Rowinski, Endotracheal tube occlusion associated with the use of heat and moisture exchangers in the intensive care unit, Crit Care Med. mars, vol.16, issue.3, pp.277-286, 1988.

F. Lellouche and L. Brochard, Optimisation de l'humidification des gaz au cours de la ventilation mécanique, 2007.

J. D. Ricard, P. Markowicz, and D. Dreyfuss, Utilisation des filtres échangeurs de chaleur et d'humidité au cours de la ventilation mécanique des patients de réanimation, p.9

F. Lellouche, S. Taillé, F. Lefrançois, N. Deye, S. M. Maggiore et al.,

, Humidification Performance of 48 Passive Airway Humidifiers, Chest. févr, vol.135, issue.2, pp.276-86, 2009.

D. Lannoy, B. Décaudin, J. Resibois, F. Barrier, L. Wierre et al., Évaluation de l'humidification de quatre filtres échangeurs de chaleur et d'humidité selon la norme ISO, Ann Fr Anesth Réanimation. févr, vol.9360, issue.2, pp.148-53, 2000.

J. Lucato, N. Da-cunha, T. M. Rocha, S. , P. De-carvalho et al.,

. Dc and J. A. Torquato, Influence of heat and moisture exchanger use on measurements performed with manovacuometer and respirometer in healthy adults, Multidiscip Respir Med, vol.11, 2015.

R. D. Restrepo and B. K. Walsh, Humidification During Invasive and Noninvasive Mechanical Ventilation: 2012, Respir Care. 1 mai, vol.57, issue.5, pp.782-790, 2012.

I. Morán, J. Bellapart, A. Vari, and J. Mancebo, Heat and moisture exchangers and heated humidifiers in acute lung injury/acute respiratory distress syndrome patients. Effects on respiratory mechanics and gas exchange, Intensive Care Med. 1 avr, vol.32, issue.4, pp.524-555, 2006.

J. W. Devlin, Y. Skrobik, C. Gélinas, D. M. Needham, A. Slooter et al., Clinical Practice Guidelines for the Prevention and Management of Pain
URL : https://hal.archives-ouvertes.fr/hal-01858069

, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, Crit Care Med. sept, vol.46, issue.9, p.825, 2018.

J. P. Kress, A. S. Pohlman, M. F. O&apos;connor, and J. B. Hall, Daily Interruption of Sedative Infusions in Critically Ill Patients Undergoing Mechanical Ventilation, N Engl J Med, vol.342, issue.20, pp.1471-1478, 2000.

J. Barr, G. L. Fraser, K. Puntillo, E. W. Ely, C. Gélinas et al., Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit, Crit Care Med. janv, vol.41, issue.1, pp.263-306, 2013.

M. Heim, R. Draheim, A. Krupp, P. Breihan, A. O&apos;rourke et al., Evaluation of a Multidisciplinary Pain, Agitation, and Delirium Guideline in Mechanically Ventilated Critically Ill Adults, Hosp Pharm. avr, vol.54, issue.2, pp.119-143, 2019.

R. R. Riker, Y. Shehabi, P. M. Bokesch, D. Ceraso, W. Wisemandle et al.,

, Dexmedetomidine vs Midazolam for Sedation of Critically Ill Patients: A Randomized Trial

, JAMA. 4 févr, vol.301, issue.5, pp.489-99, 2009.

A. Kraj?ová, P. Waldauf, M. And?l, and F. Du?ka, Propofol infusion syndrome: a structured

M. Mesnil, X. Capdevila, S. Bringuier, P. Trine, Y. Falquet et al., Long-term sedation in intensive care unit: a randomized comparison between inhaled sevoflurane and intravenous propofol or midazolam, Intensive Care Med. 1 juin, vol.37, issue.6, pp.933-974, 2011.

S. Romagnoli, C. Chelazzi, G. Villa, G. Zagli, F. Benvenuti et al., The New MIRUS System for Short-Term Sedation in Postsurgical ICU Patients*: Crit Care Med, sept, vol.45, issue.9, pp.925-956, 2017.

R. Baron, A. Binder, R. Biniek, S. Braune, H. Buerkle et al., Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Revision 2015 (DAS-Guideline 2015) -short version, GMS Ger Med Sci, vol.13, p.19, 2015.

S. Perbet, D. Bourdeaux, V. Sautou, B. Pereira, and R. Chabanne, A pharmacokinetic study of

P. Laferriere-langlois, &. Aragon-f, and W. Manzanares, Halogenated volatile anesthetics in the intensive care unit: current knowledge on an upcoming practice, Minerva Anestesiol. juill, vol.83, issue.7, pp.737-785, 2017.

G. Kunst and . Ii, From coronary steal to myocardial, renal, and cerebral protection: more questions than answers in anaesthetic preconditioning?, Br J Anaesth. 1 juin, vol.112, issue.6, pp.958-60, 2014.

Y. Lee, B. C. Song, and K. Yeum, Impact of Volatile Anesthetics on Oxidative Stress and Inflammation, BioMed Res Int, p.242709, 2015.

J. R. Mondoñedo, J. S. Mcneil, S. D. Amin, J. Herrmann, B. A. Simon et al., Volatile Anesthetics and the Treatment of Severe Bronchospasm: A Concept of Targeted Delivery

, Drug Discov Today Dis Models, vol.15, pp.43-50, 2015.

G. C. De-sousa, F. F. Cruz, L. B. Heil, C. Sobrinho, F. Saddy et al.,

M. Jabaudon, P. Boucher, E. Imhoff, R. Chabanne, J. Faure et al., Intraoperative immunomodulatory effects of sevoflurane versus total intravenous anesthesia with propofol in bariatric surgery (the OBESITA trial): study protocol for a randomized controlled pilot trial, Trials, vol.28, issue.2019

, Sevoflurane for Sedation in Acute Respiratory Distress Syndrome. A Randomized Controlled Pilot Study, Am J Respir Crit Care Med. 9 sept, vol.195, issue.6, pp.792-800, 2016.

A. Meiser, H. Bomberg, P. M. Lepper, F. C. Trudzinski, T. Volk et al., Inhaled Sedation in Patients With Acute Respiratory Distress Syndrome Undergoing Extracorporeal Membrane Oxygenation, Anesth Analg, vol.125, issue.4, p.1235, 2017.

J. Soukup, K. Schärff, K. Kubosch, C. Pohl, M. Bomplitz et al., State of the art: Sedation concepts with volatile anesthetics in critically Ill patients, J Crit Care. 1 déc, vol.24, issue.4, pp.535-579, 2009.

L. W. Sturesson, M. Bodelsson, A. Johansson, B. Jonson, and G. Malmkvist, Apparent Dead Space with the Anesthetic Conserving Device, AnaConDa®: A Clinical and Laboratory Investigation, Anesth Analg. déc, vol.117, issue.6, p.1319, 2013.

L. W. Sturesson, G. Malmkvist, M. Bodelsson, L. Niklason, and B. Jonson, Carbon dioxide rebreathing with the anaesthetic conserving device, AnaConDa ®, Br J Anaesth. août, vol.109, issue.2, pp.279-83, 2012.

H. Bomberg, F. Meiser, S. Zimmer, M. Bellgardt, T. Volk et al., Halving the volume of AnaConDa: initial clinical experience with a new small-volume anaesthetic reflector in critically ill patients-a quality improvement project, J Clin Monit Comput. août, vol.32, issue.4, pp.639-685, 2018.

R. Chabanne, S. Perbet, E. Futier, N. Said, S. Jaber et al.,

, Anesthetic Conserving Device on Respiratory Parameters and Work of Breathing in Critically Ill Patients under Light Sedation with Sevoflurane: Anesthesiology, vol.121, pp.808-824, 2014.

H. Bomberg, F. Meiser, P. Daume, M. Bellgardt, T. Volk et al., Halving the Volume of AnaConDa: Evaluation of a New Small-Volume Anesthetic Reflector in a Test Lung Model, Anesth Analg. mai, vol.1, 2018.

R. Farrell, G. Oomen, and P. Carey, A technical review of the history, development and performance of the anaesthetic conserving device "AnaConDa" for delivering volatile anaesthetic in intensive and post-operative critical care, J Clin Monit Comput. août, vol.32, issue.4, pp.595-604, 2018.

R. Arieli, Y. Daskalovic, O. Ertracht, Y. Arieli, Y. Adir et al., Flow resistance, work of breathing of humidifiers, and endotracheal tubes in the hyperbaric chamber, Am J Emerg Med. sept, vol.29, issue.7, pp.725-755, 2011.

P. Dubé, R. Blais, and N. Dubé, Bulletin d'information toxicologique, Toxicologie clinique, vol.28, p.20, 2012.

J. Herzog-niescery, H. Seipp, T. P. Weber, and M. Bellgardt, Inhaled anesthetic agent sedation in the ICU and trace gas concentrations: a review, J Clin Monit Comput. août, vol.32, issue.4, pp.667-75, 2018.

J. Herzog-niescery, H. Vogelsang, P. Gude, H. Seipp, W. Uhl et al.,

, Environmental safety: Air pollution while using MIRUS TM for short-term sedation in the ICU

, Acta Anaesthesiol Scand. janv, vol.63, issue.1, pp.86-92, 2019.

J. M. Boiano and A. L. Steege, Precautionary Practices for Administering Anesthetic Gases

, A Survey of Physician Anesthesiologists, Nurse Anesthetists and Anesthesiologist Assistants

, J Occup Environ Hyg, vol.13, issue.10, pp.782-93, 2016.

T. Pickworth, A. Jerath, R. Devine, N. Kherani, and M. W?sowicz, The scavenging of volatile anesthetic agents in the cardiovascular intensive care unit environment: a technical report, Can J Anesth Can Anesth. 1 janv, vol.60, issue.1, pp.38-43, 2013.

A. Lyazidi, A. W. Thille, G. Carteaux, F. Galia, L. Brochard et al., Bench test evaluation of volume delivered by modern ICU ventilators during volume-controlled ventilation, Intensive Care Med. 1 déc, vol.36, issue.12, pp.2074-80, 2010.

J. Arnal, A. Garnero, M. Saoli, and R. L. Chatburn, Parameters for Simulation of Adult Subjects During Mechanical Ventilation, Respir Care. févr, vol.63, issue.2, pp.158-68, 2018.

J. Thomas, M. Weiss, A. R. Schmidt, and P. K. Buehler, Performance of adjustable pressurelimiting (APL) valves in two different modern anaesthesia machines, Anaesthesia, vol.72, issue.1, pp.28-34, 2017.

R. L. Chatburn, E. Mireles-cabodevila, and M. Sasidhar, Tidal volume measurement error in pressure control modes of mechanical ventilation: A model study, Comput Biol Med. 1 août, vol.75, pp.235-277, 2016.

A. Dexter, N. Mcninch, D. Kaznoch, T. Volsko, H. Van-fleet et al., Evaluation of Functional Characteristics of 4 Oscillatory Positive Pressure Devices in a Simulated Cystic Fibrosis Model, Simul Healthc J Soc Simul Healthc. avr, vol.13, issue.2, pp.451-459, 2017.

J. B. West, A. M. Luks, and J. Pradel, Physiologie respiratoire: l'essentiel, 2017.

C. Guerin and J. Richard, Measurement of respiratory system resistance during mechanical ventilation, Intensive Care Med. 24 mai, vol.33, issue.6, pp.1046-1055, 2007.

, Acute Respiratory Distress Syndrome: The Berlin Definition, JAMA. 20 juin, vol.307, issue.23, pp.2526-2559, 2012.

J. Richard, Tables donnant les valeurs d'un volume courant (VT) de 6 ml/kg en fonction du poids idéal théorique, Réanimation. févr, vol.15, issue.1, pp.87-87, 2006.

, Recommandations pour la prise en charge du SDRA -La SFAR

, Société Française d'Anesthésie et de Réanimation, 2018.

L. Papazian, C. Aubron, L. Brochard, J. Chiche, A. Combes et al.,

E. , D. Sorbo, L. Goligher, E. C. Hodgson, C. L. Munshi et al., Management of early Acute Respiratory Distress Syndrome in adults, RFE SRLF, vol.34, 2018.

, of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome, Am J Respir Crit Care Med. 1 mai, vol.195, issue.9, pp.1253-63, 2017.

P. L. Silva and P. Rocco, The basics of respiratory mechanics: ventilator-derived parameters, Ann Transl Med, vol.21, 2018.

S. Jaber, M. Sebbane, G. Chanques, and J. Eledjam, Pression expiratoire positive et pression expiratoire positive intrinsèque dans les modes ventilatoires assistés, Réanimation. févr, vol.15, issue.1, pp.81-87, 2006.

R. H. Kallet, H. Zhuo, K. Ho, M. S. Lipnick, A. Gomez et al., Lung Injury Etiology and Other Factors Influencing the Relationship Between Dead-Space Fraction and Mortality in ARDS. Respir Care, vol.62, pp.1241-1249, 2017.

M. Ferluga, U. Lucangelo, and L. Blanch, Dead space in acute respiratory distress syndrome

A. Volta, C. A. Alvisi, V. Petrini, S. Zardi, S. Marangoni et al., Disponible sur, vol.6, 2018.

, Volatile Anesthetics on Respiratory System Resistance in Patients with Chronic Obstructive Pulmonary Disease, Anesth Analg. févr, vol.100, issue.2, pp.348-53, 2005.

J. J. Marini and S. Jaber, Dynamic predictors of VILI risk: beyond the driving pressure
URL : https://hal.archives-ouvertes.fr/hal-01781322

, Intensive Care Med, vol.42, issue.10, pp.1597-600, 2016.

A. Protti, M. Cressoni, A. Santini, T. Langer, C. Mietto et al., Lung Stress and Strain during Mechanical Ventilation: Any Safe Threshold?, Am J Respir Crit Care Med. 15 mai, vol.183, issue.10, pp.1354-62, 2011.

S. Neto, A. Deliberato, R. O. Johnson, A. Bos, L. D. Amorim et al.,

, Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts, Intensive Care Med. nov, vol.44, issue.11, pp.1914-1936, 2018.

L. Gattinoni, T. Tonetti, M. Cressoni, P. Cadringher, P. Herrmann et al.,

, Ventilator-related causes of lung injury: the mechanical power, Intensive Care Med, vol.42, issue.10, pp.1567-75, 2016.

C. S. Samary, P. L. Silva, M. Gama-de-abreu, P. Pelosi, and P. Rocco, Ventilator-induced Lung Injury: Power to the Mechanical Power, Anesthesiology, vol.125, issue.5, pp.1070-1071, 2016.

M. Cressoni, M. Gotti, C. Chiurazzi, D. Massari, I. Algieri et al., Mechanical Power and Development of Ventilator-induced Lung Injury, Anesthesiol J Am Soc Anesthesiol. 1 mai, vol.124, issue.5, pp.1100-1108, 2016.

T. Becher and M. Van-der-staay, Calculation of mechanical power for pressure-controlled ventilation: author's reply. Intensive Care Med, vol.20

D. Sur,

A. Protti, D. T. Andreis, M. Milesi, G. E. Iapichino, M. Monti et al., Lung anatomy, energy load, and ventilator-induced lung injury, Intensive Care Med Exp, 2015.

A. Medicine, . Turkey, M. Turktan, and E. Gulec,

. Serment-d&apos;hippocrate,

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