Search Results
Results 451 - 500 of 1350
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Donaldson L - - 2003
We measured oxygen consumption using a new noninvasive modular metabolic monitor, M-COVX trade mark, in ventilated critically ill patients. Oxygen consumption was measured continuously as part of routine monitoring for up to 24 h following mechanical ventilation in 27 patients admitted to a general intensive care unit. We explored several ...
Walker P P - - 2003
Morquio's disease is a metabolic disorder that can cause various respiratory abnormalities. Patients who live into adulthood are likely to develop upper airway problems and respiratory failure. With advances in home ventilation, these patients are increasingly likely to be referred to specialist respiratory units. We describe our experiences with two ...
Lanini Barbara - - 2003
Owing to difficulties in measuring ventilation symmetry, good evidence of different right/left respiratory movements has not yet been provided. We investigated VT differences between paretic and healthy sides during quiet breathing, voluntary hyperventilation, and hypercapnic stimulation in patients with hemiparesis. We studied eight patients with hemiparesis and nine normal sex- ...
Li Jia - - 2003
OBJECTIVE: To determine the validity of predictive equations in calculating oxygen consumption (Vo(2)) in ventilated patients with congenital heart disease. DESIGN: Prospective study. SETTING: Cardiac catheterization laboratories and intensive care units of two university teaching hospitals. PATIENTS: A total of 126 patients with congenital heart disease were studied. Of these, ...
Baigel G - - 2003
The management of six awake, spontaneously breathing patients with acute severe asthma who responded to a subanesthetic dose of an inhalational agent is described. All of these patients were on maximal medical treatment, the next intervention likely to be tracheal intubation and mechanical ventilation in the face of further deterioration. ...
Boyer Alexandre - - 2003
OBJECTIVE: To determine whether use of a hygroscopic heat and moisture exchanger (HME) for 48 hrs without change affects its efficiency and the level of bacterial colonization in long-term mechanically ventilated medical intensive care unit patients. DESIGN: Prospective, randomized clinical study evaluating two hygroscopic HMEs. SETTING: Medical intensive care unit ...
Pea Laurent - - 2003
Massive hemoptysis in patients with severe leptospirosis is often resistant to conventional therapies and can rapidly become fatal. Desmopressin is a fast-acting blood-saving agent used in various hereditary and acquired clotting disorders. We used desmopressin infusions to treat massive pulmonary hemorrhage in six leptospirosis patients with respiratory failure, shock, and ...
Bulpa P A - - 2003
The aim of this study was to evaluate the safety and diagnostic yield of bedside bronchoalveolar lavage (BAL) combined with fibrescopic transbronchial lung biopsy (TBLB) in determining the aetiology of pulmonary infiltrates in mechanically ventilated patients. The records of 38 mechanically ventilated patients who underwent BAL/TBLB to investigate unexplained pulmonary ...
Nakos G - - 2003
OBJECTIVE: Surfactant offers protection against alveolar collapse and contributes to the local defense mechanism, but it is unclear if surfactant alterations have a role in the development of atelectasis or ventilator-associated pneumonia (VAP). The present study was undertaken to monitor surfactant, as well as biochemical BAL fluid alterations, during the ...
Gonzalez Jesus - - 2003
OBJECTIVE: This study investigated whether air leaks from the upper airway during assisted ventilatory support are associated with persistent hypercapnia (PaCO(2) >45 mmHg) in patients with neuromuscular disorders. SETTING: A rehabilitation hospital. PATIENTS: The study was performed in 95 neuromuscular patients; 52 were tracheostomized with a cuffless tracheostomy tube (invasive ...
Boyce James Ronald - - 2003
BACKGROUND: Hypoxemia during the induction of general anesthesia for the morbidly obese patient is a major concern of anesthesiologists. The etiology of this pathophysiological problem is multifactorial, and patient positioning may be a contributing factor. The present study was designed to identify optimal patient positioning for the induction of general ...
Levy Bruno - - 2003
CONTEXT: Contrary to tonometer gastric intramucosal pH, there is currently no validated threshold prognostic value for Pco2 gap (tonometer gastric mucosal Pco2 minus arterial Pco2) in the critically ill patient. OBJECTIVE: To demonstrate a relationship between Pco2 gap and mortality in mechanically ventilated patients. DESIGN AND SETTING: Inception cohort study ...
Kwok Henry - - 2003
OBJECTIVE: Noninvasive positive pressure techniques such as continuous and bilevel positive airway pressure avoid intubation and its attendant complications in selected patients with acute respiratory failure. However, mask intolerance remains a common cause for failure of noninvasive ventilatory techniques. The aim of our study was to assess patient tolerance of ...
Lim Chae-Man - - 2003
OBJECTIVE: To assess how the level of positive end-expiratory pressure (PEEP) (antiderecruitment strategy), etiological category of diffuse lung injury, and body position of the patient modify the effect of the alveolar recruitment maneuver (ARM) in acute respiratory distress syndrome (ARDS). DESIGN: Prospective clinical trial. SETTING: Medical intensive care unit at ...
Molnár Zsolt - - 2003
OBJECTIVE: To investigate the correlation between microalbuminuria and extravascular lung water in patients in septic shock who require mechanical ventilation for severe respiratory failure. DESIGN AND SETTING: Prospective, observational, clinical study in the 20-bed intensive care unit of a university hospital. PATIENTS AND PARTICIPANTS: 25 consecutive patients in septic shock ...
Janssens Jean-Paul - - 2003
STUDY OBJECTIVES: To describe a 7-year follow-up (1992 to 2000) of patients who were treated by home nasal positive-pressure ventilation (NPPV) for chronic hypercapnic respiratory failure. DESIGN: Prospective descriptive study. SETTING: Two university hospitals and a pulmonary rehabilitation center. PATIENTS: Two hundred eleven patients with obstructive pulmonary disorders (58 patients) ...
O'Riordan T G - - 2003
The clinical course of patients undergoing prolonged mechanical ventilation is often complicated by the development of purulent tracheobronchitis. The purpose of this study was to assess whether ventilator-associated hypersecretion is associated with elevated levels of tissue kallikrein (TK) activity. TK can induce marked bronchial inflammation in animal models and TK ...
Lundy C T - - 2003
Inborn errors of metabolism have not previously been recognized as a risk factor for acute respiratory distress syndrome (ARDS). We report this complication in four patients with defects of the mitochondrial trifunctional protein (MTP). This enzyme catalyses three steps in the beta-oxidation of long-chain fatty acids. Three of the patients ...
Rishavy Thomas J - - 2003
Previously reported patients with a bridging bronchus (BB) presented with respiratory distress. In addition, each patient had one or more associated anomalies. All but two patients progressed to cardiopulmonary failure and death. We describe a case of an anterior BB without associated anomalies, who did well without operative intervention. This ...
Yosefy Chaim - - 2003
BACKGROUND: Noninvasive ventilatory support (NIVS) is intended to provide ventilatory assistance for a wide range of respiratory disturbances. The use of NIVS for treatment of respiratory distress may be applicable in the emergency department (ED). It may prevent endotracheal intubation and, likewise, may favorably influence the course of the patient's ...
Barberis Luigi - - 2003
OBJECTIVE: To compare the values of plateau pressure (Pplat) recorded at different times after end-inspiratory occlusion and those of static elastance (Est,rs) and total resistance (Rrs) of the respiratory system. DESIGN: Physiological study. SETTING: Medical intensive care unit of a university hospital. PATIENTS: Eleven patients with ARDS and ten patients ...
Matthay Michael A - - 2002
Experimental methods to quantify alveolar fluid clearance have been adapted for our studies in patients with acute lung injury (ALI) or ARDS. We recently completed a study of 79 patients with ALI/ARDS that was designed to examine alveolar fluid clearance in the setting of alveolar epithelial injury from ALI/ARDS. Pulmonary ...
Antonaglia Vittorio - - 2002
OBJECTIVE: In mechanically ventilated patients a high fraction of the pressure can be dissipated to overcome the viscoelastic components of the respiratory system. Recently it was demonstrated that sigh improved oxygenation in mechanically ventilated ARDS patients. We evaluated if, in acute lung injury (ALI) patients, the sigh can be used ...
Foley David S - - 2002
Between May 1990 and January 1999, 100 patients (68 adult, 32 pediatric) with severe respiratory or cardiac instability were successfully transported to the University of Michigan Medical Center on extracorporeal life support. Diagnoses included adult respiratory distress syndrome (n = 78), cardiac failure (n = 7), sepsis (n = 7), ...
Laghi Franco - - 2003
Because patients who fail a trial of weaning from mechanical ventilation experience a marked increase in respiratory load, we hypothesized that these patients develop diaphragmatic fatigue. Accordingly, we measured twitch transdiaphragmatic pressure using phrenic nerve stimulation in 11 weaning failure and 8 weaning success patients. Measurements were made before and ...
Bunch T Jared - - 2002
The objectives of the study were to describe a novel presentation of tetanus and to review the course of the respiratory component and the treatment and management of the disease. A case report is presented with a review of a 25-year experience at Mayo Clinic. We describe the case of ...
Wunderink Richard G - - 2002
Ventilator-associated pneumonia (VAP) complicating the course of acute respiratory distress syndrome (ARDS) is one of the most challenging diagnostic and treatment dilemmas in critical care medicine. The VAP incidence rate ranges from 37 to 60% in ARDS patients, significantly greater than for other causes of respiratory failure. Although the normal ...
Schneir Aaron B - - 2002
OxyContin (oxycodone hydrochloride controlled release) is a long-acting preparation of oxycodone that is used as an opioid analgesic to treat chronic pain conditions. We report a patient who ingested a massive quantity of OxyContin and had altered mental status, noncardiogenic pulmonary edema, and hypoventilation that proved refractory to naloxone administration. ...
Zahar J R - - 2002
There are few data on Pneumocystis carinii pneumonia (PCP) in critically ill human immunodeficiency virus (HIV)-negative patients. Improved knowledge of the presenting symptoms of and prognostic factors for PCP may help to reduce the high mortality rate associated with PCP in such patients. We retrospectively studied 39 consecutive patients with ...
Heyland Daren K - - 2002
OBJECTIVE: To evaluate the current use of strategies to prevent ventilator-associated pneumonia (VAP) and to identify interventions to target for quality-improvement initiatives. DESIGN: Cross-sectional national survey. SETTING: Canadian intensive care units (ICUs) with at least 8 beds. PATIENTS: Seven hundred and two patients in 66 ICUs in 10 provinces in ...
Fraund S - - 2002
We were interested whether immediate postoperative extubation and early discharge of the intensive care unit (ICU) is safe in minimally invasive direct coronary artery surgery (MIDCAB) patients. Therefore we retrospectively analyzed the data from 217 patients undergoing MIDCAB from 2/99 to 4/02. Immediate postoperative extubation was possible in 182/217 (83.9%) ...
Hendra Katherine - - 2002
Long-term MV, delivered by way of a tracheostomy or noninvasive mask, often is indicated in patients with restrictive or neuromuscular pulmonary diseases and occasionally in patients with severe obstructive hypercapnic respiratory failure. Regardless of the mode of ventilation, respiratory physiology seems to be significantly impacted in these patients. Although the ...
Powell Lisa L - - 2002
There are many causes of respiratory failure in veterinary patients. Assessment of oxygenation is imperative for the diagnosis and monitoring of these patients. Oxygen therapy should be instituted when hypoxemia is diagnosed to prevent tissue hypoxia, end-organ damage, and death. Methods of administering oxygen include commercial oxygen cages, mask oxygen, ...
Thys F - - 2002
The aim of the present study was to clarify whether the known effects of noninvasive positive-pressure ventilation (NPPV) in patients with respiratory failure are real or due to placebo effects and whether early application of NPPV in the emergency department leads to rapid improvement of the patients condition and outcome. ...
Wedzicha J A - - 2002
Although long-term oxygen therapy (LTOT) improves survival, it has little effect on hypoventilation and other outcomes in patients with hypercapnic respiratory failure due to chronic obstructive pulmonary disease (COPD). Recent studies have shown that the use of noninvasive positive-pressure ventilation, when used in combination with LTOT in selected stable COPD ...
Parikh Shital N - - 2002
Sleep apnea syndrome (SAS) is a condition of repeated episodes of apnea and hypopnea during sleep. It can cause life-threatening morbidities, including cardiac arrhythmia and ischemia, hypertension, and respiratory arrest, and even death. In a retrospective study at our institution of patients who underwent hip or knee total joint arthroplasty ...
Lee David Lin - - 2002
OBJECTIVES: Prone-position ventilation (PPV) induces acute improvement in oxygenation in many patients with acute respiratory distress syndrome (ARDS), with some maintaining their oxygenation even after they were returned to the supine position, but it is unclear what clinical factors determine the sustained oxygenation benefit. We hypothesized that patients with ARDS ...
Roblot F - - 2002
The aim of this retrospective study was to determine the underlying diseases associated with Pneumocystis carinii pneumonia (PCP) in immunocompromised HIV-negative patients and to identify prognosis factors in this population. One hundred three cases of PCP were diagnosed over a 5-year period. Diagnosis was established on the basis of clinical ...
Nakos George - - 2002
OBJECTIVE: To evaluate the local immune status in patients with severe trauma and the influence of interferon-gamma on patients with immunoparalysis. PATIENTS: Fifty-two mechanically ventilated patients with severe multiple trauma. SETTING: A 14-bed polyvalent intensive care unit. INTERVENTIONS: The local immune status was evaluated by examining bronchoalveolar lavage fluid. Subsequently, ...
Yende Sachin - - 2002
STUDY OBJECTIVE: To evaluate causes of failure to be extubated (FTE) after coronary artery bypass graft (CABG) surgery. DESIGN: Prospective observational study. SETTING: Cardiovascular surgical ICU. PATIENTS: Four hundred patients undergoing CABG surgery. Following surgery, patients were extubated by a standardized respiratory protocol and were assessed at 8, 24, and ...
Yende Sachin - - 2002
STUDY OBJECTIVE: Two scoring systems, (the Spivack scoring system [SSS] and the cardiac risk score [CRS]), have been proposed to predict the risk of prolonged mechanical ventilation (PMV) after coronary artery bypass graft surgery (CABG). The primary objective of this study was to validate the efficacy of these scoring systems ...
Sasajima Koji - - 2002
BACKGROUND: The circulating level of soluble L-selectin (sL-selectin) has been reported to be low in adult respiratory distress syndrome and acute lung injury. This study explores the role of L-selectin in the development of ventilator-associated pneumonia (VAP) in patients undergoing major surgery. PATIENTS AND METHODS: Thirty-four patients who underwent esophagectomy ...
Stüber F - - 2002
OBJECTIVE: To investigate the kinetic and reversibility of mechanical ventilation-associated pulmonary and systemic inflammatory response in patients with acute lung injury (ALI). DESIGN: Prospective observational cross-over study. SETTING: Intensive care unit of a university hospital. PATIENTS: Twelve mechanically ventilated patients with ALI. INTERVENTIONS: Mechanical ventilation was transiently changed from a ...
Rialp Gemma - - 2002
Acute respiratory distress syndrome (ARDS) is a severe form of respiratory failure that is characterized by marked hypoxemia, bilateral infiltrates on chest radiograph, and no clinical evidence of left ventricular failure. Mechanical ventilation with positive end-expiratory pressure (PEEP) is a cornerstone therapy for ARDS patients. Because the fundamental aim of ...
Moran J L - - 2002
OBJECTIVE: To determine the variables predicting the change of plasma phosphate over the first 24 hr period in intensive care in patients with acute respiratory failure. METHODS: Fifty-seven patients were studied prospectively in a university teaching hospital intensive care unit (ICU). Thirty two patients were classified as having acute respiratory ...
Hickling Keith G - - 2002
There has been increasing recognition that mechanical ventilation can cause acute parenchymal lung injury (ventilator-induced lung injury, or VILI) in addition to the more widely recognized forms of barotrauma. Furthermore, in patients with acute lung injury, this type of injury may cause considerable morbidity and mortality. Subsequently, the goals of ...
Tong Yanling - - 2002
In earlier work, the research group successfully used artificial neural networks (ANNs) to estimate ventilation duration for adult intensive care unit (ICU) patients. The ANNs performed well in terms of correct classification rate (CCR) and average squared error (ASE) classifying the outcome into two classes: whether patients were ventilated for ...
Mortelliti Michael P - - 2002
Acute respiratory distress syndrome is the clinical manifestation of severe, acute lung injury. It is characterized by the acute onset of diffuse, bilateral pulmonary infiltrates secondary to noncardiogenic pulmonary edema, refractory hypoxia, and decreased lung compliance. Acute respiratory distress syndrome occurs most frequently in the setting of sepsis, aspiration of ...
Heggen Judith - - 2002
OBJECTIVE: Diffuse alveolar hemorrhage (DAH) is defined as a syndrome of hypoxia, dyspnea, infiltrates on chest radiograph, and bloody fluid on successive bronchoalveolar lavages without apparent infection. Minimal experience has been reported with DAH after hematopoietic cell transplant (HCT) in children. We reviewed the incidence, management and outcome of DAH ...
Kularatne S A M - - 2002
Common krait (Bungarus caeruleus) is the deadliest snake found commonly in the dry zone of Sri Lanka. In Anuradhapura, 210 farmers bitten by the common krait over a three year period were investigated prospectively from 1 January 1996. The sex ratio was equal, 110 (52%) patients were in the age ...
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