Search Results
Results 451 - 500 of 1427
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Nagano O - - 2001
BACKGROUND: In lung protective strategy, positive end-expiratory pressure (PEEP) slightly higher than the Pflex (the airway pressure corresponding to the lower inflection point (LIP) on the inspiratory pressure-volume (P-V) curve measured with ZEEP) is generally recommended. However, this method to determine optimal PEEP lacks a theoretical background and there is ...
Huang C C - - 2001
BACKGROUND: In patients with acute respiratory distress syndrome, whether inverse ratio ventilation differs from high positive end-expiratory pressure (PEEP) for gas exchange under a similar mean airway pressure has not been adequately examined. The authors used arterial oxygenation, gastric intramucosal partial pressure of carbon dioxide (PiCO(2)), and pH (pHi) to ...
Slinger P D - - 2001
BACKGROUND: Positive end-expiratory pressure (PEEP) is commonly applied to the ventilated lung to try to improve oxygenation during one-lung ventilation but is an unreliable therapy and occasionally causes arterial oxygen partial pressure (PaO(2)) to decrease further. The current study examined whether the effects of PEEP on oxygenation depend on the ...
Rotta A T - - 2001
OBJECTIVE: To determine the impact of different protective and nonprotective mechanical ventilation strategies on the degree of pulmonary inflammation, oxidative damage, and hemodynamic stability in a saline lavage model of acute lung injury. DESIGN: A prospective, randomized, controlled, in vivo animal laboratory study. SETTING: Animal research facility of a health ...
Hess D R - - 2001
Many acute and chronic respiratory diseases are associated with increased respiratory secretions in the airways. Narrative reviews and a few systematic reviews of secretion clearance techniques have been published. These reviews raise concerns regarding the lack of evidence to support the various secretion clearance techniques. I conducted a comprehensive MEDLINE ...
Mancini M - - 2001
To investigate the mechanisms underlying improvement of arterial oxygenation during a protective ventilatory strategy (PVS) in early acute respiratory distress syndrome (ARDS), we studied eight patients during volume-controlled mechanical ventilation, keeping respiratory rate and fraction of inspired oxygen (FI(O(2))) (0.82 +/- 0.20) unchanged: (1) at baseline (tidal volume [VT] 10 ...
Imai Y - - 2001
This study compared pathophysiological and biochemical indexes of acute lung injury in a saline-lavaged rabbit model with different ventilatory strategies: a control group consisting of moderate tidal volume (V(T)) (10-12 ml/kg) and low positive end-expiratory pressure (PEEP) (4-5 cmH(2)O); and three protective groups: 1) low V(T) (5-6 ml/kg) high PEEP, ...
Ruiz-Ferrón F - - 2001
OBJECTIVE: To compare the measurements of total resistance and dynamic elastance determined by different techniques of respiratory mechanics analysis based on the time or frequency domains. DESIGN: Prospective study. SETTING: A 12-bed medical and surgical intensive care unit in a 700-bed university hospital. PATIENTS: Eighteen sedoparalyzed patients who needed controlled ...
Kong W - - 2001
OBJECTIVE: To choose one optimal extrinsic positive end-expiratory pressure (PEEPe) for ventilated patients with chronic obstructive pulmonary disease (COPD) and to compare two methods for choosing the optimal level of PEEPe. METHODS: Ten ventilated patients with COPD were included in the study. First, static intrinsic positive end-expiratory pressure (PEEPi, st) ...
Magder S - - 2001
PURPOSE: The purpose of this study was to determine whether the pattern of respiratory variation in right atrial pressure (Pra) predicts the cardiac output response to positive end-expiratory pressure (PEEP). MATERIALS AND METHODS: We studied 18 patients with a variety of cardiac and pulmonary disorders requiring ventilatory support. A pulmonary ...
Georgiadis D - - 2001
BACKGROUND AND PURPOSE: We undertook this study to evaluate the influence of positive end-expiratory pressure (PEEP) on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with acute stroke. METHODS: A total of 20 ventilated patients of a neurological intensive care unit were examined under a protocol entailing variation ...
Maggiore S M - - 2001
We examined the hypothesis that recording multiple elastic pressure-volume (Pel/V) curves and calculating alveolar derecruitment (V(DER)) induced by decreasing positive end-expiratory pressure (PEEP) may allow determination of alveolar closing pressures, thus helping to select the optimal PEEP level. V(DER) measured in 16 patients with acute lung injury (ALI) was compared ...
Overfield D M - - 2001
BACKGROUND/PURPOSE: The aim of this study was to compare the effect of positive end-expiratory pressure (PEEP) application on hemodynamics, lung mechanics, and oxygenation in the intact newborn lung during conventional ventilation (CV) and partial liquid ventilation (PLV) at functional residual capacity (FRC). CV or PLV modes of ventilation do not ...
De Robertis E - - 2001
OBJECTIVE: In acute lung injury (ALI) mechanical ventilation damages lungs. We hypothesised that aspiration and replacement of dead space during expiration (ASPIDS) allows normocapnic ventilation at higher end-expiratory pressure (PEEP) and reduced tidal volume (V(T)), peak and plateau pressures (Paw(peak), Paw(plat)), thus avoiding lung damage. SETTING: University Hospital. PATIENTS: Seven ...
Guérin C - - 2001
This study aimed to investigate the effect of increased lung volume with positive end-expiratory pressure (PEEP) on respiratory resistance in patients with chronic obstructive pulmonary disease (COPD). Ten patients with COPD were mechanically ventilated for acute respiratory failure. PEEP was set at 0, 5, 10 and 15 cm H2O. Using ...
Fujino Y - - 2001
OBJECTIVE: To compare the effects of two different recruitment maneuvers repeated multiple times on gas exchange lung injury, hemodynamic, and lung mechanics. DESIGN: Randomized prospective comparison. SETTINGS: Animal research laboratory. SUBJECT: Nineteen fasted Hampshire sheep. INTERVENTIONS: In 15 27-kg sheep with saline lavage lung injury, we compared the effects of ...
Chou N K - - 2001
Adult respiratory distress syndrome (ARDS) has been the major cause of mortality in burn injury. The authors reported the experience of using extracorporeal membrane oxygenation (ECMO) to treat adult burn patient with ARDS. Three patients with burn or electric injury, around 48.9% of body surface area over second-degree burns, developed ...
Kárason S - - 2001
OBJECTIVE: We present a concept of on-line, manoeuvre-free monitoring of respiratory mechanics during dynamic conditions, displaying calculated alveolar pressure/volume curves continuously and separating lung and chest wall mechanics. DESIGN: Prospective observational study. SETTING: Intensive care unit of a university hospital. PATIENTS: Ten ventilator-treated patients with acute lung injury. INTERVENTIONS: Different ...
McCann U G UG - - 2001
BACKGROUND: Positive end-expiratory pressure (PEEP) reduces ventilator-induced lung injury (VILI), presumably by mechanically stabilizing alveoli and decreasing intrapulmonary shear. Although there is indirect support for this concept in the literature, direct evidence is lacking. In a surfactant depletion model of acute lung injury we observed unstable alveolar mechanics referred to ...
Kong W - - 2001
OBJECTIVE: To investigate the effects of extrinsic positive end-expiratory pressure (PEEPe) on work of breathing in patients with chronic obstructive pulmonary disease (COPD) and their corresponding mechanism. METHODS: Ten ventilated patients with COPD were included in the study. A Bicore CP-100 pulmonary monitor (Bicore Monitoring System, USA) was used for ...
Solsona J F - - 2001
The purpose of this study was to determine whether auditory warnings in the intensive care unit (ICU) were properly adjusted. An intervention study (before- and-after assessment) was conducted in a 12-bed medical-surgical ICU of an acute-care teaching hospital in Barcelona, Spain. A total of 100 patients with stable haemodynamic and ...
Rauh R - - 2001
STUDY OBJECTIVE: To investigate the influence of pneumoperitoneum (PP) and posture on respiratory compliance and ventilation pressures. DESIGN: Prospective, single blind trial. PATIENTS: 10 female ASA physical status I and II patients scheduled for elective gynecologic laparoscopy. SETTING: University medical center. INTERVENTIONS: Anesthesia was performed as total IV anesthesia (TIVA) ...
Adams A B - - 2001
INTRODUCTION: A lower inflection point, an upper inflection (or deflection) point, and respiratory system compliance can be estimated from an inspiratory static pressure-volume (SPV) curve of the respiratory system. Such data are often used to guide selection of positive end-expiratory pressure (PEEP)/tidal volume combinations. Dynamic pressure-volume (DPV) curves obtained during ...
Sanders R C RC - - 2001
The purpose of this study was to compare the work of breathing during pressure support ventilation (PSV) with positive end expiratory pressure (PEEP) utilizing the Siemens SV300 (SV300) and Dräger Evita 4 (EV4) ventilators. Our hypothesis was that patients' work of breathing (WOB(P)) would be unchanged in PSV utilizing flow ...
Crotti S - - 2001
In a model of acute lung injury, we showed that positive end-expiratory pressure (PEEP) and tidal volume (VT) are interactive variables that determine the extent of lung recruitment, that recruitment occurs across the entire range of total lung capacity, and that superimposed pressure is a key determinant of lung collapse. ...
Pelosi P - - 2001
We aimed to elucidate the relationships between pleural (Ppl), esophageal (Pes), and superimposed gravitational pressures in acute lung injury, and to understand the mechanisms of recruitment and derecruitment. In six dogs with oleic acid respiratory failure, we measured Pes and Ppl in the uppermost, middle, and most dependent lung regions. ...
Richard J C - - 2001
Both reduction in tidal volume (VT) and alveolar recruitment may be important to limit ventilator-associated lung injury during mechanical ventilation of patients with the acute respiratory distress syndrome (ARDS). The aim of this study was to assess the risk of alveolar derecruitment associated with VT reduction from 10 to 6 ...
Lim C M - - 2001
OBJECTIVE: To devise a new form of sigh ("extended sigh") capable of providing a sufficient recruiting pressure x time, and to test it as a recruitment maneuver in patients with acute respiratory distress syndrome. DESIGN: Prospective uncontrolled clinical trial. SETTING: Medical intensive care unit of a university-affiliated hospital. PATIENTS: Twenty ...
Finer N N - - 2001
BACKGROUND: There are a variety of manual bagging devices used for neonatal resuscitation. To our knowledge, there has been no comparison of the ability of different operators to utilize such devices for the delivery of predetermined inspiratory and end-expiratory pressures. In addition, the use of prolonged inflation may be of ...
Fauchère J C - - 2001
Although the lungs and pericardium constrain the heart and limit cardiac output, no method exists to assess this constraint in sick newborns. We hypothesize that a useful estimate of ventricular constraint may be obtained by measuring right atrial pressure (P(RA)) in the newborn. To test this hypothesis, we measured P(RA), ...
Schmitt J M - - 2001
OBJECTIVE: Positive end-expiratory pressure (PEEP) titration in acute respiratory distress syndrome patients remains debatable. We used two mechanical approaches, calculation of the compliance of the respiratory system and determination of the lower inflexion point of the pressure-volume curve of the respiratory system, to identify specific PEEPs (PEEPS and PEEPA) whose ...
Goddon S - - 2001
BACKGROUND: A number of groups have recommended setting positive end-expiratory pressure during conventional mechanical ventilation in adults at 2 cm H2O above the lower corner pressure (P(CL)) of the inspiratory pressure-volume (P-V) curve of the respiratory system. No equivalent recommendations for the setting of the mean airway pressure (Paw) during ...
Wigder H N - - 2001
We assessed cardiogenic pulmonary edema (CPE) patient response to full mask pressure support noninvasive positive pressure ventilation (NPPV). Adult patients presenting to the emergency department (ED) in acute respiratory failure who clinically required endotracheal intubation (ETI) were studied. In addition to routine therapy consisting of oxygen, nitrates, and diuretics, patients ...
Bolivar J - - 2001
We continuously measured proximal and carinal pressures at low and high flow rates and frequencies during conventional mechanical ventilation (CMV) and intratracheal pulmonary ventilation (ITPV), using an artificial lung. The proximal peak inspiratory pressure (PIP), carinal PIP, proximal positive end expiratory pressure (PEEP), and carinal PEEP, or negative end expiratory ...
Laghi F - - 2001
Decreases in ventilator inflation time (TI,vent) can cause tachypnea, probably as a response to lung inflation. The response may differ in chronic obstructive pulmonary disease (COPD) because time-constant inhomogeneities could foster overdistention of some lung units during early inflation, causing neural inspiratory time to be shorter than in healthy subjects. ...
JedliƄska B - - 2001
Evaluation of splanchnic perfusion and oxygenation was performed by measurements of serosal tissue oxygen tension (PserO2) and intramucosal pH (pHi) in relation to subcutaneous oxygen tension (PscO2), subcutaneous carbon dioxide tension (PscCO2) and subcutaneous pH (pHsc) in pigs subjected to oleic acid-induced lung injury during ventilation with increasing levels of ...
Kaczka D W - - 2001
Frequency-dependent characteristics of lung resistance (RL) and elastance (EL) are sensitive to different patterns of airway obstruction. We used an enhanced ventilator waveform (EVW) to measure inspiratory RL and EL spectra in ventilated patients during thoracic surgery. The EVW delivers an inspiratory flow waveform with enhanced spectral excitation from 0.156 ...
Hardaway R M - - 2001
Adult respiratory distress syndrome (ARDS) has a high mortality. Its only effective treatment is respiratory therapy. If this fails mortality is probably 100 per cent. No other treatment for ARDS has proved effective including "magic bullets." Twenty patients suffering from ARDS secondary to trauma and/or sepsis failed to respond to ...
Pommel L - - 2001
The purpose of this study was to evaluate the influence of the measurement time and the pressure on the outcome of a fluid filtration test. Thirty-six roots were prepared with a Profile device and filled with Thermafil. The leakage along the filling material was recorded under a 15 cm H2O ...
Voelckel W G - - 2001
The use of an inspiratory impedance threshold valve (ITV) during active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) improves perfusion pressures, and vital organ blood flow. We evaluated the effects of positive end-expiratory pressure (PEEP) on gas exchange, and coronary perfusion pressure gradients during ACD + ITV CPR in a porcine cardiac ...
Tsen L C - - 2001
STUDY OBJECTIVES: To evaluate estrogen-induced alternations in noxious stimuli response. DESIGN: Randomized, prospective, double-blind study. SETTINGS: Tertiary-care academic medical center. PATIENTS: 40 ASA physical status I and II women at the beginning and conclusion of an in vitro fertilization stimulation cycle. INTERVENTIONS: Stimuli were applied to the fingers of the ...
Stenqvist O - - 2001
BACKGROUND: Closed system suctioning, CSS, has been advocated to avoid alveolar collapse. However, ventilator manufacturers indicate that extreme negative pressure levels can be obtained during closed system suctioning, impeding the performance of the ventilator. METHODS: Suctioning with a 12 or 14 Fr catheter with a vacuum level of -50 kPa ...
Mols G - - 2001
OBJECTIVE: Volume-dependent alterations of lung compliance are usually studied over a very large volume range. However, the course of compliance within the comparably small tidal volume (intratidal compliance-volume curve) may also provide relevant information about the impact of mechanical ventilation on pulmonary gas exchange. Consequently, we determined the association of ...
Hickling K G - - 2001
A mathematical model of the acute respiratory distress syndrome (ARDS) lung, incorporating simulated gravitational superimposed pressure and alveolar opening and closing pressures, was used to study the mean tidal pressure-volume (PV) slope ("effective compliance") during incremental and decremental positive end-expiratory pressure (PEEP) trials with constant tidal volume (VT) "ventilation." During ...
Uchida T - - 2001
OBJECTIVE: To investigate the regional partial pressure of oxygen (PO2) and partial pressure of carbon dioxide (PCO2) of the perfluorocarbon liquid (PpfcO2, PpfcCO2) during partial liquid ventilation (PLV). DESIGN: Prospective, controlled study. SETTING: A research laboratory at a university medical center. SUBJECTS: Thirteen Japanese white rabbits. INTERVENTIONS: After the tracheostomy, ...
Khirani S - - 2001
Patients suffering from chronic obstructive pulmonary diseases, frequently exhibit expiratory airflow limitation. We propose a mathematical model describing the mechanical behavior of the ventilated respiratory system. This model has to simulate applied positive end-expiratory pressure (PEEP) effects during expiration, a process used by clinicians to improve airflow. The proposed model ...
Mercat A - - 2001
OBJECTIVE: To assess the short-term effects of extending inspiratory time by lengthening end-inspiratory pause (EIP) without inducing a clinically significant increase in intrinsic positive end-expiratory pressure (PEEPi) in patients with acute respiratory distress syndrome (ARDS). DESIGN: Controlled, randomized, crossover study. SETTING: Two medical intensive care units of university hospitals. PATIENTS: ...
Huang C C - - 2001
OBJECTIVE: Gastric intramucosal PCO2 (PiCO2) and pH (pHi) are currently used as indices of the adequacy of splanchnic perfusion and as end points to guide therapeutic intervention. However, little is known about their spontaneous variability over time. The present study was designed to define the magnitude of spontaneous variability of ...
Tryfon S - - 2001
BACKGROUND: It has been suggested that the Hering-Breuer reflex (HBR) is unimportant in adults during normal tidal breathing and that it is elicited only if tidal volume is increased above a certain critical threshold. OBJECTIVE: The aim of this study was (1) to study the occurrence of the HBR in ...
Kallet R H - - 2001
BACKGROUND: Current ventilator management for acute respiratory distress syndrome (ARDS) incorporates low tidal volume (V(T)) ventilation in order to limit ventilator-induced lung injury. Low V(T) ventilation in supine patients, without the use of intermittent hyperinflations, may cause small airway closure, progressive atelectasis, and secretion retention. Use of high positive end-expiratory ...
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