Search Results
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Michard F - - 1999
In ventilated patients with acute lung injury (ALI) we investigated whether respiratory changes in arterial pulse pressure (DeltaPP) could be related to the effects of PEEP and fluid loading (FL) on cardiac index (CI). Measurements were performed before and after application of a PEEP (10 cm H2O) in 14 patients. ...
Weiss Y G - - 1999
Fluid management in patients following blast injury is a major challenge. Fluid overload can exacerbate pulmonary dysfunction, whereas suboptimal resuscitation may exacerbate tissue damage. In three patients, we compared three methods of assessing volume status: central venous (CVP) and pulmonary artery occlusion (PAOP) pressures, left ventricular end-diastolic area (LVEDA) as ...
Chen R C - - 1999
Dynamic hyperinflation loads the inspiratory muscles by increasing end-expiratory lung volume (EELV) and imposing intrinsic positive end-expiratory pressure (PEEPi), the latter behaving as an inspiratory threshold load (ITL). The major purpose of this study was to describe the independent effects of the imposed ITL and changes in operating lung volume ...
Neumann P - - 1999
BACKGROUND: General anaesthesia impairs the gas exchange in the lungs, and moderate desaturation (SaO2 86-90%) occurred in 50% of anaesthetised patients in a blinded pulse oximetry study. A high FiO2 might reduce the risk of hypoxaemia, but can also promote atelectasis. We hypothesised that a moderate positive end-expiratory pressure (PEEP) ...
Pelosi P - - 1999
Mechanical ventilation with plateau pressure lower than 35 cm H2O and high positive end-expiratory pressure (PEEP) has been recommended as lung protective strategy. Ten patients with ARDS (five from pulmonary [p] and five from extrapulmonary [exp] origin), underwent 2 h of lung protective strategy, 1 h of lung protective strategy ...
Ruiz-Bailén M - - 1999
OBJECTIVE: To determine by the measurement of extravascular lung water (EVLW) whether the timing of positive-end expiratory pressure (PEEP) application influences the intensity of lung injury. DESIGN: Animal experimental study. SETTING: Animal experimental laboratory. SUBJECTS: Mixed-breed pigs (n = 18), aged 4 to 5 mos, weighing 25 to 30 kg. ...
Ducros L - - 1999
OBJECTIVE: Evaluation of the magnitude of pulmonary air trapping during routine thoracic surgery and single-lung transplantation. DESIGN: Prospective study on consecutive patients. SETTING: Single institution, university hospital. PARTICIPANTS: Sixteen patients with no or moderate obstructive lung disease undergoing routine thoracic surgery (group 1), six patients with severe emphysema (group 2), ...
Tusman G - - 1999
Abnormalities in gas exchange during general anaesthesia are caused partly by atelectasis. Inspiratory pressures of approximately 40 cm H2O are required to fully re-expand healthy but collapsed alveoli. However, without PEEP these re-expanded alveoli tend to collapse again. We hypothesized that an initial increase in pressure would open collapsed alveoli; ...
Serafini G - - 1999
The case series consisted of ten children, ranged in age from one to three years (median 1.8 yrs), and in body weight from 10.2 to 13.5 kg (median 11.7 kg), in ASA class 1 or 2, all without lung disease. Having undergone general anaesthesia for cranial or abdominal CT scans, ...
Kacmarek R M - - 1999
There is injury caused in numerous animal species when overdistending airway pressure and volume are delivered. The extent of this injury is attenuated by the application of PEEP. Patient case series point to the benefit of LPVS. In randomized controlled trials, the data may appear confusing. However, based on the ...
Lim C M - - 1999
This study was designed to examine whether the oxygenation response in the prone position differs in magnitude depending on the level of positive end-expiratory pressure (PEEP) applied in the supine position, and whether cardiac output (CO) increases in the prone position. In seven supine dogs, acute lung injury was established ...
Konieczny B - - 1999
All employees of a chemical plant division producing chlorfenvinphos were studied, i.e. 35 males aged 25-57 years (mean 42.1); their employment period ranged from 1-15 years (mean 9.0). Chronic bronchitis was diagnosed in 13 workers (37.1%). Mean air chlorfenvinphos concentrations in the work environment estimated with gas-liquid chromatography were from ...
Blevins S S - - 1999
The roles of the carotid arterial baroreceptor reflex and of vagally mediated mechanisms during positive end-expiratory pressure (PEEP) were determined in pentobarbital-anesthetized dogs with isolated carotid sinuses. Spontaneously breathing dogs were placed on PEEP (5-10 cmH2O) with the carotid sinus pressure set to the systemic arterial pressure (with feedback) or ...
Tsai Y H - - 1999
OBJECTIVE: To assess the magnitude of spontaneous variability of arterial oxygenation and oxygen tension-based indices over time in medical intensive care unit (ICU) patients and to study whether high positive end-expiratory pressure (PEEP) or inverse inspiratory-to-expiratory (I:E) ratio ventilation (IRV) results in a greater variability than low PEEP with conventional ...
Rusterholtz T T Service de Réanimation Médicale et Centre Anti Poisons, Hôpitaux Universitaires de Strasbourg, - - 1999
To assess (1) the short-term hemodynamic, respiratory and arterial blood gas effects of NIPSV in patients with ACPE who were likely to require endotracheal intubation, (2) the initial causes of failure and (3) the side effects and the difficulties of this technique. Uncontrolled, prospective clinical study. Teaching hospital intensive care ...
Kraut E J - - 1999
BACKGROUND: The cardiopulmonary effects of the combination of abdominal and thoracic pressures in humans have not been well delineated. OBJECTIVE: To study the cardiopulmonary effects of 15 mm Hg of intra-abdominal pressure in the presence and absence of 10 cm H20 of positive end-expiratory pressure (PEEP). DESIGN: Prospective. SETTING: University ...
Cheatham M L - - 1998
OBJECTIVE: To evaluate the clinical utility of right ventricular end-diastolic volume index (RVEDVI) and pulmonary artery occlusion pressure (PAOP) as measures of preload status in patients with acute respiratory failure receiving treatment with positive end-expiratory pressure. DESIGN: Prospective, cohort study. SETTING: Surgical intensive care unit in a Level I trauma ...
Vieira S R - - 1998
The aim of this study was to assess positive end-expiratory pressure (PEEP)-induced lung overdistension and alveolar recruitment in six patients with acute lung injury (ALI) using a computed tomographic (CT) scan method. Lung overdistension was first determined in six healthy volunteers in whom CT sections were obtained at FRC and ...
Paven D - - 1998
BACKGROUND: The partition of pulmonary blood flow between normal and shunting zones is an important determinant of oxygen tension in arterial blood (PaO2). The authors hypothesized that the combination of inhaled nitric oxide (iNO) and almitrine infusion might have additional effects related to their pharmacologic properties to improve PaO2. Such ...
Kirmse M - - 1998
Partial liquid ventilation (PLV) with perflubron (PFB) has been proposed as an adjunct to the current therapies for the acute respiratory distress syndrome (ARDS). Because PFB has been also referred to as "liquid PEEP," distributing to the most gravity-dependent regions of the lung, less attention has been paid to the ...
Neumann P - - 1998
The effects of different inspiratory and expiratory airway pressures (Paw) on the dynamics of lung collapse and recruitment were studied in 14 anesthetized, mechanically ventilated, pigs with oleic-acid-induced lung injury. Repetitive CT scans of the same slice were obtained every 0.8 s during different inspiration and expiration hold procedures. The ...
Squara P - - 1998
OBJECTIVE: Although the acute respiratory distress syndrome (ARDS) was identified as long as 30 years ago, potential therapeutic objectives have been defined from small series rather than large trials. Moreover, relationships between ARDS and hemodynamics are unclear. The European Collaborative ARDS Study was designed to identify factors influencing the pathogenesis, ...
Rossi N - - 1998
STUDY OBJECTIVE: The pulmonary parenchyma in patients with acute respiratory failure (ARF) is commonly not involved in a homogenous disease process. Conventional mechanical ventilation (MV) at elevated positive end-expiratory pressure (PEEP) and peak inspiratory pressure (PIP) aims at recruiting collapsed or nonventilated lung units. Invariably, those pressures are also transmitted ...
Thome U - - 1998
In mechanical ventilation of preterm infants, positive endexpiratory pressure (PEEP) is widely used to prevent alveolar collapse, maintain functional residual capacity (FRC) and improve oxygenation. Prolongation of inspiratory time (ti) and increase of peak inspiratory pressure (PIP) are also used for this purpose. We investigated the effect of variations of ...
Colton D M - - 1998
OBJECTIVE: This study evaluates the ability of perflubron to inhibit pulmonary neutrophil accumulation during partial liquid ventilation (PLV) in the setting of acute lung injury. DESIGN: Randomized, controlled, nonblinded study. SETTING: Research laboratory at a university. SUBJECTS: Male, Sprague-Dawley rats (n = 120, 506 +/- 42 g). INTERVENTIONS: Animals were ...
Yanos J - - 1998
STUDY OBJECTIVES: The efficacy of inverse ratio ventilation in ARDS is not clear. Furthermore, the mechanism responsible has not been determined. We designed an animal study to determine if inverse ratio ventilation improves gas exchange and by what mechanism. DESIGN: Prospective randomized, controlled design was used. SETTING: University of Missouri ...
Bersten A D - - 1998
Strategies to optimize alveolar recruitment and prevent lung overinflation are central to ventilatory management of patients with acute lung injury (ALI). The recent description of overinflation using multilinear regression analysis of airway pressure (Paw) and flow (V') data allows a functional assessment of lung mechanics. However, this technique has not ...
Fellahi J L - - 1998
STUDY OBJECTIVES: Positive end-expiratory pressure (PEEP) has been proposed to improve cardiac output in patients with left ventricular (LV) dysfunction. This study was designed to compare quantitative global and regional LV performance in response to PEEP in patients with normal and poor LV function. DESIGN: A prospective clinical trial. SETTING: ...
Moomey C B CB - - 1998
PURPOSE: To compare the effects of mechanical ventilation with either positive end-expiratory pressure (PEEP) or partial liquid ventilation (PLV) on cardiopulmonary function after severe pulmonary contusion. METHODS: Mongrel pigs (32 +/- 1 kg) were anesthetized, paralyzed, and mechanically ventilated (8-10 mL/kg tidal volume; 12 breaths/min; FiO2 = 0.5). Systemic hemodynamics ...
Genoni M - - 1998
OBJECTIVE: To evaluate the usefulness of transthoracic electrical bioimpedance in sedated and paralyzed patients with acute lung injury during mechanical ventilation with and without early application of positive end-expiratory pressure (PEEP). DESIGN: Prospective, repeated-measures study. SETTING: University-affiliated intensive care center. PATIENTS: Ten patients with acute lung injury. INTERVENTIONS: Simultaneous, three-paired ...
Punt C D - - 1998
OBJECTIVE: The aim of this study was to show the feasibility of a slow, continuously increasing level of positive end-expiratory pressure (PEEP) (ramp manoeuvre) in selecting best PEEP and to evaluate whether best PEEP, as defined by maximal oxygen transport, coincides with best systemic arterial oxygenation or best compliance. DESIGN: ...
Gregoretti C - - 1998
OBJECTIVE: To investigate the effectiveness of noninvasive (face mask) versus invasive (endotracheal tube) equal pressure values on blood gases and respiratory pattern and to evaluate the feasibility of using mask ventilation after the short term physiologic study. DESIGN: Open, prospective, physiologic study and uncontrolled clinical study. SETTING: Intensive care unit ...
Weiswasser J - - 1998
BACKGROUND/PURPOSE: If the goal of partial liquid ventilation (PLV) with perfluorocarbons in the management of respiratory failure is to improve dynamic lung compliance (Cdyn) and pulmonary vascular resistance (PVR) while sustaining O2 delivery, the optimal ventilatory management is unclear. The authors asked if volume-cycled or pressure-limited ventilation had different effects ...
Hickling K G - - 1998
A mathematical model of the ARDS lung, with simulated gravitational superimposed pressure, evaluated the effect of varying alveolar threshold opening pressures (TOP), PEEP and peak inspiratory pressure (PIP) on the static pressure-volume (PV) curve. The lower inflection point (Pflex) was affected by SP and TOP, and did not accurately indicate ...
Gattinoni L - - 1998
To assess the possible differences in respiratory mechanics between the acute respiratory distress syndrome (ARDS) originating from pulmonary disease (ARDSp) and that originating from extrapulmonary disease (ARDSexp) we measured the total respiratory system (Est,rs), chest wall (Est,w) and lung (Est,L) elastance, the intra-abdominal pressure (IAP), and the end-expiratory lung volume ...
Kim Y J - - 1998
Controlled mechanical ventilation (CMV) with positive and expiratory pressure (PEEP) is often used to improve the pulmonary gas exchange in patients with acute respiratory distress syndrome. However, this ventilatory technique may induce hemodynamic and hormonal changes which may lead to vital organ dysfunction, such as oliguria. Low dose dopamine, acting ...
Abe K K Department of Anesthesiology, Osaka University Medical School, Japan. - - 1998
The aim of this study was to evaluate the effect of isoflurane and sevoflurane on oxygenation and shunt fraction during one-lung ventilation (OLV). Twenty patients undergoing lobectomy for lung cancer and scheduled for long-term OLV were enrolled in this study. Patients were allocated to treatment with either isoflurane or sevoflurane. ...
O'Keefe G E - - 1998
BACKGROUND: Static pressure-volume (PV) curves have been promoted as a tool for selecting positive end-expiratory pressure (PEEP) by identifying a lower "inflection point" (Pflex) from these curves. Their visual interpretation is subjective and difficult, however, particularly with subtle changes in the slope of the curves. This study was designed to ...
Clarke J P - - 1998
Several methods of ventilation have previously been shown to reduce intraoperative atelectasis and alveolar to arterial oxygen gradient (A-a DO2) in healthy patients. This study was designed to show firstly the relative intra-operative benefit and secondly if any method had an effect on atelectasis postoperatively. Using a factorial design we ...
Michalopoulos A - - 1998
The role of positive end-expiratory pressure (PEEP) in the postoperative course of cardiac surgery patients remains questionable. In this prospective study, we examined the effect of different levels of PEEP on arterial oxygenation, SvO2 and PvO2 values, and on haemodynamic indices, during the early postoperative period in cardiac surgery patients. ...
Borelli M - - 1998
OBJECTIVE: To compare the effects of continuous negative extrathoracic pressure (CNEP) and positive end-expiratory pressure (PEEP) at the same level of transpulmonary pressure. DESIGN: Prospective analysis. SETTING: Medical intensive care unit of a university hospital. PATIENTS: Nine consecutive acute lung injury patients. Patients with cardiac failure and patients with chronic ...
Imanaka H - - 1998
OBJECTIVE: To evaluate in a lung model the effects of expiratory-phase tracheal gas insufflation (expiratory-phase TGI) with both volume and pressure control ventilation, and tidal volume-adjusted continuous flow TGI (volume-adjusted TGI) on system pressures and volumes. DESIGN: Single-compartment lung model. SETTING: Research laboratory in a university medical center. INTERVENTIONS: Expiratory-phase ...
Guglielminotti J - - 1998
OBJECTIVE: To evaluate the effects of tracheal suctioning (TS) on respiratory resistances in sedated critical care patients receiving mechanical ventilation (MV). SETTING: Surgical ICU of Bichat Hospital, Paris. PATIENTS AND PARTICIPANTS: Thirteen sedated critical care patients receiving MV for various conditions. MEASUREMENTS AND RESULTS: Airway resistances (R1), airway and pulmonary ...
Koperna T - - 1998
The excessive uncontrolled activation of inflammatory cells and mediators after trauma or major surgery plays a key role in the development of adult respiratory distress syndrome and multiple organ system failure (MOSF). In the past elevated cytokine levels were shown to influence the outcome of these patients adversely. There are ...
Kaisers U - - 1998
This study was undertaken to determine the effects of superimposing incremental levels of positive end-expiratory pressure (PEEP) during partial liquid ventilation (PLV) on gas exchange, respiratory mechanics and morphological changes in experimental acute lung injury (ALI). In a prospective trial, six pigs weighing 30+/-5 kg (mean+/-SD) were tracheotomized, submitted to ...
Ng S P - - 1998
We studied 13 consecutive infants admitted to our Neonatal Intensive Care Unit over 37 months from 1 June 1994 to 30 June 1997, who were diagnosed with severe persistent pulmonary hypertension (PPHN) meeting extracorporeal membrane oxygenation (ECMO) criteria as defined by Bartlett and/or Short. They were managed with conservative ventilation ...
Lafferty W J - - 1998
We measured at 296 K the rotational line strengths and pressure-broadening coefficients for the 1.27-mum, a (1)D(g)-X (3)?(g)(-), v = 0-0 band of O(2) with a Fourier transform infrared spectrometer using an optical path length of 84 m, a spectral resolution of 0.01 cm(-1), and sample pressures between 13 and ...
Naik S - - 1998
During mechanical ventilation, mean airway pressure (MAP) can be increased by a variety of manoeuvres, for example increasing inspiratory time or elevating the positive end expiratory pressure (PEEP). It seemed likely that the effect on blood gases and lung function of a particular manoeuvre to increase MAP would be influenced ...
Perry R J - - 1998
OBJECTIVE: To investigate the effects of positive end-expiratory pressure (PEEP) on end-expiratory lung volume (EELV) and mean oscillated flow rate (VOSC) during high-frequency chest compression (HFCC) in normal subjects and patients with severe COPD. DESIGN: Comparative study. SETTING: Pulmonary function and lung mechanics laboratory, University of Alberta Hospitals. PARTICIPANTS: Six ...
Slinger P D - - 1998
OBJECTIVE: To investigate the relationship between applied external positive end-expiratory pressure (PEEP) and auto-PEEP and the resultant total PEEP experienced by the patient during one-lung ventilation (OLV). DESIGN: A prospective clinical study. SETTING: A university hospital. PARTICIPANTS: Ten adult patients undergoing elective thoracotomies. INTERVENTIONS: End-expiratory airway occlusion and measurement of ...
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