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Deakin C D - - 1998
The success of defibrillation is determined by trans-myocardial current. This current is inversely proportional to transthoracic impedance (TTI). We proposed that increasing lung volume using positive end-expiratory pressure (PEEP) would increase TTI. 12 healthy subjects aged 21-37 years (6 male) were recruited. TTI between self-adhesive defibrillation pads placed in the ...
Cheifetz I M - - 1998
OBJECTIVES: In a pediatric swine model, the effects of increasing tidal volumes and the subsequent development of pulmonary overdistention on cardiopulmonary interactions were studied. The objective was to test the hypothesis that increasing tidal volumes adversely affect pulmonary vascular mechanics and cardiac output. An additional goal was to determine whether ...
Bardoczky G I GI Department of Anesthesiology, Erasme University Hospital, Free University of Brussels, - - 1998
We studied patients undergoing elective pulmonary surgery to establish whether observing interrupted expiratory flow (IEF) on the flow-volume curves constructed by the Ultima SV respiratory monitor is a reliable way to identify patients with dynamic pulmonary hyperinflation and intrinsic positive end-expiratory pressure (PEEPi). Patients' tracheas were intubated with a double-lumen ...
Verbrugge S J - - 1998
We have assessed the effects of overinflation on surfactant function and composition in rats undergoing ventilation for 20 min with 100% oxygen at a peak inspiratory pressure of 45 cm H2O, with or without PEEP 10 cm H2O (groups 45/10 and 45/0, respectively). Mean tidal volumes were 48.4 (SEM 0.3) ...
Moens Y - - 1998
OBJECTIVE: To study effects of intermittent positive-pressure ventilation (IPPV) with large tidal volumes and addition of positive end-expiratory pressure (PEEP) on maldistribution of ventilation in anesthetized horses positioned in lateral recumbency. ANIMALS: 6 healthy adult horses. PROCEDURE: Anesthesia was induced by i.v. infusion of thiopental sodium and guiafenesin and was ...
Lindhorst E - - 1998
Recent reports on the treatment of chylothorax postulate a benefit to ventilator therapy, especially using positive end-expiratory pressure (PEEP). This report describes the use of mechanical ventilation with PEEP in the management of a 24-year-old male motorcyclist who sustained a ligamentous Chance fracture of the thoracic spine at the T6-7 ...
Ludwigs U U Medical Intensive Care Unit, Department of Medicine, Södersjukhuset, Stockholm, Sweden. - - 1998
(1) To explore the interaction between mechanical ventilation and oleic acid (OA)-induced lung injury on indexes of pulmonary gas exchange and epithelial permeability, and (2) to compare this interaction using two different modes of ventilation: pressure-controlled inverse ratio ventilation (PCIRV) and volume-controlled ventilation with positive end-expiratory pressure (VCV PEEP). Randomized ...
Giele H H Department of Plastic and Maxillofacial Surgery, Royal Perth Hospital, Western - - 1998
Pressure therapy is the predominant means for prophylaxis and treatment of hypertrophic scar. Despite this, there is little scientific evidence to support its use. This study examines the pressures generated by pressure garments in four subjects at 36 different anatomical sites chosen to represent the varying body geometry. Direct subdermal ...
Luce J M - - 1998
OBJECTIVE: To review acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) in light of recent information about the definitions, epidemiology, pathophysiology, management, and outcome of these conditions. DATA SOURCES: The author's personal files as well as the computerized MEDLINE database. STUDY SOLUTION: Studies were selected for their ...
Verbrugge S J - - 1998
OBJECTIVE: To determine the effect of peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP) on the development of bacteremia with Klebsiella pneumoniae after mechanical ventilation of intratracheally inoculated rats. DESIGN: Prospective, randomized, animal study. SETTING: Experimental intensive care unit of a University. SUBJECTS: Eighty male Sprague Dawley rats. INTERVENTIONS: ...
Talmor M - - 1998
BACKGROUND: As part of an ongoing prospective evaluation of the response of acute respiratory failure (ARF) to ventilation with titrated amounts of positive end-expiratory pressure (PEEP), a subset of patients with a poor response to the initial application of PEEP and radiographic evidence of pleural effusion was identified. The effusion(s) ...
Fournell A - - 1998
OBJECTIVE: To evaluate if normalization of cardiac output reverses the attenuation of local intracapillary hemoglobin saturation (HbO2) of gastric mucosa by PEEP (positive end-expiratory pressure) during IPPV (intermittent positive pressure ventilation). MATERIALS AND METHODS: Four healthy, chronically instrumented, anesthetized dogs were repeatedly studied (n = 7). Local HbO2 of gastric ...
Gauthier R - - 1998
The aim of the study was to describe the pattern of respiratory oscillation mechanics and responses to positive end-expiratory pressure (PEEP) in bronchiolitis. Six infants were studied during the course of mechanical ventilation. A 20 Hz sinusoidal pressure variation was applied at the endotracheal tube where flow was measured with ...
Savourey G - - 1998
In order to study the use of positive end expiratory pressure (PEEP) to prevent acute mountain sickness (AMS), 22 subjects were exposed randomly to 8-h hypobaric hypoxia in a hypobaric chamber (4500 m, 589 hPa, 22 degrees C) once being administered 5-cm H2O PEEP and once without. The prevention of ...
Zavala E - - 1998
BACKGROUND: It is not known whether inverse I:E ratio ventilation (IRV) offers any real benefit over conventional mechanical ventilation with positive end-expiratory pressure (CMV-PEEP) at similar levels of end-expiratory pressure. METHODS: The effects of volume-controlled and pressure-controlled IRV (VC-IRV and PC-IRV, respectively) on VA/Q inequality were compared with those of ...
Giebler R - - 1998
We have studied prospectively the effect of 10 cm H2O of PEEP on the incidence of venous air embolism and on the cardiovascular response to change from the supine to the seated position in a large neurosurgical population. Patients were allocated randomly to receive either PEEP (10 cm H2O, n ...
Hoffman A M - - 1997
OBJECTIVE: To compare the efficacy of positive pressure ventilation applied through a mask versus an endotracheal tube, using anesthetized/paralyzed foals as a model for foals with hypoventilation. ANIMALS: Six 1-month-old foals. PROCEDURE: A crossover design was used to compare the physiologic response of foals to 2 ventilatory techniques, noninvasive mask ...
Musch G - - 1997
In order to assess the relative contribution of the lung and the chest wall to the derangements of respiratory mechanics in chronic obstructive pulmonary disease (COPD) patients with acute ventilatory failure (AVF), we studied eight COPD patients undergoing controlled mechanical ventilation for AVF and nine normal subjects anaesthetized for surgery ...
Carvalho C R - - 1997
The associated use of permissive hypercapnia (PHY) and high PEEP levels (PEEP(IDEAL)) has been recently indicated as part of a lung-protective-approach (LPA) in acute respiratory distress syndrome (ARDS). However, the net hemodynamic effect produced by this association is not known. We analyzed the temporal hemodynamic effects of this combined strategy ...
Sugimoto M - - 1997
Tension pneumopericardium is a rare complication of mechanical ventilation following tracheoplasty for congenital tracheal stenosis. This case report describes fatal tension pneumopericardium in a three-month-old male infant some 24 hours following tracheoplasty for this condition. Because of persisting stenosis of the left main bronchus, ventilation pressures of PIP 23 cm ...
Nahum A - - 1997
OBJECTIVE: To test the effect of different mechanical ventilation strategies on dissemination of intratracheally instilled Escherichia coli in dogs and to determine the extent and distribution of lung damage. DESIGN: Prospective, randomized study. SETTING: Experimental animal laboratory. SUBJECTS: Eighteen anesthetized and paralyzed dogs. INTERVENTIONS: We studied the effect of three ...
Jourdan D - - 1997
Brief electrical pulses applied to a rat's tail elicit complex vocal responses including audible ("peeps," "chatters") and ultrasonic components. These responses, particularly the two first peeps which have been shown to be triggered by A delta- and C-fibers, could provide a useful tool in pain studies. In the present study, ...
Takeda S - - 1997
The purpose of this study was to evaluate the efficacy of external high-frequency oscillation (EHFO) in patients with hypercapnia following upper abdominal surgery. Seven patients were ventilated with EHFO for 2 hr at 60 oscillations/min, with cuirass pressures of 36 cm H2O (-26 to +10), and an inspiratory to expiratory ...
Furukawa T - - 1997
PURPOSE: To compare the permeability of 10 contrast media (CM) through the hemodialysis membrane. MATERIAL AND METHODS: An experimental model was constructed from clinical hemodialysis equipment. The 10 CM that were used were: diatrizoate, iothalamate, iopamidol, iohexol, iopromide, ioversol, iomeprol, ioxaglate, iodixanol and iotrolan. They were dissolved into the dialysate. ...
Dambrosio M - - 1997
BACKGROUND: The morphologic effect of positive end-expiratory pressure (PEEP) and of two tidal volumes were studied by computed tomography to determine whether setting the tidal volume (Vt) at the upper inflection point (UIP) of the pressure-volume (P-V) curve of the respiratory system or 10 ml/kg have different effects on hyperinflation ...
Artucio H - - 1997
OBJECTIVE: To determine the presence of tricuspid regurgitation (TR) in patients affected by acute lung injury (ALI) and the adult respiratory distress syndrome (ARDS) during mechanical ventilation with positive end-expiratory pressure (PEEP). DESIGN: A prospective clinical study. SETTING: 10-bed general intensive care unit in a University Hospital. PATIENTS: 7 consecutive ...
Svantesson C - - 1997
The pressure-volume relationship of the respiratory system offers a guideline for setting of ventilators. The occlusion method for determination of the static elastic pressure-volume (Pel(st)/V) relationship is used as a reference and the aim of the study was to improve it with respect to time consumption and precision of recording ...
Berg J T - - 1997
Remodeling of pulmonary capillaries occurs after chronic increases in capillary pressure (e.g., mitral stenosis). Also, remodeling of pulmonary arteries begins within 4 h of increased wall stress and is endothelium dependent. We have previously shown that high lung inflation increases wall stress in pulmonary capillaries. This study was designed to ...
Uhlig T - - 1997
STUDY OBJECTIVE: To evaluate a newly developed laser monitor in the measurement of positive end-expiratory pressure (PEEP)-induced changes in end-expiratory lung volume (EELV) in spontaneously breathing subjects. DESIGN: An open comparison between two different methods to assess breathing parameters. SETTING: A respiratory research unit. PARTICIPANTS: Six spontaneously breathing, healthy volunteers. ...
Kalfon P - - 1997
BACKGROUND: Permissive hypercapnia is a ventilatory strategy aimed at avoiding lung volutrauma in patients with severe acute respiratory distress syndrome (ARDS). Expiratory washout (EWO) is a modality of tracheal gas insufflation that enhances carbon dioxide removal during mechanical ventilation by reducing dead space. The goal of this prospective study was ...
Guerin C - - 1997
The effects of positive end-expiratory pressure (PEEP) on alveolar recruitment and closing volume were studied in ten supine, sedated, and paralyzed patients with chronic obstructive respiratory disease and acute respiratory failure. We applied PEEP (0, 5, 10, and 15 cm H2O) and constructed inflation static volume-pressure (V-P) curves. In all ...
Peters J K - - 1997
We examined the relative importance of arteriolar and venous reflex responses during reductions in cardiac output provoked by conditions that increase [positive end-expiratory pressure (PEEP)] or decrease [lower body negative pressure (LBNP)] peripheral venous filling. Five healthy subjects were exposed to PEEP (10, 15, 20, and 25 cmH2O) and LBNP ...
Lichtwarck-Aschoff M - - 1997
BACKGROUND: A step decrease in positive end-expiratory airway pressure (PEEP) is not followed by an instantaneous loss of the PEEP-induced increase in end-expiratory lung volume (EELV). Rather, the reduction of EELV is delayed, while adverse PEEP effects on hemodynamics are immediately attenuated upon the drop in airway pressure. Step PEEP ...
Inomata S - - 1997
Eight patients were studied under general anaesthesia for elective pulmonary lobectomy to see if intrinsic positive end-expired pressure (PEEPi) would appear or increase in the dependent lung during one-lung ventilation (OLV) or if application of external PEEP equal to individually measured PEEPi would produce better arterial oxygenation, haemodynamic state and ...
Aerts J G - - 1997
BACKGROUND: Continuous positive airway pressure (CPAP) is known to decrease inspiratory work of breathing in patients with chronic obstructive pulmonary disease (COPD). This effect is primarily attributed to a reduction in inspiratory elastic work of breathing (Wi,el) related to a decrease in intrinsic positive end-expiratory pressure (PEEP). METHODS: The aim ...
Berglund J E - - 1997
BACKGROUND: Does ventilation with positive end-expiratory pressure (PEEP) act to reduce cardiac output (CO) not only by impeding venous return but also by inducing myocardial depression? The present study was aimed to demonstrate the possible existence of this latter mechanism. METHODS: Eight pigs of Swedish native breed weighing 20-25 kg ...
Mercat A - - 1997
To assess the cardiorespiratory effects of a prolonged application of inverse ratio ventilation (IRV), we compared IRV (I/E = 2) with conventional ventilation (CV) (I/E = 0.5), applied for 6 h each in a randomized order, with constant tidal volume (VT) and total positive end-expiratory pressure (PEEP(tot)) in eight patients ...
Feldman Z - - 1997
Acute respiratory distress syndrome is commonly encountered in head-injured patients. Positive and expiratory pressure (PEEP) is useful in improving oxygenation. However, PEEP, by increasing intrathoracic pressure, decreases venous return, mean arterial pressure, and cardiac output and increases jugular vein pressure. There is conflicting evidence in the literature as to the ...
Colmenero-Ruiz M - - 1997
This study analyzed the effect of both positive end-expiratory pressure (PEEP) and reduction in tidal volume (VT) on extravascular lung water (EVLW) in a permeability model of pulmonary edema. Immediately after producing a pulmonary edema with oleic acid, 21 pigs were randomized into three groups. Group I (n = 8): ...
Aerts J G - - 1997
In patients with severe chronic obstructive pulmonary disease (COPD), lung emptying may be affected by flow limitation. We tested the hypothesis that the airway compression leading to flow limitation can be counteracted by controlling the expiratory flow. The effects of an external resistor on lung emptying were studied in six ...
Tremblay L - - 1997
We examined the effect of ventilation strategy on lung inflammatory mediators in the presence and absence of a preexisting inflammatory stimulus. 55 Sprague-Dawley rats were randomized to either intravenous saline or lipopolysaccharide (LPS). After 50 min of spontaneous respiration, the lungs were excised and randomized to 2 h of ventilation ...
Ganassini A - - 1997
The aims of positive end-expiratory pressure (PEEP) are: 1) in acute lung failure, to increase lung volume and to improve oxygenation; 2) in acute exacerbation of chronic obstructive pulmonary disease (COPD), to unload inspiratory muscles. Excessive levels of PEEP may increase the risk of barotrauma. Application of low levels of ...
Ranieri V M - - 1997
BACKGROUND: Acute respiratory failure may develop in patients with chronic obstructive pulmonary disease because of intrinsic positive end-expiratory pressure (PEEPi) and increased resistive and elastic loads. Proportional assist ventilation is an experimental mode of partial ventilatory support in which the ventilator generates flow to unload the resistive burden (flow assistance: ...
Strömberg S - - 1997
Positive end-exspiratory pressure (PEEP) and nitric oxide (NO) can influence lung VA/Q-matching and pulmonary vascular resistance, and application of PEEP can increase exhaled NO in animals. To obtain a better understanding of these mechanisms, we examined how different types of ventilation or changes in CO2 affect the formation of endogenous ...
Broccard A F - - 1997
OBJECTIVE: To evaluate the influence of body position on the extent and distribution of experimental lung damage in an oleic acid canine model of acute respiratory distress syndrome, using mechanical ventilation with high tidal volumes and positive end-expiratory pressure (PEEP). DESIGN: Prospective, randomized study. SETTING: Experimental animal laboratory. SUBJECTS: Twelve ...
MacIntyre N R - - 1997
OBJECTIVES: Mechanical ventilation in patients with obstructive airway disease (OAD) is associated with the development of dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEPi). One of the effects of this form of PEEPi is to act as an inspiratory threshold load that can produce ineffective breath triggering, dyspnea, and muscle ...
Ludwigs U - - 1997
BACKGROUND: Inverse ratio ventilation (IRV) is frequently used in severe acute respiratory failure. IRV may lead to intrinsic positive end-expiratory pressure (PEEP) and is thought to improve oxygenation and to have advantageous effects on lung mechanics. Published data to support the use of IRV are scarce. This animal study compares ...
Fessler H E - - 1997
Since the circulatory and pulmonary systems are both driven by pressure and share space in the thorax, it is inevitable that they interact. These mechanical interactions, whilst relatively few in number, are protean in their manifestations. The circulatory system of the critically ill is often particularly susceptible to interference from ...
Alverdy J - - 1997
BACKGROUND: The purpose of this study was to determine the safety and feasibility of whole gut washout for severe sepsis in human beings. METHODS: High-volume polyethylene glycol-3500 was administered to patients with severe sepsis. Body temperature, white blood cell count, and ventilatory indexes were recorded 24 hours before and 24 ...
Hickling K G - - 1996
OBJECTIVE: To determine whether pressure-limited intermittent mandatory ventilation with permissive hypercapnia and positive end-expiratory pressure (PEEP) titrated to arterial oxygen tension (PaO2) prevents or reduces acute lung injury, compared to conventional ventilation, in saline-lavaged rabbits. DESIGN: Prospective randomised trial. SETTING: University animal laboratory. SUBJECTS: 18 New Zealand White rabbits. INTERVENTIONS: ...
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