Search Results
Results 301 - 350 of 1426
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Tusman Gerardo - - 2004
PURPOSE: The goal of this study was to analyze the effect of positive end-expiratory pressure (PEEP), with and without a lung recruitment maneuver, on dead space. METHODS: 16 anesthetized patients were sequentially studied in three steps: 1) without PEEP (ZEEP), 2) with 5 cm H(2)O of PEEP and 3) with ...
Launay Jean-Claude - - 2004
OBJECTIVES: This study evaluates the ability of positive end-expiratory pressure (PEEP), a nonpharmacological method, to prevent the occurrence of acute mountain sickness during two ascents of Mount Blanc. METHODS: In a random order (once with PEEP and once without), PEEP was administered or not to eight subjects during two ascents ...
Schwarte L A - - 2004
BACKGROUND: The effects of thoracic epidural anaesthesia (TEA) on gastric mucosal microvascular haemoglobin oxygenation (microHbO(2)) are unclear. At the splanchnic level, reduction of sympathetic tone may promote vasodilation and increase microHbO(2). However, these splanchnic effects are counteracted by systemic effects of TEA (e.g., decreased cardiac output (CO) and mean arterial ...
Calzia Enrico - - 2004
A recent study by Bruhn and colleagues, discussed here, confirms that even high levels of positive end-expiratory pressure (PEEP) - up to 20 cmH2O - may be applied in conditions of moderate acute respiratory distress syndrome. Such levels of PEEP were found to be safe in terms of their impact ...
Bruhn Alejandro - - 2004
INTRODUCTION: Positive end-expiratory pressure (PEEP) improves oxygenation and can prevent ventilator-induced lung injury in patients with acute respiratory distress syndrome (ARDS). Nevertheless, PEEP can also induce detrimental effects by its influence on the cardiovascular system. The purpose of this study was to assess the effects of PEEP on gastric mucosal ...
Reis Miranda D - - 2004
BACKGROUND: The open lung concept (OLC) is a method of ventilation intended to maintain end-expiratory lung volume by increased airway pressure. Since this could increase right ventricular afterload, we studied the effect of this method on right ventricular afterload in patients after cardiac surgery. METHODS: We studied 24 stable patients ...
Kallet Richard H - - 2004
This report explores the efficacy of existing therapies for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), primarily in terms of clinically important outcomes such as the duration of mechanical ventilation and hospital mortality. Of the 15 therapies reviewed, the strongest evidence suggests that ALI/ARDS should be managed ...
Whitehead Thomas C - - 2004
BACKGROUND: Mechanical ventilation may cause lung injury through the excitation of an inflammatory response and the release of mediators, such as cytokines. The authors tested the hypothesis that intratracheal lipopolysaccharide amplifies the cytokine response to mechanical ventilation. METHODS: Rat lungs were intratracheally instilled with lipopolysaccharide followed by ex vivo mechanical ...
Probyn Megan E - - 2004
Positive end expiratory pressure (PEEP) is important for neonatal ventilation but is not considered in guidelines for resuscitation. Our aim was to investigate the effects of PEEP on cardiorespiratory parameters during resuscitation of very premature lambs delivered by hysterotomy at approximately 125 d gestation (term approximately 147 d). Before delivery, ...
Barbieri A - - 2004
AIM: The aim of this study is to analyse if the decrease of cardiac performance due to positive end-expiratory pressure (PEEP) application, within low values applied in clinical practice (5 cm H(2)O) is able to trigger a response of the main endogenous factors which control and maintain the mean arterial ...
Prodhan Parthak - - 2004
Acute hypoxemic respiratory failure (AHRF) is one of the hallmarks of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), which are caused by an inflammatory process initiated by any of a number of potential systemic and/or pulmonary insults that result in heterogeneous disruption of the capillary-pithelial interface. In ...
Jandre Frederico C - - 2004
A closed-loop lung ventilation controller was designed, aiming to: 1) track a desired end-tidal CO2 pressure (Pet CO2), 2) find the positive end-expiratory pressure (PEEP) of minimum estimated respiratory system elastance (Ers,e), and 3) follow objective functions conjectured to reduce lung injury. After numerical simulations, tests were performed in six ...
Coussa Marta - - 2004
Atelectasis caused by general anesthesia is increased in morbidly obese patients. We have shown that application of positive end-expiratory pressure (PEEP) during the induction of anesthesia prevents atelectasis formation in nonobese patients. We therefore studied the efficacy of PEEP in morbidly obese patients to prevent atelectasis. Twenty-three adult morbidly obese ...
Kurahashi Kiyoyasu - - 2004
Pneumonia caused by Pseudomonas aeruginosa carries a high rate of morbidity and mortality. A lung-protective strategy using low tidal volume (V(T)) ventilation for acute lung injury improves patient outcomes. The goal of this study was to determine whether low V(T) ventilation has similar utility in severe P. aeruginosa infection. A ...
Szakmany T - - 2004
This study aimed to evaluate the relationship between PaO2/FiO2 ratio and extravascular lung water in septic shock-induced acute respiratory distress syndrome in a prospective observational clinical trial. Twenty-three patients suffering from sepsis induced acute respiratory distress syndrome were recruited. All patients were ventilated in pressure control/support mode. Haemodynamic parameters were ...
Schreiter Dierk - - 2004
OBJECTIVE: Investigation of oxygenation and lung aeration during mechanical ventilation according to the open lung concept in patients with acute lung injury or acute respiratory distress syndrome. DESIGN: Retrospective analysis. SETTING: Surgical intensive care unit of a university hospital. PATIENTS: We retrospectively identified 17 patients with acute lung injury/acute respiratory ...
Lim Sung Chul - - 2004
To examine the impact of lactate dehydrogenase (LDH) as an early marker of ventilator-induced lung injury (VILI) and the effect of prone position during the VILI, we ventilated 28 normal white rabbits (10 supine, 10 prone, 8 controls) for 6 hr or until PaO2/FIO2 ratio was<200 mmHg. We applied an ...
Vitacca M - - 2004
BACKGROUND: In severe stable hypercapnic COPD patients the amount of pressure time product (PTP) spent to counterbalance their dynamic intrinsic positive end expiratory pressure (PEEPi,dyn) is high: no data are available on the best setting of non invasive pressure support ventilation (NPSV) to reduce the inspiratory muscle workload due to ...
Kondili Eumorfia - - 2004
OBJECTIVES: To study the pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD). DESIGN: A prospective physiological study. SETTING: A 12-bed Intensive Care Unit. PATIENTS: Ten patients with acute exacerbation of COPD. INTERVENTIONS: At three levels of positive end-expiratory pressure (PEEP, 0, ...
Barbier Christophe - - 2004
OBJECTIVE: To evaluate the extent to which respiratory changes in inferior vena cava (IVC) diameter can be used to predict fluid responsiveness. DESIGN: Prospective clinical study. SETTING: Hospital intensive care unit. PATIENTS: Twenty-three patients with acute circulatory failure related to sepsis and mechanically ventilated because of an acute lung injury. ...
D'Angelo Edgardo - - 2004
Lung mechanics and morphometry were assessed in two groups of nine normal open-chest rabbits mechanically ventilated (MV) for 3-4 h at zero end-expiratory pressure (ZEEP) with physiological tidal volumes (Vt; 11 ml/kg) and high (group A) or low (group B) inflation flow (44 and 6.1 ml x kg(-1) x s(-1), ...
Herriger A - - 2004
Positive end-expiratory pressure (PEEP) applied during induction of anaesthesia may prevent atelectasis formation in the lungs. This may increase the duration of non-hypoxic apnoea by increasing the functional residual capacity. We studied the benefit of PEEP applied during the induction of anaesthesia on the duration of apnoea until the SpO2 ...
Nunes S - - 2004
BACKGROUND: Pressure-volume relationships (PV curves) are the only available method for bedside monitoring of respiratory mechanics. Alveolar recruitment modifies the results obtained from the PV curves. We hypothesized that method-related differences may influence PV-curve guided ventilatory management. METHODS: Twelve acute lung injury (ALI) patients [PaO2/FiO2 13.0 +/- 1.5 kPa (97.6 ...
Suwanvanichkij Voravit - - 2004
We report a case in which a non-trauma patient suffering hematemesis and undergoing massive volume resuscitation developed abdominal compartment syndrome (ACS). The abdominal distension severely compromised his pulmonary functioning: a chest radiograph showed low lung volumes and dense bilateral parenchymal opacities. His blood oxygen saturation reached as low as 32%. ...
Póvoa P - - 2004
BACKGROUND: To evaluate the effect of a recruitment maneuver (RM) with constant positive inspiratory pressure and high positive end-expiratory pressure (PEEP) on oxygenation and static compliance (Cs) in patients with severe acute respiratory distress syndrome (ARDS). METHODS: Eight patients with ARDS ventilated with lung-protective strategy and an arterial partial pressure ...
Dyhr T - - 2004
BACKGROUND: Patients ventilated after cardiac surgery commonly have impaired oxygenation, mainly due to lung collapse. We have previously found that PaO2 and end-expiratory lung volume (EELV) were increased by a lung recruitment maneuver (LRM) followed by positive end-expiratory pressure (PEEP). The aim of this study was to evaluate whether only ...
Schortgen Frédérique - - 2004
OBJECTIVE: To evaluate the effect of V(T) reduction and alveolar recruitment on systemic and contralateral dissemination of bacteria and inflammation during right-side pneumonia. DESIGN: Interventional animal study. SETTING. University hospital research laboratory. SUBJECTS: A total of 54 male Wistar rats. INTERVENTIONS: One day after right lung instillation of 1.4x10(7) Pseudomonas ...
Koner Ozge - - 2004
OBJECTIVE: To evaluate the effects of protective and conventional ventilation with or without positive end-expiratory pressure (PEEP), on systemic tumor necrosis factor-alpha, interleukin-6 levels and pulmonary function during open heart surgery. DESIGN: Prospective, randomized clinical study. SETTING: Single university hospital. PATIENTS AND PARTICIPANTS: Forty-four patients undergoing elective coronary artery bypass ...
Khirani S - - 2004
Expiratory flow limitation (EFL) can occur in mechanically ventilated patients with chronic obstructive pulmonary disease and other disorders. It leads to dynamic hyperinflation with ensuing deleterious consequences. Detecting EFL is thus clinically relevant. Easily applicable methods however lack this detection being routinely made in intensive care. Using a simple mathematical ...
Funk Duane J - - 2004
BACKGROUND: Biologically variable ventilation (return of physiological variability in rate and tidal volume using a computer-controller) was compared to control mode ventilation with and without a recruitment manoeuvre - 40 cm H2O for 40 sec performed hourly; in a porcine oleic acid acute lung injury model. METHODS: We compared gas ...
Boigner Harald - - 2004
BACKGROUND: The development of renal dysfunction in the postoperative course of cardiac surgery is still associated with high mortality in pediatric patients. In particular for small infants peritoneal dialysis offers a secure and useful treatment option. The aim of the present study was to investigate if routinely used laboratory and ...
Luecke T - - 2004
BACKGROUND: Lung protective ventilation using low end-inspiratory pressures and tidal volumes (VT) has been shown to impair alveolar recruitment and to promote derecruitment in acute lung injury. The aim of the present study was to compare the effects of two different end-inspiratory pressure levels on alveolar recruitment, alveolar derecruitment and ...
Schwarte Lothar A - - 2004
OBJECTIVE: To compare the effects of dopamine, both in the presence and absence of alpha1-blockade, and fenoldopam on microvascular gastric mucosal oxygenation and systemic oxygen transport under compromised circulatory conditions, both without and with fluid resuscitation. DESIGN: Randomized controlled animal study. SETTING: University department of anesthesiology. SUBJECTS: Eight anesthetized dogs ...
Chu Eric K - - 2004
OBJECTIVE: To examine the mechanisms of ventilator-induced lung injury at low and high lung volumes. DESIGN: Prospective, randomized, laboratory study. SETTING: University research laboratory. SUBJECTS: Eighty-eight adult male Sprague-Dawley rats. INTERVENTIONS: Mechanical ventilation using low and high lung volumes. MEASUREMENTS AND MAIN RESULTS: An ex vivo rat lung model was ...
Vreugdenhil H A - - 2004
This study was designed to investigate the possible effect of injurious mechanical ventilation on peripheral immune function of healthy rats. Three ventilation strategies were compared: 1) low peak inspiratory pressure (PIP)/positive end-expiratory pressure (PEEP); 2) high PIP/PEEP; and 3) high PIP/zero PEEP (ZEEP). As a reference group, healthy, nonventilated, sham-operated, ...
O'Donnell C - - 2004
Effective ventilation is the key to successful neonatal resuscitation. Positive pressure ventilation is initiated with manual ventilation devices which may or not deliver positive end-expiratory pressure (PEEP). PEEP is known to have beneficial effects in preterm animal models and its use is ubiquitous in mechanical ventilation in neonatal intensive care. ...
Bendjelid Karim - - 2004
The accuracy and clinical utility of preload indexes as bedside indicators of fluid responsiveness in patients after cardiac surgery is controversial. This study evaluates whether respiratory changes (Delta) in the preejection period (PEP; DeltaPEP) predict fluid responsiveness in mechanically ventilated patients. Sixteen postcoronary artery bypass surgery patients, deeply sedated under ...
Barbas Carmen Sílvia Valente - - 2003
In the experimental setting, repeated derecruitments of the lungs of ARDS models accentuate lung injury during mechanical ventilation, whereas open lung concept strategies can attenuate the injury. In the clinical setting, recruitment manuevers that use a continuous positive airway pressure of 40 cmH2O for 40 secs improve oxygenation in patients ...
Hashmonai M - - 2003
The main effect of upper thoracic sympathectomy is sudomotor. To abolish sweating of the palms, T(2) ganglionectomy (often with the addition of T(3)) was invariably performed. To prevent axillary sweating, additional T(4) ablation was recommended. Sympathectomy produces a vasodilatatory cutaneous effect. The circulation in the muscles, however, is unaltered or ...
Kurita Shigeaki - - 2003
Artificial ventilation with positive end-expiratory pressure (PEEP) is commonly applied for brain damaged patients. However, the effect of the ventilation on brain function, including cardiovascular autonomic nervous system (CANS) activity, is not well elucidated. In order to investigate the effect of 5 cmH2O PEEP on CANS activity in brain damaged ...
Gainnier Marc - - 2003
OBJECTIVE: To determine whether positive end-expiratory pressure (PEEP) and prone position present a synergistic effect on oxygenation and if the effect of PEEP is related to computed tomography scan lung characteristic. DESIGN: Prospective randomized study. SETTING: French medical intensive care unit. PATIENTS: Twenty-five patients with acute respiratory distress syndrome. INTERVENTIONS: ...
Rusca Marco - - 2003
General anesthesia promotes atelectasis formation, which is augmented by administration of large oxygen concentrations. We studied the efficacy of positive end-expiratory pressure (PEEP) application during the induction of general anesthesia (fraction of inspired oxygen [FIO(2)] 1.0) to prevent atelectasis. Sixteen adult patients were randomly assigned to one of two groups. ...
Ma Amy - - 2003
Rapidly adapting receptors (RAR) in the lung are stimulated when the lung compliance is reduced. The present investigation was undertaken to determine whether bronchial C-fibers are also activated when lung compliance is decreased since both RAR and bronchial C-fibers are influenced by extra-vascular fluid in the airways. Action potentials (AP) ...
Brower Roy G - - 2003
Objective: Positive end-expiratory pressure (PEEP) and recruitment maneuvers (RMs) may partially reverse atelectasis and reduce ventilation-associated lung injury. The purposes of this study were to assess a) magnitude and duration of RM effects on arterial oxygenation and on requirements for oxygenation support (Fio2/PEEP) in patients with acute lung injury and ...
Patel Rupa - - 2003
BACKGROUND AND PURPOSE: One of the challenges of laparoscopic partial nephrectomies is the repair of a collecting system injury. We hypothesized that fibrin glue plus Gelfoam could be sufficient to repair such injuries. MATERIALS AND METHODS: Four pigs (eight kidneys) underwent collecting system injuries of various lengths (3, 5, and ...
Nunes Silvia - - 2003
OBJECTIVES: (1). To describe the evolution of pulmonary capillary pressure (Pcap) and of the pressure drop across the pulmonary venous bed from early to established acute respiratory distress syndrome (ARDS), (2). to assess Pcap under different levels of positive end-expiratory pressure (PEEP) and (3). to compare the visual method and ...
Schibler Andreas - - 2004
OBJECTIVE: Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. DESIGN: The bias flow nitrogen washout technique (FRC(N2MC)), the multiple breath nitrogen washout ...
Hoit Jeannette D - - 2003
STUDY OBJECTIVES: We sought to improve speech in tracheostomized individuals receiving positive-pressure ventilation. Such individuals often speak with short phrases, long pauses, and have problems with loudness and voice quality. SUBJECTS: We studied 15 adults with spinal cord injuries or neuromuscular diseases receiving long-term ventilation. INTERVENTIONS: The ventilator was adjusted ...
De Robertis E - - 2003
BACKGROUND AND OBJECTIVE: It has recently been suggested that recruitment proceeds far above the lower inflection point of the elastic pressure-volume (Pel/V) curve of the respiratory system. Accordingly, the value of the lower inflection point as a guide to set the positive end-expiratory pressure (PEEP) has been challenged. Our aim ...
Maitland Kathryn - - 2003
OBJECTIVES: To examine whether hypovolemia is an important cause of the acidosis in children with severe malaria. DESIGN: Prospective phase 1 study examining the safety of volume expansion using detailed hemodynamic monitoring. SETTING: High-dependency unit of Kilifi District Hospital on the coast of Kenya. PATIENTS: Kenyan children admitted with clinical ...
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