Abstract：
OBJECTIVE:To evaluate the physiological effects of decannulation on breathing patterns and respiratory mechanics by comparing mouth breathing (MB) to tracheal breathing (TB) in tracheostomized patients. DESIGN AND SETTING:Prospective cross-over study in a critical and neuromuscular care unit. PATIENTS AND METHODS:Nine consecutive neuromuscular tracheostomized patients. Flow, esophageal pressure, gastric pressure, expiratory gas, and arterial blood gases were measured during MB and TB. RESULTS:MB induced an increase in tidal volume (from 330+/-60 ml to 400+/-80 ml) without changing respiratory frequency, inspiratory time, or arterial CO(2) pressure. This ventilation increase was due to a significant increase in physiological dead space (from 156+/-67 to 230+/-82 ml) and was associated with significant increases in work of breathing (from 6.9+/-3.4 to 9.1+/-3.3 J/min), transdiaphragmatic pressure swing (from 10+/-4 to 12.5+/-7 cmH(2)O), diaphragmatic pressure-time product per minute (from 214+/-100 to 271+/-92 cmH(2)O s(-1) min(-1)), and oxygen uptake (from 206+/-30 to 229+/-34 ml/min). Upper airway resistance did not differ from in vitro tracheostomy tube resistance. In addition, total lung-airway resistance, dynamic pulmonary compliance, and intrinsic positive end-expiratory pressure were similar in both conditions. CONCLUSIONS:Decannulation resulted in a dead space increase with no other detectable additional loading. It increased work of breathing by more than 30%. Decannulation deserves special attention in patients with restrictive respiratory disease.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Chadda K,Louis B,Benaïssa L,Annane D,Gajdos P,Raphaël JC,Lofaso Fdoi
10.1007/s00134-002-1545-6keywords:
subject
Has Abstractpub_date
2002-12-01 00:00:00pages
1761-7issue
12eissn
0342-4642issn
1432-1238journal_volume
28pub_type
杂志文章abstract：PURPOSE:Type 1 angiotensin II (AT1) receptor antagonists have anti-inflammatory effects in vitro and in patients. The purpose of this study was to investigate whether losartan (LOS), an AT1 receptor antagonist, reduces lung damage by inhibiting the induction of high mobility group box 1 (HMGB1) protein and cytokines by...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1545-x
更新日期：2009-08-01 00:00:00
abstract：PURPOSE:Providing mechanical ventilation is challenging at supra-atmospheric pressure. The higher gas density increases resistance, reducing the flow delivered by the ventilator. A new hyperbaric ventilator (Siaretron IPER 1000) is said to compensate for these effects automatically. The aim of this bench test study was...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2590-4
更新日期：2012-08-01 00:00:00
abstract：:Six different types of continuous flush devices have been assessed for accuracy in vitro and ease of use in vivo. Only two types of device matched the manufacturers' specifications of performance. The other four gave higher flow rates than expected. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01691259
更新日期：1983-01-01 00:00:00
abstract：PURPOSE:Evidence of variation in mortality after surgery may indicate preventable postoperative death. We sought to determine if regional differences in outcome were present in surgical patients admitted to critical care in the UK. METHODS:We extracted data on admission characteristics, case mix and outcome of all pat...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-015-3980-1
更新日期：2015-10-01 00:00:00
abstract：RATIONALE:Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. PURPOSE:To develop and validate a model based on data available at ICU admission to predict delirium development during a patient's complete I...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-015-3777-2
更新日期：2015-06-01 00:00:00
abstract：:Knowledge translation is an important step for translational research. In this issue of Intensive Care Medicine, a new mini-series of basic research-related reviews is published. Three invited reviews focus on the role of extracellular matrix in ventilator-induced lung injury and mechanotransduction. The major challen...
journal_title：Intensive care medicine
pub_type： 评论,社论
doi：10.1007/s00134-007-0965-8
更新日期：2008-04-01 00:00:00
abstract：OBJECTIVE:To describe the syndrome of rhabdomyolysis during bacterial sepsis with regard to incidence, blood bacteriology and complications and to examine the association between hyperosmolal state and rhabdomyolysis, evaluating the relationship between plasma osmolality (Posm) and serum creatine phosphokinase (CPK) le...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050882
更新日期：1999-05-01 00:00:00
abstract：BACKGROUND:We determined the effects of two antibiotic policies (predominance of either beta-lactam antibiotics or fluroquinolones) on acquisition with third-generation cephalosporin-resistant Enterobacteriaceae (CRE) and fluoroquinolone-resistant CRE (FCRE) in two ICUs, with monitoring of other variables that may infl...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s00134-009-1714-y
更新日期：2010-03-01 00:00:00
abstract：OBJECTIVE:To investigate whether the respiratory variation in inferior vena cava diameter (DeltaD(IVC)) could be related to fluid responsiveness in mechanically ventilated patients. DESIGN:Prospective clinical study. SETTING:Medical ICU of a non-university hospital. PATIENTS:Mechanically ventilated patients with sep...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2233-5
更新日期：2004-09-01 00:00:00
abstract：OBJECTIVE:To investigate the accuracy of eight different prognostic scores (Stiehm, Niklasson, Leclerc, Garlund, the MOC score, Tesero, the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) and Tüyzüs) in the prediction of fatal outcome in meningococcal disease. DESIGN:Combined prospective and retrospective s...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709565
更新日期：1996-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the usefulness of early transcranial Doppler ultrasound (TCD) goal-directed therapy after severe traumatic brain injury initiated before invasive cerebral monitoring is available. DESIGN:Prospective, observational clinical study. SETTING:Surgical intensive care unit, university hospital. PATIEN...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0558-6
更新日期：2007-04-01 00:00:00
abstract：OBJECTIVES:To establish a preliminary list of critical incidents (CIs) associated with mechanical ventilation and to describe a CI reporting method. DESIGN:A list of CIs was established based on a consensus among ICU caregivers. The list was compared to CIs collected prospectively during a predefined study period. SE...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-002-1251-4
更新日期：2002-04-01 00:00:00
abstract：:Acetazolamide (Diamox) induced carbonic anhydrase inhibition is an efficient means of eliminating surplus water and bicarbonate in the overhydrated and alkalotic patient. Previous studies have demonstrated an unexpected and unexplained increase in arterial and venous oxygenation during acute carbonic anhydrase inhibit...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00255787
更新日期：1987-01-01 00:00:00
abstract：OBJECTIVE:To determine: (1) the proportion of small (<5 mm) or thrombosed internal jugular veins (IJV) and femoral veins (FV) in which catheter placement would be difficult without ultrasound guidance; (2) which position increases central vein sizes and may facilitate cannulation of these vessels. DESIGN:Prospective s...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0875-9
更新日期：2008-02-01 00:00:00
abstract：:Arrhythmias are extremely common early after AMI. An arrhythmia is defined by exclusion, either because the sequence of myocardial depolarisation is other than normal or because certain arbitrary limits are exceeded. It follows that the term "arrhythmia" encompasses a complex heterogenous group. Although arrhythmias a...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01683131
更新日期：1978-01-01 00:00:00
abstract：:A 65-year-old man developed postsurgical septic shock, unresponsive to plasma volume expansion and administration of dopamine and dobutamine. A continuous norepinephrine infusion was then started and the dose increased to 0.62 micrograms.kg-1.min-1 until the mean arterial pressure was 70 mmHg. Prior to and during the ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF02575309
更新日期：1990-01-01 00:00:00
abstract：INTRODUCTION:Extracorporeal carbon dioxide removal (ECCO2R) has been proposed for hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD) exacerbations, to avoid intubation or reduce length of invasive ventilation. Balance of risks, efficacy, and benefits of ECCO2R in patients with COPD is uncle...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-015-3921-z
更新日期：2015-10-01 00:00:00
abstract：OBJECTIVE:Comparison of side effects (fever shivering and/or allergic reactions, collapse, symptomatic hypocalcaemia) of the different substitution fluids used during therapeutical plasmapheresis. DESIGN:Multicentric retrospective comparative study designed to explore the side effects due to the replacements fluids (a...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s001340050595
更新日期：1998-05-01 00:00:00
abstract：:We report a fatal case of a child presenting Reye's syndrome associated with a variety of arrhythmias and ischemia-like ST-T ECG changes. At autopsy, fatty infiltration and patchy myocytolysis were detected in sections of the heart. This case report emphasizes cardiac involvement in Reye's syndrome and the possible me...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01728333
更新日期：1996-01-01 00:00:00
abstract：OBJECTIVE:1) To compare saline gastric tonometry monitoring with air tonometry (Tonocap) in a group of general ICU patients. 2) An in vitro investigation of the performance of other fluids used in gastric tonometry and to assess the effects of variation of temperature and carbon dioxide concentration within the range e...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050665
更新日期：1998-08-01 00:00:00
abstract：PURPOSE:To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies. METHODS:Based on a literature review and expert opinion, a Delphi process was use...
journal_title：Intensive care medicine
pub_type： 指南,杂志文章
doi：10.1007/s00134-010-1763-2
更新日期：2010-04-01 00:00:00
abstract：:We observed a 51-year-old woman who was admitted for severe amitriptyline overdose. Besides major cardiovascular complications, the patient developed severe hyperpyrexia with a central body temperature of more than 43 degrees C for 5 h. The patient died on day 3 from cardiocirculatory collapse and arrhythmias. Hyperth...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01712165
更新日期：1996-05-01 00:00:00
abstract：PURPOSE:To use the World Health Organisation's International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. METHODS:A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been a...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-017-4830-0
更新日期：2017-07-01 00:00:00
abstract：PURPOSE:To determine the global metabolomic profile as measured in circulating plasma from surviving and non-surviving patients with community-acquired pneumonia (CAP) and sepsis. METHODS:Random, outcome-stratified case-control sample from a prospective study of 1,895 patients hospitalized with CAP and sepsis. Cases (...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-013-2935-7
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:The aim of the study was to investigate the effect of lung volume changes on end-expiratory lung impedance change (ELIC) in mechanically ventilated patients, since we hypothesized that ELIC may be a suitable parameter to monitor lung volume change at the bedside. DESIGN:Clinical trial on patients requiring m...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-002-1555-4
更新日期：2003-01-01 00:00:00
abstract：:We have treated 30 patients with flail chest, with priority given to associated factors (pain, secretions retention, hemo-/pneumothorax and underlying pulmonary contusion). When this treatment was insufficient IMV + PEEP was instituted; in this group there was a 58.8% incidence of pneumonia, 47.5% of sepsis and 11.7 d...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01687161
更新日期：1980-08-01 00:00:00
abstract：OBJECTIVE:A readily available assessment of changes in pleural pressure would be useful for ventilator and fluid management in critically ill patients. We examined whether changes in pulmonary artery occlusion pressure (Ppao) adequately reflect respiratory changes in pleural pressure as assessed by changes in intraesop...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0842-5
更新日期：2007-11-01 00:00:00
abstract：PURPOSE:Plasma immunoglobulin concentrations are acutely altered in critically ill patients with sepsis. However, the association between immunoglobulin levels on the day of sepsis diagnosis and subsequent mortality is inconsistent. METHODS:Systematic review of studies that report immunoglobulin measurements and morta...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00134-015-3845-7
更新日期：2015-08-01 00:00:00
abstract：:The endothelium is a highly dynamic cell layer that is involved in a multitude of physiological functions, including the control of vascular tone, the movement of cells and nutrients, the maintenance of blood fluidity and the growth of new vessels. During severe sepsis, the endothelium becomes proadhesive, procoagulan...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-010-1893-6
更新日期：2010-08-01 00:00:00
abstract：:Clearly the main determinant of outcome in severe acute pancreatitis is the extent of pancreatic necrosis and the subsequent risk for the development of infected necrosis. A thorough assessment using appropriate scoring systems and the early use of dynamic contrast-enhanced CT will highlight those patients likely to b...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s001340050808
更新日期：1999-02-01 00:00:00
