Abstract:
OBJECTIVE:We propose that higher airway occlusion pressure (P0.1) responses to hypercapnic challenge (HC) indicate less severe injury. The study aim was to determine whether P0.1 responses to HC were associated with successful weaning after prolonged mechanical ventilation (PMV) in patients with brainstem lesions and to determine a reference value for clinical use. DESIGN AND SETTING:Forty-two patients with brainstem lesions on PMV were recruited. Breathing parameters and P0.1 were measured before HC. Three-minute HC challenges with increasing CO(2) concentrations were initiated and P0.1, respiratory rate, minute ventilation (V (e)), tidal volume (V (t)) and end tidal CO(2) were measured. MEASUREMENTS AND RESULTS:Patients were classified into high (group I) and low (group II) response groups on the basis of P0.1 responses to HC. Increases in V (e) and V (t) after HC were significantly greater in group I patients (12.22 +/- 8.22 vs. 3.08 +/- 4.84 L/min, P < 0.001 and 399.11 +/- 278.18 vs. 110.54 +/- 18.275 ml, P < 0.001). P0.1 levels were significantly higher in group I compared to group II before HC (2.69 +/- 1.81 vs. 1.28 +/- 1.04 cmH(2)O, P = 0.003). The increase in P0.1 following HC was significantly greater in group I compared to group II patients (11.05 +/- 4.06 vs. 2.90 +/- 2.53 cmH(2)O, P < 0.001). Weaning success was significantly higher in group I compared to group II patients (72.2% vs. 33.3%, P = 0.02). A P0.1 increase of >6 cmH(2)O following HC was significantly associated with successful weaning. CONCLUSIONS:Assessing the P.01 response to serial increases in the level of HC may be a safe means to ascertain whether patients with brainstem lesions are ready for ventilator weaning.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Wu YK,Lee CH,Shia BC,Tsai YH,Tsao TCdoi
10.1007/s00134-008-1197-2subject
Has Abstractpub_date
2009-01-01 00:00:00pages
108-14issue
1eissn
0342-4642issn
1432-1238journal_volume
35pub_type
杂志文章abstract:OBJECTIVE:Fibroproliferation markers like procollagen I predict mortality in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We sought to determine whether bronchoalveolar lavage fluid (BALF) from patients with lung injury contained mediators that would activate procollagen I promo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2503-2
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:Critically ill patients often develop anaemia which can be related to a number of factors. However, the exact causes of anaemia in many patients remain unexplained. We hypothesized that the relationship between erythropoietin (EPO) and haematocrit may be altered in critically ill patients. DESIGN:Serum conc...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s001340050310
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abstract:OBJECTIVE:To analyze the effects of polymyxin B-immobilized fiber (PMX-F) on bone resorption in septic patients. DESIGN AND SETTING:Observational prospective study in intensive care units of a general hospital. PATIENTS AND PARTICIPANTS:25 patients with severe sepsis and 20 healthy controls. MEASUREMENTS AND RESULTS...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-004-2357-7
更新日期:2004-09-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-006-0265-8
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Dislocation of the heart is a rare complication of thoracic blunt trauma. A high index of suspicion of pericardium rupture is necessary to formulate an early diagnosis to reduce morbidity and mortality. PATIENTS:A 23-year-old man suffered a blunt thoracoabdominal trauma and was admitted 3 days later to a un...
journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2002-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000784
更新日期:2001-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263553
更新日期:1987-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1961-2
更新日期:2003-12-01 00:00:00
abstract::The use of ultrasonography has become increasingly popular in the everyday management of critically ill patients. It has been demonstrated to be a safe and handy bedside tool that allows rapid hemodynamic assessment and visualization of the thoracic, abdominal and major vessels structures. More recently, M-mode ultras...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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更新日期:2013-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions. DESIGN AND SETTING:Prospective observational consecutive clinical study at a university hospital. PATIENTS:The stud...
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doi:10.1007/s00134-003-1664-8
更新日期:2003-04-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2043-x
更新日期:2011-02-01 00:00:00
abstract:PURPOSE:To investigate the relationship between hemoglobin (Hgb) and brain tissue oxygen tension (PbtO(2)) after severe traumatic brain injury (TBI) and to examine its impact on outcome. METHODS:This was a retrospective analysis of a prospective cohort of severe TBI patients whose PbtO(2) was monitored. The relationsh...
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pub_type: 杂志文章
doi:10.1007/s00134-012-2593-1
更新日期:2012-09-01 00:00:00
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更新日期:2012-01-01 00:00:00
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pub_type: 临床试验,杂志文章
doi:10.1007/s001340101012
更新日期:2001-08-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00271065
更新日期:1989-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00134-010-1863-z
更新日期:2010-06-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2006-07-01 00:00:00
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更新日期:2008-01-01 00:00:00
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更新日期:2003-07-01 00:00:00
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更新日期:2013-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709279
更新日期:1993-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-10-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1981-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01772577
更新日期:1983-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s001340051285
更新日期:2000-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2019-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1995-11-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315364
更新日期:1986-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2000-05-01 00:00:00