Abstract:
PURPOSE:To determine whether, during mechanical ventilation, an optimal positive end-expiratory pressure (PEEP) can be identified by measurement of regional tidal volume and compliance [V (T(reg)), C (RS(reg))]. METHODS:Sixteen anaesthetized intubated neonatal piglets underwent a stepwise vital capacity manoeuvre performed during pressure control ventilation, with 5 cmH₂O PEEP increments to 25 cmH₂O, and decrements to 0 cmH₂O. Peak inflating pressure was 10 cmH₂O above PEEP throughout. The manoeuvre was performed in the normal lung, after repeated saline lavage and after surfactant therapy. Global V (T) and C (RS) were measured at the airway opening; V (T(reg)) and C (RS(reg)) were measured in the ventral, medial and dorsal lung using electrical impedance tomography (EIT). RESULTS:Most uniform distribution of regional tidal ventilation was noted during PEEP decrements after lung recruitment, at varying PEEP levels. In the lavaged and surfactant-treated lung the PEEP optimal for ventilation distribution was also associated with highest mean V (T(reg)) [lavaged: 95 ± 9.3% of maximum, mean ± standard deviation (SD); surfactant-treated: 92 ± 17%] and global V (T) (96 ± 10%; 96 ± 15%). Regional C (RS) plots clearly demonstrated co-existent ventral overdistension and dorsal recruitment, particularly during PEEP increments; whereas during PEEP decrements, peak C (RS(reg)) values showed considerable interregional concordance [e.g. peak C (RS(reg)) in the lavaged left lung; ventral: 0.017 ± 0.0036; medial: 0.016 ± 0.0054; dorsal: 0.017 ± 0.0073 cmH₂O⁻¹; P = 0.98, analysis of variance (ANOVA)]. CONCLUSIONS:After lung recruitment, a PEEP level can be identified by EIT at which tidal ventilation is uniformly distributed, with associated concordance in compliance between lung regions. Bedside monitoring of regional tidal ventilation and compliance using EIT may thus aid in PEEP selection.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Dargaville PA,Rimensberger PC,Frerichs Idoi
10.1007/s00134-010-1995-1subject
Has Abstractpub_date
2010-11-01 00:00:00pages
1953-61issue
11eissn
0342-4642issn
1432-1238journal_volume
36pub_type
杂志文章abstract:PURPOSE:To determine whether erythromycin is non-inferior to metoclopramide in facilitating post-pyloric placement of self-propelled spiral nasoenteric tubes (NETs) in critically ill patients. METHODS:A prospective, multicenter, open-label, parallel, and non-inferiority randomized controlled trial was conducted compar...
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/s00134-018-5466-4
更新日期:2018-12-01 00:00:00
abstract::Intravenous bolus endotoxin elicits a marked but transient increase in plasma TxB2 and 6-keto-PGF1 alpha in a large number of species. A smaller, delayed and more prolonged increase in TxB2 and 6-keto-PGF1 alpha are reported in animals with septic shock, i.e., those with fecal peritonitis or cecal ligation. Thromboxan...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF00254925
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the sensitivity, specificity and overall accuracy of a model based on the presence or absence of organ dysfunctions and/or infection (ODIN) to predict the outcome for intensive care unit patients. DESIGN:Prospective study. SETTING:General intensive care unit in a university teaching hospital. P...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720528
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:The Pediatric Index of Mortality 2 (PIM2), one of the key mortality prediction models for children in intensive care units, has not been validated in Japan. The purpose of this study was to validate the performance of PIM2 in a population of patients admitted to one pediatric intensive care unit (PICU) in Jap...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2460-5
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To provide evidence for the upregulation of endothelial nitric oxide synthase (eNOS) or inducible nitric oxide synthase (iNOS) in the assumed imbalance in the pathophysiology of rapid progressive pulmonary hypertension of the newborn (RPPHN), which is characterized by abnormal hypertrophy of the pulmonary art...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1892-y
更新日期:2003-10-01 00:00:00
abstract::Owing to an oversight by the authors, Figure 2 in this article was not the version intended for publication. The correct Figure 2, reproduced here, features footnote symbols and Figure 2b includes three studies as described in the main text. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00134-018-5055-6
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the nursing time required for difficult-to-wean patients in a dedicated weaning center (WC) and to examine the correlation of the nursing time with nursing workload (NW) scores and with clinical severity and dependency. SETTING:Four-bed WC of a pulmonary rehabilitation department. INTERVENTION:N...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051249
更新日期:2000-06-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5278-6
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To investigate the correlation between microalbuminuria and extravascular lung water in patients in septic shock who require mechanical ventilation for severe respiratory failure. DESIGN AND SETTING:Prospective, observational, clinical study in the 20-bed intensive care unit of a university hospital. PATIEN...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1651-0
更新日期:2003-03-01 00:00:00
abstract::The aim of this investigation was to evaluate the role of ultrasonography in avoiding cranial misplacement of the tracheostomy tube and tracheal ring fractures during percutaneous dilatational tracheostomy (PDT). The tracheas of 26 consecutive ICU patients who had undergone PDT but who later died were removed en bloc ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000589
更新日期:2000-09-01 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:(1) To describe the pattern of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in a group of severe head-injured patients, (2) to quantify complications of ICP monitoring, and (3) to describe a management protocol and its results. DESIGN:Prospective observational study. SETTING:General int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050860
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:Postoperative pneumonia is a potentially devastating complication associated with high mortality in intensive care unit (ICU)-patients. One of the major predisposing factors is the perioperative occurrence of atelectatic formations in non-dependent lung areas. Perioperative ventilation/perfusion mismatch due ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1122-8
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To determine the effects of increasing dosages of continuously infused arginine-vasopressin (AVP) on mucosal tissue oxygen tension and oxygen supply in an auto-perfused, innervated jejunal segment in an acute endotoxic porcine model. DESIGN:Prospective, randomized, experimental study. SETTING:University hos...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2858-z
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:We investigated the effect of different levels of continuous positive airway pressure (CPAP) on the cricothyroid (CT; a tensor muscle of the vocal folds) and posterior cricoarytenoid (PCA; sole abductor muscle of the vocal folds) muscles in dogs. DESIGN:Prospective, controlled animal study. SUBJECTS:Nine m...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709524
更新日期:1996-08-01 00:00:00
abstract:PURPOSE:Intensive care unit survivors suffer from prolonged impairment, reduced quality of life, and higher mortality rates after discharge compared to the general population. Socioeconomic status may play a partial but important role in mortality and recovery. Therefore, the detection of factors that are responsible f...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-018-5412-5
更新日期:2018-12-01 00:00:00
abstract::Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) devi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706360
更新日期:1990-01-01 00:00:00
abstract:PURPOSE:We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS:Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French inte...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-017-4764-6
更新日期:2017-07-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 社论
doi:10.1007/s00134-018-5401-8
更新日期:2018-12-01 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:The aim of our study was to analyze changes in the consumption of MRSA-active antibiotics and in the burden of methicillin-resistant S. aureus (MRSA) over a period of 9 years in a network of German intensive care units (ICU). METHODS:Data from 55 ICUs in Germany were analyzed from 2001 through 2009. The term "...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2335-9
更新日期:2011-10-01 00:00:00
abstract::During a 3-year period, a clinical diagnosis of invasive candidosis was made in 8 out of 2054 consecutive surgical intensive care unit (ICU) patients. These patients were retrospectively matched with 16 control patients who underwent similar surgical procedures and had a similar clinical course except for negative Can...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100891
更新日期:2001-05-01 00:00:00
abstract:PURPOSE:Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood-brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are assoc...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5120-1
更新日期:2018-03-01 00:00:00
abstract:PURPOSE:An International Consensus Conference proposed classifying weaning into simple, difficult, and prolonged weaning. However, the usefulness of this classification in a respiratory intensive care unit (ICU) is unknown. The aims of the study were: (1) to compare the clinical characteristics and outcomes of patients...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2179-3
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was (1) to determine the prevalence of intensive care unit (ICU) admissions due to an adverse drug reaction (ADR), and (2) to compare affected patients with patients admitted to the ICU for the treatment of deliberate self-poisoning using medical drugs. DESIGN:Prospective observa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1250-1
更新日期:2009-02-01 00:00:00
abstract::The arterial oxygen and carbon dioxide tensions, pulmonary and systemic haemodynamics and pulmonary shunting and mechanics were measured during the first 30 min after intravenous labetalol administration. Thirty patients, recovering in the intensive care unit after neurosurgical interventions were randomly divided in ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00255635
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To study the pharmacokinetics and local tissue effects resulting from the intratracheal administration of preservative-free fentanyl. DESIGN:Prospective, randomized, blinded and controlled animal study. SETTING:University research laboratory. SUBJECTS:Eighteen adult male New Zealand rabbits. INTERVENTIONS...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720719
更新日期:1996-02-01 00:00:00
abstract::One hundred consecutive patients were interviewed between the 3rd and 7th days, inclusive, of their discharge from an intensive care unit to a general ward. The patients' recall of events related to their admission to the ICU was generally poor, and 41% of them felt that they had been confused at some time during thei...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01686054
更新日期:1979-05-01 00:00:00
abstract::In the past two years several guidelines for suggested components of emergency medical systems for children have been suggested, and for the first time, specific standards of pediatric trauma care have also been formulated. The American Academy of Pediatrics new Provisional Committee on Emergency Medicine has been cha...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00260888
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To investigate whether serum procalcitonin (PCT) levels could be useful to differentiate between systemic infection and the activity of the underlying disease in autoimmune disease. METHODS:In 18 patients with systemic lupus erythematodes (SLE) and 35 patients with systemic antineutrophil cytoplasmic antibod...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02900738
更新日期:2000-03-01 00:00:00