Abstract:
PURPOSE:We evaluated whether oscillatory compliance (C(X5)) measured by forced oscillation technique (FOT) at 5 Hz may be useful for positive end-expiratory pressure (PEEP) optimisation. METHODS:We studied seven pigs in which lung injury was induced by broncho-alveolar lavage. The animals were ventilated in volume control mode with a tidal volume of 6 ml/kg. Forced oscillations were superimposed on the ventilation waveform for the assessment of respiratory mechanics. PEEP was increased from 0 to 24 cmH(2)O in steps of 4 cmH(2)O and subsequently decreased from 24 to 0 in steps of 2 cmH(2)O. At each 8-min step, a CT scan was acquired during an end-expiratory hold, and blood gas analysis was performed. C(X5) was monitored continuously, and data relative to the expiratory hold were selected and averaged for comparison with CT and oxygenation. RESULTS:Open lung PEEP (PEEP(ol)) was defined as the level of PEEP corresponding to the maximum value of C(X5) on the decremental limb of the PEEP trial. PEEP(ol) was on average 13.4 (± 1.0) cmH(2)O. For higher levels of PEEP, there were no significant changes in the amount of non-aerated tissue (V(tissNA)%). In contrast, when PEEP was reduced below PEEP(ol), V(tissNA)% dramatically increased. PEEP(ol) was able to prevent a 5% drop in V(tissNA)% with 100% sensitivity and 92% specificity. At PEEP(ol) V(tissNA)% was significantly lower than at the corresponding PEEP level on the incremental limb. CONCLUSIONS:The assessment of C(X5) allowed the definition of PEEP(ol) to be in agreement with CT data. Thus, FOT measurements of C(X5) may provide a non-invasive bedside tool for PEEP titration.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Dellacà RL,Zannin E,Kostic P,Olerud MA,Pompilio PP,Hedenstierna G,Pedotti A,Frykholm Pdoi
10.1007/s00134-011-2211-7subject
Has Abstractpub_date
2011-06-01 00:00:00pages
1021-30issue
6eissn
0342-4642issn
1432-1238journal_volume
37pub_type
杂志文章abstract:PURPOSE:To describe the course of early organ dysfunction in a cohort of patients admitted in ICU suffering classic heatstroke. METHODS:Prospective observational single-centre cohort study with a 1-year follow-up. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Clinical and biological data of 22 patients were anal...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1500-x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that, during high-frequency oscillatory ventilation (HFOV) of pigs with acute lung injury, the oxygenation index (OI = Paw*FIO(2)*100/PaO(2)) is minimal at the lowest continuous distending pressure (Paw), where the physiological shunt fraction is below 0.1 (Paw(optimal)). DESIGN AND SE...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1368-5
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To investigate the morphological changes in the liver in patients with organ failure and hyperbilirubinemia and to correlate them to the outcome. DESIGN:A case series prospective study. SETTING:Intensive care units of two general hospitals. PATIENTS:Twelve patients in organ failure with predominant hepatic...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01708095
更新日期:1996-06-01 00:00:00
abstract::The acute respiratory distress syndrome (ARDS) continues as a contributor to the morbidity and mortality of patients in intensive care units throughout the world, imparting tremendous human and financial costs. During the last ten years there has been a decline in ARDS mortality without a clear explanation. The Americ...
journal_title:Intensive care medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1007/s001340050585
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:To analyze the actual cost of pediatric intensive care and its different components, particularly the differences between various patient groups, with special reference to the variable cost and the elements included in it. DESIGN:Prospective, observational study. SETTING:Multidisciplinary 12-bed pediatric i...
journal_title:Intensive care medicine
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更新日期:1997-02-01 00:00:00
abstract:PURPOSE:The early diagnosis of traumatic internal carotid artery dissection (TICAD) is essential for initiating appropriate treatment and improving outcome. We searched for criteria from transcranial Doppler (TCD) measurements on admission that could be associated with subsequent TICAD diagnosis in patients with trauma...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1919-0
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To investigate efficacy and safety of enoxaparin for catheter-related arterial thrombosis in infants with congenital heart disease. DESIGN:Prospective observational study. SETTING:Pediatric Intensive Care and Cardiology Unit at the University Children's Hospital of Zurich. PATIENTS:A cohort of 32[Symbol: s...
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更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the perceived health and cognitive status in survivors of chronic obstructive pulmonary disease (COPD) exacerbations requiring mechanical ventilation. DESIGN AND SETTING:Prospective controlled cohort study in a respiratory intermediate intensive care unit. PATIENTS:Sixty-three COPD patients at t...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-001-1165-6
更新日期:2002-02-01 00:00:00
abstract::The treatment of severe tetanus with autonomic dysfunction is discussed, with emphasis on the use of magnesium sulphate. An exemplary case is reported, describing the inadequate response to magnesium, but the previously unreported and successful use of clonidine to control sympathetic overactivity. The properties of c...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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更新日期:1990-01-01 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/s00134-014-3625-9
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To investigate the efficacy of somatostatin for the treatment of severe acute pancreatitis. DESIGN:Prospective, randomized and unblinded study. SETTING:A general intensive care unit (ICU) in a university hospital. PATIENTS:50 patients with severe acute pancreatitis. INTERVENTIONS:All patients received the...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340050512
更新日期:1998-01-01 00:00:00
abstract:PURPOSE:To assess the feasibility of remifentanil-based sedation in hypoxemic acute respiratory failure (HARF) patients refusing to continue noninvasive ventilation (NPPV) for intolerance to two different interfaces-helmet and total face mask. DESIGN AND SETTING:Prospective uncontrolled clinical investigation in a 14-...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-010-2026-y
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:Inhalation of nitric oxide (NO) can improve oxygenation and decrease mean pulmonary artery pressure (MPAP) in patients with the acute respiratory distress syndrome (ARDS). It is not known whether inhaled NO exerts a similar effect in hypoxemic patients with chronic obstructive pulmonary disease (COPD). DESIG...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050290
更新日期:1997-01-01 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: 信件
doi:10.1007/s00134-018-5420-5
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Chronic pulmonary hypertension (PH) therapy is poorly investigated in intensive care. Our aim was to evaluate haemodynamic and neuroendocrine effects of the dual endothelin-1 (ET-1) blocker tezosentan in monocrotaline (MCT)-induced PH. METHODS:Male Wistar rats (180-200 g, n = 194) randomly received 60 mg kg(-1...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2484-5
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:Children with peripheral airways obstruction suffer the negative effects of intrinsic positive end-expiratory pressure: increased work of breathing and difficulty triggering assisted ventilatory support. We examined whether external positive end-expiratory pressure to offset intrinsic positive end-expiratory...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-006-0445-6
更新日期:2007-01-01 00:00:00
abstract:PURPOSE:To examine the consequences of administration of norepinephrine on muscle tissue oxygenation in severely hypotensive septic shock patients. METHODS:This was a prospective observational study conducted in a medical intensive care unit of a university hospital. We included 28 septic shock patients that received ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2013-3
更新日期:2010-11-01 00:00:00
abstract::This report identifies some of the risk factors underlying the acquisition of hospital infections in patients admitted to Intensive Care Units (ICUs). Infection rates vary in different institutes and in different types of ICUs. Patients are particularly prone to septicaemia and respiratory infections and the underlyin...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01709700
更新日期:1990-01-01 00:00:00
abstract:PURPOSE:Meconium aspiration syndrome (MAS) is a life-threatening neonatal lung injury, whose pathophysiology has been mainly studied in animal models. In such models, pancreatic secretory phospholipase A2 (sPLA2-IB) and proinflammatory cytokines present in meconium challenge the lungs, catabolising surfactant and harmi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2243-z
更新日期:2011-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00134-003-1933-6
更新日期:2003-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00265119
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/s001340051013
更新日期:1999-10-01 00:00:00
abstract::Pneumonia caused by herpes simplex virus type 1 (HSV1) is rare and occurs in severely immunosuppressed patients. HSV1 can be detected in bronchoalveolar lavage (BAL) from patients presenting with respiratory failure, but its direct effect on disease is difficult to prove. We demonstrate the causative role of HSV1 in t...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050339
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVES:To develop a simplified Therapeutic Intervention Scoring System (TISS) based on the TISS-28 items and to validate the new score in an independent database. DESIGN:Retrospective statistical analysis of a database and a prospective multicentre study. SETTING:Development in the database of the Foundation for ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050406
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify risk factors and to describe epidemiological patterns for early-(EOB) and late-onset bacteremias (LOB) after trauma. DESIGN:A prospective study conducted on 141 consecutive trauma patients. SETTING:A general intensive care unit (ICU) of a university hospital. PATIENTS:...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709514
更新日期:1996-08-01 00:00:00
abstract:PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. ME...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1735-6
更新日期:2010-03-01 00:00:00
abstract::A case of bilateral pseudoaneurysms of the pulmonary arteries caused by blunt chest injury is presented. Although this is a very rare complication, this entity should always be suspected in a patient with hemoptysis and a radiodensity on chest radiograph following chest injury. Selection of operative procedures should...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01706428
更新日期:1992-01-01 00:00:00
abstract:PURPOSE:Acute kidney injury (AKI) frequently occurs after heart transplantation (HTx), but its relation to preoperative right heart hemodynamic (RHH) parameters remains unknown. Therefore, we aimed to determine their predictive properties for postoperative AKI severity within 30 days after HTx. METHODS:From 1984 to 20...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5159-z
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To clarify the effects of hypercapnia (increased PaCO2) on gastric mucosal oxygenation during anaesthesia in dogs. DESIGN:Prospective, controlled animal study. SETTING:Experimental research laboratory of an university hospital. SUBJECTS:Six chronically instrumented dogs. INTERVENTIONS:Dogs were anaestheti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1183-8
更新日期:2008-10-01 00:00:00