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 to validate the compensation, define its limits and provide details on the ventilator's output at varied atmospheric pressures. METHODS:Experiments were conducted inside a multiplace hyperbaric chamber at 1, 2.2, 2.8 and 4 atmospheres absolute (ATA), with the ventilator connected to a test lung. Transducers were recalibrated at each ATA level. Various ventilator settings were tested in volume and pressure control modes. Measured tidal volumes were compared with theoretical predictions based on gas laws. RESULTS:Results confirmed the ventilator's ability to provide compensation, but also identified its limits. The compensation range could be predicted and depended on the maximal flow attainable, decreasing linearly with increasing atmospheric pressure. With settings inside the range, tidal volumes approximated set values (mean error 10 ± 5 %). With settings outside the range, the volume was limited to the predicted maximal value calculated from maximal flow. A practical guide for clinicians is provided. CONCLUSION:The IPER 1000 ventilator attempted to deliver stable tidal volume by adjusting the opening of the inspiratory valve in proportion to atmospheric pressure. Adequate compensation was observed, albeit only within a predictable range, which can be reliably predicted for each setting and ATA level combination. Setting a tidal volume outside this range can result in an unwanted decrease in minute ventilation.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Lefebvre JC,Lyazidi A,Parceiro M,Sferrazza Papa GF,Akoumianaki E,Pugin D,Tassaux D,Brochard L,Richard JCdoi
10.1007/s00134-012-2590-4subject
Has Abstractpub_date
2012-08-01 00:00:00pages
1400-4issue
8eissn
0342-4642issn
1432-1238journal_volume
38pub_type
杂志文章abstract：OBJECTIVE:Invasive candidiasis (IC) outcomes in intensive care units (ICUs) could be improved by the early administration of antifungals. The Candida Score (CS) prediction rule has been proposed for the selection of patients who could develop IC. Procalcitonin (PCT) levels allow prompt identification of sepsis, but the...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1623-0
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVE:To determine the prevalence, risk factors, and outcomes of critical illness neuromuscular abnormalities (CINMA). DESIGN:Systematic review. DATA SOURCES AND STUDY SELECTION:MEDLINE, EMBASE, CINAHL, and the Cochrane Library were searched for reports on adult ICU patients who were evaluated for CINMA clinicall...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-007-0772-2
更新日期：2007-11-01 00:00:00
abstract：:In alcoholic patients, metabolic acidosis can be related to lactate acidosis associated with sepsis or thiamine deficiency, ketoacidosis, methanol or ethylene glycol poisoning. High resolution proton nuclear magnetic resonance (NMR) can be used to detect abnormal organic acid metabolites in urine or serum from patient...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340100892
更新日期：2001-04-01 00:00:00
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 t...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1197-2
更新日期：2009-01-01 00:00:00
abstract：:The goals of management of patients with respiratory failure include improving arterial oxygenation with PEEP and red cell transfusion to maintain oxygen carrying capacity, both of which contribute to improving tissue oxygen delivery. However, standard CPD-stored blood is rapidly depleted of 2,3 diphosphoglycerate (2,...
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
abstract：:A case of brainstem encephalitis complicated by torsade de pointes is described. The possible occurrence of ventricular arrhythmias may contribute to the mortality in this condition. We recommend the admission of patients with brainstem encephalitis to an intensive care unit, for a period of electrocardiographic monit...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00263564
更新日期：1987-01-01 00:00:00
abstract：: ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-018-5063-6
更新日期：2018-12-01 00:00:00
abstract：PURPOSE:This prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU). METHODS:Data of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Re...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-014-3323-7
更新日期：2014-07-01 00:00:00
abstract：:Placement of a Swan-Ganz catheter can cause many complications. This case report presents a new complication of Swan-Ganz catheter insertion--placement of the Swan-Ganz catheter tip in the coronary sinus. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254707
更新日期：1987-01-01 00:00:00
abstract：:In 9 Goettingen minipigs we studied the effect of E. coli bacteremia on effective pulmonary capillary pressure and the longitudinal distribution of pulmonary vascular resistance. Precapillary pressure gradient (dPa) was calculated as the difference between mean pulmonary artery pressure (MPP) and effective pulmonary c...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709400
更新日期：1990-01-01 00:00:00
abstract：PURPOSE:The use of heat and moisture exchangers (HME) during noninvasive ventilation (NIV) can increase the work of breathing, decrease alveolar ventilation, and deliver less humidity in comparison with heated humidifiers (HH). We tested the hypothesis that the use of HH during NIV with ICU ventilators for patients wit...
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/s00134-013-3145-z
更新日期：2014-02-01 00:00:00
abstract：PURPOSE:Severe acute pancreatitis (SAP) remains a life-threatening disease with classic etiology of systemic inflammatory response and mortality between 30 and 50 %. The aim of the present study is to compare two different treatment strategies of goal-directed hemodynamic management and evaluate their impact on surviva...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2775-x
更新日期：2013-04-01 00:00:00
abstract：INTRODUCTION:Approximately 20 years have passed since we reported our results of histologically proven cytomegalovirus (CMV) pneumonia in non-immunocompromised ICU patients. Even if there are more recent reports suggesting that CMV may worsen the outcomes for ICU patients, there is no definite answer to this question: ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-015-4066-9
更新日期：2016-01-01 00:00:00
abstract：OBJECTIVE:To investigate the effects of some acid-base abnormalities on blood capacity of transporting CO(2). DESIGN:Prospective study. SETTING:General and Cardiosurgical ICUs of a University hospital. PATIENTS:Six groups of ten patients characterized by: metabolic alkalosis; respiratory alkalosis; absence of acid-b...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1259-9
更新日期：2002-05-01 00:00:00
abstract：OBJECTIVE:To assess the safety and efficacy of sustained inflations (SI) as lung recruitment maneuvers (RMs) in ventilated pediatric intensive care unit (PICU) patients. DESIGN:Observational, prospective data collection. SETTING:Tertiary-care PICU. PATIENTS AND PARTICIPANTS:Thirty-two consecutive ventilated pediatri...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0764-2
更新日期：2007-10-01 00:00:00
abstract：INTRODUCTION:The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper was impressive. However, insight into the elements of professionalism as perceived relevant for intensivists from the fellows' view, and how these are taught and learned, is limited. OBJECTIVES AND METHODS:A nationwide study ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1644-8
更新日期：2010-02-01 00:00:00
abstract：BACKGROUND:Limiting the duration of invasive ventilation is an important goal in caring for critically ill patients. Several clinical trials have shown that compared to traditional care, protocols can reduce the total duration of mechanical ventilation. Computerized or automated weaning has the potential to improve wea...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-008-1154-0
更新日期：2008-10-01 00:00:00
abstract：OBJECTIVE:The most recent approach to estimate nursing resources consumption has led to the generation of the Nine Equivalents of Nursing Manpower use Score (NEMS). The objective of this prospective study was to establish a completely automatically generated calculation of the NEMS using a patient data management syste...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2239-z
更新日期：2004-07-01 00:00:00
abstract：OBJECTIVES:(a) To assess whether differences in lung morphology observed in patients with adult respiratory distress syndrome (ARDS) are associated with differences in cardiorespiratory parameters, lung mechanics, and outcome. (b) To propose a new ARDS Severity Score to identify patients with a high mortality risk. DE...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051317
更新日期：2000-08-01 00:00:00
abstract：PURPOSE:During neurally adjusted ventilatory assist (NAVA) the ventilator is driven by the patients electrical activation of the diaphragm (EAdi), detected by a special esophageal catheter. A reliable positioning of the EAdi-catheter is mandatory to trace a representative EAdi signal. We aimed to determine whether a fo...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1587-0
更新日期：2009-10-01 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：OBJECTIVE:To determine the cell content and purity of Ficoll-separated peripheral blood mononuclear cells and granulocyte isolates in sepsis patients compared to healthy controls. DESIGN AND SETTING:Prospective study in the adult and pediatric intensive care departments of the Erasmus University Medical Center in the ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0989-0
更新日期：2008-05-01 00:00:00
abstract：OBJECTIVE:We undertook this study to evaluate the influence of the inspiration:expiration (I:E) ratio on intracranial pressure and cerebral perfusion in patients with acute stroke. DESIGN:Ventilated patients with acute stroke were examined under a protocol involving variations of I:E ratio from 1:2 to 1:1 to 1:2 under...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1351-1
更新日期：2002-08-01 00:00:00
abstract：OBJECTIVE:Angiopoietin-2 (Ang-2) is a potent regulator of vascular permeability and inflammation in acute lung injury and acute respiratory distress syndrome (ARDS). Genetic variants in the Ang-2 gene may lead to altered activities of Ang-2 (or ANGPT2) gene. The aim of this study was to assess if genetic variants of An...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1413-8
更新日期：2009-06-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis whether PMN-Elastase in bronchoalveolar lavage fluid (BALF) could reflect neutrophil activity in the lower respiratory tract. DESIGN:Prospectively, morphologic findings of acute and chronic inflammation in the transbronchial lung biopsy specimens were compared with the numbers of neutr...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01720908
更新日期：1994-05-01 00:00:00
abstract：OBJECTIVES:Circulating levels of the proinflammatory mediator High Mobility Group Box Protein 1 (HMGB1) are increased in septic patients and may contribute to sepsis-induced organ dysfunction. Although HMGB1 has been shown to activate neutrophils from healthy volunteers, the responses of neutrophils from septic patient...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0748-2
更新日期：2007-10-01 00:00:00
abstract：:A prospective study of thiamine status in patients with severe injuries (injury severity scores greater than 12) showed that they all developed signs of severe thiamine deficiency on the basis of transketolase activity, the standard biochemical test for thiamine deficiency. This occurred within the first week after th...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00256767
更新日期：1988-01-01 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：OBJECTIVES:To document the effect of neurocritical care, delivered by specialist staff and based on protocol-driven therapy aimed at intracranial pressure (ICP) and cerebral perfusion pressure (CPP) targets, on outcome in acute head injury. DESIGN:Retrospective record review to compare presentation, therapy and outcom...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1235-4
更新日期：2002-05-01 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
