Abstract:
:Controlled mechanical ventilation is an accepted therapy for acute respiratory failure but by virtue of the increase in intrathoracic pressure has a large number of disadvantages. It is to overcome these disadvantages that alternative modes of ventilation have been introduced. These aim to reduce the effects of abnormally high airway pressure on the lung whilst recruiting solid alveoli and at the same time maintaining effective blood volume. Intermittent mandatory ventilation is a mode of ventilation first introduced to aid weaning which may reduce the need for sedation, permit better tolerance of high levels of PEEP and maintain urine osmolar output. High frequency ventilation utilising low airway pressures can maintain pulmonary gas exchange whilst reducing the effects of stretch on the lung. Its major role would seem to be in cases of bronchopleural fistula and necrotising pneumonia where a low mean airway pressure is essential. Low frequency positive pressure ventilation with extra corporeal CO2 removal, whilst a very labour intensive technique, has produced a favourable outcome in patients with terminal respiratory failure. Use of PEEP is associated with further deleterious haemodynamic effects which are largely overcome with use of continuous positive airway pressure during spontaneous respiration. PEEP is widely used. Its effect on pulmonary compliance, dead space and oxygen delivery are unpredictable making haemodynamic monitoring mandatory. Inversed ratio ventilation requires further evaluation whereas differential lung ventilation is logical, complicated but very valuable where the time constants for each lung are significantly different.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Willatts SMdoi
10.1007/BF00254773subject
Has Abstractpub_date
1985-01-01 00:00:00pages
51-5issue
2eissn
0342-4642issn
1432-1238journal_volume
11pub_type
杂志文章,评审abstract::In severe status asthmaticus basic medical treatment often fails to improve the patient's condition. Mechanical ventilation in this situation is associated with a high incidence of serious complications. After the bronchodilating effect of moderate-dose magnesium sulfate in asthmatic patients had been demonstrated in ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711089
更新日期:1993-01-01 00:00:00
abstract:PURPOSE:Inflammatory markers may have a role in predicting severity of illness of intensive care unit (ICU) patients. The aim of this study is to determine whether low eosinophil count can predict 28-day mortality in medical ICU. METHODS:A prospective study over a 4-month period. To evaluate the prognosis information ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2170-z
更新日期:2011-07-01 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:OBJECTIVE:To describe the use of volumetric capnography, a plot of expired CO(2) concentration against expired volume, in monitoring fibrinolytic treatment of major pulmonary embolism. DESIGN AND SETTING:Two case reports in the emergency department of a teaching hospital. PATIENTS:Two conscious and spontaneously brea...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2444-9
更新日期:2004-11-01 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:Information on predisposing risk factors influencing long-term survival after extracorporeal membrane oxygenation (ECMO) support remains scarce. In critically ill patients chronic obstructive pulmonary disease (COPD) is an independent risk factor for mortality and morbidity. We assessed the influence of COPD on...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-2931-y
更新日期:2013-08-01 00:00:00
abstract:INTRODUCTION:Microcirculatory abnormalities are frequently observed in patients with severe heart failure and correlate to worse outcomes. We tested the hypothesis that nitroglycerin dose-dependently improves perfusion in severe heart failure and that this could be monitored by measuring central-peripheral temperature ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1591-4
更新日期:2009-11-01 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:PURPOSE:Mechanical ventilation with lower tidal volumes (≤6 ml/kg of predicted body weight, PBW) could benefit patients without acute respiratory distress syndrome (ARDS). However, tidal volume reduction could be associated with increased patient discomfort and sedation needs, and consequent longer duration of ventilat...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-014-3318-4
更新日期:2014-07-01 00:00:00
abstract::We describe a case of the dialysis disequilibrium syndrome (DDS) that was marked by the rapid onset of cerebral edema and the subsequent development of acute respiratory failure. The patient was treated successfully with a combination of mechanical hyperventilation and mannitol. The clinical presentation, pathogenesis...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051214
更新日期:2000-05-01 00:00:00
abstract::A 42 year old pregnant woman was admitted in acute respiratory failure. Viral pneumonia was suspected and oxygen therapy, CPAP, water restriction and diuretics were started with good response. She remained febrile and had an abnormal chest X-ray, a diagnosis of miliary tuberculosis was confirmed by transbronchial fibr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01902549
更新日期:1978-11-01 00:00:00
abstract::Myxoedema coma is a medical emergency with high mortality. In this study, clinical response and plasma variations of thyroid hormones were analysed in 7 patients, 6 presenting with myxoedema coma and one with myxoedema ileus. These patients were treated with intravenous or oral l-thyroxine (l-T4). 1000 mu l-T4 iv were...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01708403
更新日期:1991-01-01 00:00:00
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:Nin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1545-6
更新日期:2002-12-01 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::Extracorporeal life support (ECLS) can support gas exchange in patients with the acute respiratory distress syndrome (ARDS). During ECLS, venous blood is drained from a central vein via a cannula, pumped through a semipermeable membrane that permits diffusion of oxygen and carbon dioxide, and returned via a cannula to...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-020-06290-1
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:A prospective physiological study was performed in 12 paediatric patients with acute moderate hypercapnic respiratory insufficiency to assess the ability of noninvasive positive pressure ventilation (NPPV) to unload the respiratory muscles and improve gas exchange. MATERIALS AND METHODS:Breathing pattern,...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-008-1202-9
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of prone positioning on systemic hemodynamics, intra-abdominal pressure (IAP), plasma disappearance rate of indocyanine green (PDR(ICG)), and gastric intramucosal to arterial PCO2 difference (Pi-aCO2). DESIGN AND SETTING:Prospective randomized study in the intensive care unit of a ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-001-1166-5
更新日期:2002-01-01 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::The side effects of positive pressure ventilation on cardiovascular function are well known. However, in most clinical studies its influence on left ventricular function was examined. In the present study right ventricular (RV) performance was studied in 13 patients undergoing coronary artery bypass grafting during me...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256962
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To characterize hemodynamic changes during experimental aspiration pneumonitis, paying special attention to echocardiographic assessment. DESIGN AND SETTING:Animal study in a university-based research laboratory. SUBJECTS:Fourteen mechanically ventilated New Zealand white rabbits INTERVENTIONS:We instilled...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0457-2
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Atracurium besylate and laudanosine cause excitement and seizures when introduced into the central nervous system of laboratory animals. We examined the modulation of lipid-protein interaction in the lipid environment of rat brain synaptosomal plasma membrane (SPM)-bound enzymes as a possible mechanism leadin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050605
更新日期:1998-05-01 00:00:00
abstract::Although colitis is often seen in critically all patients who have received multiple broad-spectrum antibiotics, there are no reports describing severe sepsis as a result of Clostridium difficile infection. We describe three cases of severe sepsis with local intestinal Clostridium difficile infection as the only ident...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02044130
更新日期:1996-09-01 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:OBJECTIVE:To explore translation, conversion and definition ambiguities, when using severity scoring systems in patients admitted to intensive care units (ICUs). DESIGN:A prospective study of the prognosis of acute renal failure in ICUs. SETTING:The study was conducted in 20 French ICUs. PATIENTS:360 patients presen...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01705416
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:Capillary leakage syndrome (CLS) is a frequent complication in sepsis, characterized by loss of intravasal fluids leading to generalized edema and hemodynamic instability despite massive fluid therapy. In spite of its importance no standardized diagnostic criteria are available for CLS. DESIGN:Prospective cl...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000601
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To characterize N-terminal pro-brain natriuretic peptide (N-proBNP) and troponin I (TnI) profile following mitral and/or aortic valve surgery and to evaluate correlations with echocardiography measures and outcome criteria. DESIGN AND SETTING:Prospective cross-controlled study in a university children's hosp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1025-8
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To assess the role of antipseudomonal agents on Pseudomonas aeruginosa colonization and acquisition of resistance. DESIGN:Prospective cohort study. SETTING:Two medical intensive care units. PATIENTS AND PARTICIPANTS:346 patients admitted for >or= 48 h. INTERVENTION:Analysis of data from an 8-month study c...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1326-y
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Adult studies evaluating corticosteroids have found varied efficacy. One study showing mortality benefit utilized fludrocortisone (FLU) and hydrocortisone (HC) (Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862-871, 2002). Use of...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2090-3
更新日期:2011-03-01 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:PURPOSE:Bioactive NO carriers in circulating blood formed during NO inhalation selectively distribute blood flow to areas in need, and may thus improve collateral perfusion to the area-at-risk in acute myocardial infarction (AMI). Here, we tested the hypothesis that NO inhalation during the ischemic phase of AMI may im...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2605-1
更新日期:2012-08-01 00:00:00