Abstract：
BACKGROUND:Measuring patient work of breathing (WOBpt) has been suggested to provide safe, aggressive weaning from mechanical ventilation. We compared WOBpt and pressure-time-product (PTP) to routine weaning parameters [breath rate (f), tidal volume (VT), frequency/tidal volume ratio (f/VT)] at different levels of pressure support ventilation (PSV). METHODS:Fifteen patients in the surgical intensive care unit requiring prolonged weaning (more than 3 days) were entered in the study. A balloon-tipped esophageal catheter was placed and position confirmed by inspection of pressure and flow waveforms. Each patient was randomly assigned to breathe with 5, 10, 15, and 20 cm H2O of PSV. After 30 minutes, 40 breaths were recorded and analyzed. Measurement of WOBpt PTP, f, VT, and f/VT were made using the Bicore CP-100 monitor. Mean values for each parameter were calculated. PTP and WOBpt were plotted against f/VT to determine correlation coefficient. RESULTS:PTP, WOBpt and f/VT decreased in a stepwise fashion as PSV was increased. The f/VT correlated most closely with WOBpt (r = 0.983) and PTP (r = 0.972). Monitoring f alone also correlated with WOBpt (r = 0.894) and PTP (r = 0.881). All patients were weaned from the ventilator (mean duration, 22 +/- 5.9 days). Nine patients required tracheostomy before final liberation from the ventilator (mean duration, 22 +/- 5.9 days). Nine patients required tracheostomy before final liberation from the ventilator. CONCLUSIONS:Direct measurement of WOBpt is invasive, expensive, and' may be confusing to clinicians. Monitoring f/VT may be useful when changing PSV during weaning.
journal_name
Surgeryjournal_title
Surgeryauthors
Johannigman JA,Davis K Jr,Campbell RS,Branson RD,Luchette FA,Hurst JMdoi
10.1016/s0039-6060(97)90081-7subject
Has Abstractpub_date
1997-10-01 00:00:00pages
737-40; discussion 740-1issue
4eissn
0039-6060issn
1532-7361pii
S0039-6060(97)90081-7journal_volume
122pub_type
临床试验,杂志文章,随机对照试验相关文献
SURGERY文献大全abstract：BACKGROUND:To compare operative morbidity, mortality, quality of life, and survival after pancreatoduodenectomy (PD) versus pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) in patients with resectable pancreatic cancer. METHODS:From May 1997 to July 2003 there were 132 patients with biopsy examination-pro...
journal_title：Surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.surg.2005.06.044
更新日期：2005-10-01 00:00:00
abstract：BACKGROUND:Because of controversy about the correct treatment of toxic solitary thyroid nodules, we reviewed our experience. METHODS:We retrospectively studied 32 patients (24 women and 8 men) with solitary toxic thyroid nodules who were treated at our institution (1970 to 1985). RESULTS:Median values were as follows...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-12-01 00:00:00
abstract：BACKGROUND:Seeding of vascular grafts with genetically engineered human endothelial cells (hECs) secreting antithrombogenic or fibrinolytic agents has considerable clinical potential. METHODS:An adenoviral vector was used to transfer the human tissue-type plasminogen activator (htPA) gene to hECs, and the ability of t...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90269-5
更新日期：1997-07-01 00:00:00
abstract：BACKGROUND:Hemorrhage-induced activation of endothelial cell Na+/H+ -exchanger results in cellular swelling, which physically impedes capillary filling and compromises gut perfusion. We hypothesized that correction of the vascular volume deficit by conventional resuscitation does not improve capillary filling unless ce...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2007.08.007
更新日期：2007-10-01 00:00:00
abstract：:The effect of somatostatin analogue SMS 201-995 on pancreatic blood flow was studied. In 24 dogs all vessels to the pancreas, except for the pancreaticoduodenal artery and vein, were divided. A flow probe was placed around the pancreaticoduodenal artery. The animals were divided into four groups. Control animals recei...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1988-12-01 00:00:00
abstract：:We performed spirometry on 114 morbidly obese patients considered for gastric bypass surgery to assess its efficacy as a preoperative screening test. One hundred eight subjects underwent surgery, and 61 patients returned for repeat spirometry 1 year later. The average preoperative forced vital capacity (FVC), forced e...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1986-06-01 00:00:00
abstract：BACKGROUND:The impact of the location of colorectal cancer on patient outcomes has been reported in several settings. The objective of this study was to assess the prognostic impact of the location of the primary colon cancer among patients with colorectal cancer peritoneal metastases undergoing complete cytoreductive ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.07.027
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:Patients with primary mediastinal lymphomas frequently present with a residual mass after completion of first-line therapy. Although a positron emission tomography scan is usually recommended, it fails to distinguish between persistent lymphoma and inflammation. Although percutaneous biopsy may have a high d...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.05.039
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Minority-serving hospitals have greater readmission rates after operative procedures including colectomy; however, little is known about the contribution of hospital factors to readmission risk and mortality in this setting. This study evaluated the impact of hospital factors on readmissions and inpatient mo...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.08.041
更新日期：2017-03-01 00:00:00
abstract：BACKGROUND:Current isolation techniques recover only 20% to 50% of the pancreatic islets. Brain death (BD) is characterized by activation of proinflammatory cytokines (PICs) with reduced islet yields and functionality. We previously reported that 17beta-estradiol (E2) induces cytoprotection to human islets exposed to P...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2004.05.009
更新日期：2004-08-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to clarify the still poorly understood dynamics of peritoneal inflammatory cells (PICs) in acute pancreatitis. METHODS:Acute pancreatitis of 3 different degrees of severity was induced in male Wistar rats. Peritoneal lavage was performed at 1, 6, 12, and 24 hours after the indu...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2002.125171
更新日期：2002-07-01 00:00:00
abstract：:The emergence of both absorbable and nonabsorbable synthetic materials has been primary among the many new developments in suture materials. This is a study of 16 types of natural and synthetic suture materials and their resistance to both gram-positive and gram-negative infections. Four hundred and twenty suture inpl...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：BACKGROUND:Patients with locally advanced pancreatic cancer have historically been considered inoperable. The purpose of this report was to determine resectability rates for patients with locally advanced pancreatic cancer based on our recently described definitions of type A and type B locally advanced pancreatic canc...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2017.09.012
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:It was shown in a murine model that sham laparotomy is associated with a higher incidence of postoperative lung metastases when compared with results seen after carbon dioxide pneumoperitoneum. Using the same tumor model, the present study was undertaken to determine if the addition of bowel resection to the...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/s0039-6060(03)00136-3
更新日期：2003-09-01 00:00:00
abstract：BACKGROUND:Early survival after pancreaticoduodenectomy has improved, but its morbidity remains high. The purpose of this study is to determine how the intra-operative (OR) occurrence of major vascular complications affects the outcome of pancreaticoduodenectomy. METHODS:The medical records of 180 consecutive patients...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2002.127688
更新日期：2002-10-01 00:00:00
abstract：BACKGROUND:After portal vein ligation of 1 side of the liver, the other side regenerates at a slow rate. This slow growth may be accelerated to rapid growth by adding a transection between the 2 sides, i.e., performing portal vein ligation and parenchymal transection. We found that in patients undergoing portal vein li...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.05.018
更新日期：2017-03-01 00:00:00
abstract：BACKGROUND:Parastomal hernia (PH) is a frequent complication of stoma formation, and recurrence after repair is common. A laparoscopic modified Sugarbaker technique (SB) may decrease the recurrence of PH compared with other methods. METHODS:A retrospective review, approved by the institutional review board, of patient...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.04.052
更新日期：2015-10-01 00:00:00
abstract：:We have previously shown that the timing of surgical removal of an estrogen-receptor-bearing mammary adenocarcinoma within the estrous cycle of the female C3HeB/FeJ mouse profoundly influences the frequency of subsequent tumor cell metastasis. In order to investigate the role of the immune response in this phenomenon,...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1988-08-01 00:00:00
abstract：BACKGROUND:Cyclosporine causes intrarenal vasoconstriction, which may account for its nephrotoxic side effects. Plasma levels of the vasoconstrictor peptide endothelin-1 are increased after cyclosporine administration, and endothelin-1 has been shown to cause renal vasoconstriction. In this study we used in vivo micros...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:Adenosine (Ado) is a potent coronary vasodilator. Recent studies suggest that Ado may also have an important effect on myocardial carbohydrate metabolism. To determine whether Ado has a direct effect on myocardial glucose uptake, a recirculating, constant-flow, isolated rat-heart preparation was used. The hearts were ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1988-04-01 00:00:00
abstract：BACKGROUND:Sphingosine-1-phosphate, a pleiotropic bioactive lipid mediator, is an important player in cancer progression. Previous studies suggested that sphingosine-1-phosphate produced by sphingosine kinase 1, which is activated by phosphorylation, plays important roles in the progression of disease and metastasis. T...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2017.11.024
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:Stress adaptation requires interactions between the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system, and a family of intracellular stress response proteins termed heat shock proteins (HSPs). These HSPs are present in every living organism and are selectively induced in the adrenal cortex ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1994-05-01 00:00:00
abstract：BACKGROUND:As a measure of quality, ambulatory surgery centers have begun reporting rates of hospital transfer at discharge. This process, however, may underestimate the acute care needs of patients after care. We conducted this study to determine rates and evaluate variation in hospital transfer and hospital-based, ac...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2013.12.008
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:Recurrent acute pancreatitis often leads to chronic obstructive ductal disease requiring operative decompression. METHODS:From 1983 through 1998, 124 patients with ductal obstruction underwent lateral pancreaticojejunostomy (78 patients), distal pancreatectomy with end-to-side pancreaticojejunostomy (27 pat...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：:Little is known about the response of surface cells and glandular cells of the gastric mucosa to various injurious agents. This study examines the effects of bile acid and salicylate on oxygen consumption and membraneolysis of isolated gastric mucosal surface cells and compares these responses to those of cells consti...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：:Refractory esophageal variceal hemorrhage (EVH) remains a formidable problem in patients awaiting liver transplantations. Transjugular intrahepatic portosystemic shunts (TIPS) have provided an alternative approach for managing EVH that may obviate the need for portosystemic shunt surgery. Experience with TIPS placemen...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1993-03-01 00:00:00
abstract：:Diffuse compensatory extramedullary hematopoiesis is well known to involve the spleen and liver in certain hematologic disorders. Hematopoietic tumor masses occasionally form and usually occur paraspinally in the posterior mediastinum. A 31-year-old patient with thalassemia is described with a massive, solitary, intra...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1990-06-01 00:00:00
abstract：:Earlier work has shown that morphine sulfate can produce a dose-related decrease in heart rate (HR) and cardiac output (CO) in isolated working rat hearts. This response is preventable with the use of the opiate receptor antagonist, naloxone hydrochloride. In this study, the stereospecificity of the opiate response wa...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1987-08-01 00:00:00
abstract：BACKGROUND:Complex anal fistulas are unsuitable for fistulotomy because of the risk of fecal incontinence. The anal fistula plug (AFP) has demonstrated fistula healing without sphincter division. This study aims to evaluate the cost-effectiveness of the AFP compared to the endoanal advancement flap (EAAF) as an alterna...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2009.05.018
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:Necrotizing enterocolitis is the leading case of gastrointestinal-related morbidity in premature infants. Necrotizing enterocolitis totalis is an aggressive form of necrotizing enterocolitis, which has traditionally been managed with comfort care. Recent advances in management of short bowel syndrome have re...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2019.03.005
更新日期：2019-06-01 00:00:00
