Abstract:
BACKGROUND:Owing to complexities of measuring dead space, ventilatory failure is difficult to quantify in critical care. A simple, novel index called ventilatory ratio (VR) can quantify ventilatory efficiency at the bedside. The study objectives were to evaluate physiological properties of VR and examine its clinical applicability in acute respiratory distress syndrome (ARDS) patients. METHODS:A validated computational model of cardiopulmonary physiology [Nottingham Physiology Simulator (NPS)] was used to evaluate VR ex vivo in three virtual patients with varying degrees of gas exchange defects. Arterial P(CO₂) and mixed expired P(CO₂) were obtained from the simulator while either dead space or CO₂ production was altered in isolation. VR and deadspace fraction was calculated using these values. A retrospective analysis of a previously presented prospective ARDS database was then used to evaluate the clinical utility of VR. Basic characteristics of VR and its association with mortality were examined. RESULTS:The NPS showed that VR behaved in an intuitive manner as would be predicted by its physiological properties. When CO₂ production was constant, there was strong positive correlation between dead space and VR (modified Pearson's r 0.98, P<0.01). The ARDS database had a mean VR of 1.47 (standard deviation 0.58). Non-survivors had a significantly higher VR compared with survivors [1.70 vs 1.34, mean difference 0.35, 95% confidence interval (CI) 0.16-0.56, P<0.01]. VR was an independent predictor of mortality (odds ratio 3.05, CI 1.35-6.91, P<0.01). CONCLUSIONS:VR is influenced by dead space and CO₂ production. In ARDS, high VR was associated with increased mortality.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Sinha P,Singh S,Hardman JG,Bersten AD,Soni N,Australia and New Zealand Intensive Care Society Clinical Trials Group.doi
10.1093/bja/aet283subject
Has Abstractpub_date
2014-01-01 00:00:00pages
96-101issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31974-8journal_volume
112pub_type
杂志文章abstract::Successful tracheal intubation with the flexible fibreoptic bronchoscope requires a certain amount of skill which is acquired by practice. It has been suggested that the new Bullard laryngoscope may be mastered more easily. To determine if learning was superior with a flexible fibreoptic or the Bullard device, the eas...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.2.268
更新日期:1990-08-01 00:00:00
abstract::Use of inhaled nitric oxide for treatment of pulmonary hypertension in adult critical illness is limited by its mode of delivery and high costs, prompting evaluation of alternative therapies. We report the use of oral sildenafil in a patient with severe secondary pulmonary hypertension and right ventricular dysfunctio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei114
更新日期:2005-06-01 00:00:00
abstract::In a prospective randomized multi-centre study, the mortality following internal fixation surgery for fracture of the upper femur was investigated in 538 elderly patients allocated to receive subarachnoid blockade or general (narcotic-relaxant) anaesthesia. The 28-day mortality was 6.6% with subarachnoid, and 5.9% wit...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/59.9.1080
更新日期:1987-09-01 00:00:00
abstract::In 10 dogs, one carotid sinus was isolated from the systemic circulation without disturbing its sympathetic innervation. The isolated sinus was connected to a servo-controlled pressure generator which kept mean intrasinus pressure, pulse pressure, and frequency of pulsation constant. The carotid sinus baroreceptor ner...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.4.489
更新日期:1987-04-01 00:00:00
abstract::Regional haemodynamic control by the cardiovascular baroreceptors was examined in dogs anaesthetized with 1 + MAC halothane in oxygen (1%). The open-loop relationships between carotid sinus pressure (CSP) and regional haemodynamics in the iliac, renal, mesenteric, aortic and coeliac beds were examined before vagotomy,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.6.535
更新日期:1977-06-01 00:00:00
abstract:BACKGROUND:Cardiac output (CO) monitoring by uncalibrated arterial pressure waveform analysis (APCO) using the FloTrac/Vigileo™ is feasible in patients with intracranial haemorrhage, but the results of validation studies are contradictory. The aim of the present study was to analyse the clinical agreement between the i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer170
更新日期:2011-10-01 00:00:00
abstract::This case series presents 10 patients undergoing vascular surgery with asymptomatic elevated high-sensitivity troponin T concentrations, measured at outpatient clinic before surgery. Patients were included in the RAVE (Rotterdam Antiplatelet therapy in Vascular patiEnts) pilot study. All included patients underwent co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2019.08.013
更新日期:2019-11-01 00:00:00
abstract::A computer program written mainly in a high level language (ALGOL), but with the sampling routine and certain calculations written in assembly language (SIR), has been developed to assess neuromuscular blockade in anaesthetized man by means of an Elliott 903 digital computer. The program allows the on-line real-time a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.10.1097
更新日期:1975-10-01 00:00:00
abstract::Changes in intragastric pressure after the administration of suxamethonium 1.5 mg kg-1 i.v. were studied in 32 children (mean age 6.9 yr) pretreated with either physiological saline or alfentanil 50 micrograms kg-1. Anaesthesia was induced with thiopentone 5 mg kg-1. The incidence and intensity of muscle fasciculation...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.2.176
更新日期:1988-02-01 00:00:00
abstract::The activity of a new i.v. anesthetic agent ICI 35 868, a compound unrelated to currently used barbiturate, eugenol or steroid agents, has been examined in a range of animal species. Some of the properties of ICI 35 868 resemble those of thiopentone in that it is a rapidly acting agent which produces anaesthesia of sh...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.8.731
更新日期:1980-08-01 00:00:00
abstract::The rapid detection and evaluation of patients presenting with perioperative neurological dysfunction is of great clinical relevance. Biomarkers have been defined as biological molecules that can be used as an indicator of new onset or progression of a biological process or effect of treatment. Biomarkers have become ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aer338
更新日期:2011-12-01 00:00:00
abstract::We have measured in 38 patients the plasma concentration profile of atracurium and its effect on the electromyographic first response of the train-of-four. One of three techniques was used to supplement anaesthesia with 66% nitrous oxide in oxygen, 0.9% isoflurane (end-tidal), 0.5% halothane (end-tidal) or midazolam 3...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/70.1.38
更新日期:1993-01-01 00:00:00
abstract::A recently installed anti-pollution system, initially designed to function in a passive mode, was evaluated, but found to be inconstant in its performance. A simple method of making the system active is described and evaluated. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.5.439
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Pressure recording analytical method (PRAM) is a novel, arterial pulse contour-based method for measuring cardiac output (CO). Validation studies of PRAM in children are few, and have not assessed both absolute accuracy and ability to track changes in CO across a broad case mix. We aimed to compare CO as mea...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes420
更新日期:2013-03-01 00:00:00
abstract::We have compared the effects of inhalation of aerosolized surfactant on experimental acute respiratory distress syndrome. Escherichia coli endotoxin (55 (SD 20) mg kg(-1)) was injected into the tracheas of 36 adult rats anaesthetized and mechanically ventilated with pure oxygen. When the Pa(O(2)) decreased to 11.3 (3....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.2.266
更新日期:2001-08-01 00:00:00
abstract::The Myotest is a new nerve stimulator which can give train-of-four, single twitch (1 and 10 s) and tetanic stimuli. Power is supplied by standard batteries, which allow 200 h effective use. The impulse is unipolar constant current, and the amplitude can be adjusted between 0 and 40 mA. These factors, plus the electron...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.5.547
更新日期:1980-05-01 00:00:00
abstract::Buprenorphine 0.3 mg or fentanyl 0.125 mg i.v. were used to supplement nitrous oxide anaesthesia in a double-blind investigation of 40 patients undergoing major abdominal surgery. Initially both narcotics appeared to suppress tachycardia and increased arterial pressure in response to surgery, but 80% of the patients w...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/52.4.453
更新日期:1980-04-01 00:00:00
abstract::We have evaluated the effect of delivering nitric oxide using a continuous flow system (CFS) or two commercially available proportional gas injection systems (PGIS), Nodomo (Dräger, Lübeck, Germany) and Pulmonox-Mini (Messer Griesheim Austria, Gumpoldskirchen, Austria) on measured and simulated concentrations of nitri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.4.544
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Fast onset and short duration are prominent properties of the amide-type local anaesthetic articaine. Similar to bupivacaine, a hyperbaric solution of articaine may produce faster onset and shorter duration of spinal anaesthesia than a plain solution. METHODS:Patients undergoing open inguinal hernia repair ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen294
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Intravenous amino acid infusion during general anaesthesia prevents decreases in core temperature resulting from increased energy expenditure and heat accumulation. METHODS:We investigated whether such stimulation also occurs during spinal anaesthesia, which blocks sympathetic nervous activity. We examined ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:High-frequency oscillation (HFO) is a widely used lung-protective ventilatory strategy in paediatric and neonatal acute lung injury. Its safe and effective use has been hindered by inadequate recruitment of the lung during oscillation and, until recently, the lack of an adequately powered oscillator for use ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/88.5.708
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Recent studies have concluded that i.v. dexamethasone can prolong the duration of peripheral nerve blockade. We hypothesized that a 4 mg dose would equally prolong the duration of psoas compartment blocks (PCBs) when compared with 8 mg, and that both doses would prolong the duration when compared with placeb...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2017.11.073
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Cyclic redistribution of air within the cuff during respiratory pressure changes creates a self-sealing mechanism which allows tracheal sealing, despite tracheal airway pressure being above baseline cuff inflation pressure. The aim of the present study was to investigate the effect of continuous automated cu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen355
更新日期:2009-02-01 00:00:00
abstract::Gastric (GP) and lower oesophageal sphincter pressures (LOSP) were measured in non-pregnant female volunteers (group I) and pregnant women with (group III) or without (group II) heartburn. Patients in early pregnancy had greater gastric pressures than group I. Mean barrier pressure (LOSP-GP) was significantly decrease...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.4.381
更新日期:1981-04-01 00:00:00
abstract::Diltiazem inhibited and antagonized the abnormal contractures induced by halothane, caffeine and potassium chloride in isolated skeletal muscle from pigs susceptible to malignant hyperpyrexia (MHS). Contractile responses to caffeine and electrical stimulation also were suppressed by diltiazem in control tissue. Simila...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.5.566
更新日期:1989-05-01 00:00:00
abstract::We have studied the complications associated with three techniques used to maintain extradural analgesia in labour: midwife top-up doses of 0.25% bupivacaine 10 ml, continuous infusion of 0.125% bupivacaine 10 ml h-1 and patient-controlled extradural analgesia (PCEA) with self-administered 3-ml bolus doses of 0.25% bu...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/73.5.619
更新日期:1994-11-01 00:00:00
abstract::Perioperative risk of death after general surgery is quoted as overall less than 1%. However, each individual's risk varies widely according to many identified factors with some having a significantly increased risk of a worse outcome. The observation that manipulating and targeting certain physiological parameters in...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/ael102
更新日期:2006-07-01 00:00:00
abstract::We have investigated whether nitrous oxide antagonizes or augments the CNS stimulant action of laudanosine in mice by comparing the mean convulsive doses (CD50 (SE] of a control group and those following pretreatment with 65% nitrous oxide in oxygen for 20 and 180 min. Nitrous oxide significantly increased CD50 from 4...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.5.704
更新日期:1990-11-01 00:00:00
abstract::Skills related to driving, the ability to discriminate the fusion of flickering light, and hand and foot proprioception, were measured double-blind in 34 healthy volunteers before and after three doses of i.v. diazepam. The effects of diazepam were most harmful to co-ordination. With 0.15 mg/kg, 0.30 mg/kg and 0.45 mg...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.4.457
更新日期:1975-04-01 00:00:00
abstract:BACKGROUND:This study was undertaken to compare the effects of general anaesthesia (GA) and spinal anaesthesia (SA) on the need for postoperative hospitalization and early postoperative comfort in patients undergoing fast-track total knee arthroplasty (TKA). METHODS:One hundred and twenty subjects were randomly alloca...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet104
更新日期:2013-09-01 00:00:00