Aspiration pneumonia: beneficial and harmful effects of positive end-expiratory pressure.

Abstract:

:With an ex vivo, isolated, ventilated, perfused canine pulmonary lobe, the effects of various levels of positive end-expiratory pressure (PEEP) were evaluated following acid injury. Following intrabronchial instillation of hydrochloric acid, eight lobes were ventilated with 5 cm of H2O of PEEP, 12 lobes with 10 cm of PEEP, and eight lobes with 15 cm of PEEP during a 4 hour perfusion period. Blood flow was kept constant in all preparations. Lobes with 5 cm of PEEP developed a 39% intrapulmonary shunt and increased their weight by 220%. When PEEP was increased to 10 cm, weight gain was similar (184%), but shunting decreased markedly, to 7%. When PEEP was increased further to 15 cm, shunting remained low (13%), but weight gain increased markedly, to 411% of the initial lobe weight. This study demonstrates the beneficial effects of PEEP in aspiration pneumonia, but it also points out that increasing levels of PEEP can magnify acid-pulmonary injury by causing a further increase in interstitial and intralveolar edema.

journal_name

Surgery

journal_title

Surgery

authors

Toung T,Saharia P,Permutt S,Zuidema GD,Cameron JL

subject

Has Abstract

pub_date

1977-08-01 00:00:00

pages

279-83

issue

2

eissn

0039-6060

issn

1532-7361

journal_volume

82

pub_type

杂志文章

相关文献

SURGERY文献大全
  • Multifactor evaluations of surgical trainees and teaching services.

    abstract::Surgical education has been exposed to increasing challenges as students have moved from the highly structured environment of a university hospital into a variety of clinical settings within the community. Presented with a general surgical service that uses ten relatively autonomous teaching services in seven hospital...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Albo D Jr,Taylor CW,Page B,Chang FC,Moody FG

    更新日期:1976-07-01 00:00:00

  • Parathyroidectomy is underused in patients with tertiary hyperparathyroidism after renal transplantation.

    abstract:BACKGROUND:Parathyroidectomy (PTX) is the only curative treatment for tertiary hyperparathyroidism (3HPT). With the introduction of calcimimetics (cinacalcet), PTX can sometimes be delayed or avoided. The purpose of this study was to determine the current incidence of utilization of PTX in patients with posttransplant ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2015.08.039

    authors: Lou I,Schneider DF,Leverson G,Foley D,Sippel R,Chen H

    更新日期:2016-01-01 00:00:00

  • Treatment of superficial cancer of the esophagus: a summary of responses to a questionnaire on superficial cancer of the esophagus in Japan.

    abstract:BACKGROUND:Histopathologic characteristics and optimal treatment modality for superficial esophageal cancer were reevaluated on the basis of 2418 patients from 143 institutions through a nationwide questionnaire to the members of the Japanese Society for Esophageal Diseases. METHODS:A questionnaire was designed for pa...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Kodama M,Kakegawa T

    更新日期:1998-04-01 00:00:00

  • Volume-outcome relationship in pancreatic surgery: the situation in Germany.

    abstract:BACKGROUND:Discussion of the volume-outcome relationship in pancreatic surgery has gained increasing interest. Currently, no data describe the situation in Germany. Pursuant to a recent legislative reform, a threshold of 10 operations per year was introduced for pancreatic surgery in 2006. This study describes the situ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2012.05.011

    authors: Alsfasser G,Kittner J,Eisold S,Klar E

    更新日期:2012-09-01 00:00:00

  • Assessment of arterial obstruction in vessels supplying the fingers by measurement of local blood pressures and the skin temperature response test--correlation with angiographic evidence.

    abstract::The systolic blood pressure measured in the fingers and wrists by the spectroscopic method and in the arm by auscultation were correlated with angiographic evidence of organic arterial obstruction in 29 patients. The pressures also were measured in 14 normal people. Results in the normal people suggest that a differen...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Downs AR,Gaskell P,Morrow I,Munson CL

    更新日期:1975-04-01 00:00:00

  • Assessing cesarean section and inguinal hernia repair as proxy indicators of the total number of surgeries performed in Sierra Leone in 2012.

    abstract:BACKGROUND:The traditional tools to assess surgical capacity in low-income countries require significant amounts of time and resources, and have thus not been utilized systematically in this context. Proxy indicators have been suggested as a simpler tool to estimate surgical volume. The aim of this study was to assess ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2014.12.014

    authors: Bjerring AW,Lier ME,Rød SM,Vestby PF,Melf K,Endreseth BH,Salvesen Ø,von Schreeb J,Wibe A,Kamara TB,Bolkan HA

    更新日期:2015-05-01 00:00:00

  • Soluble intercellular adhesion molecule-1 provokes polymorphonuclear leukocyte elastase release by CD18.

    abstract:BACKGROUND:Elevated levels of soluble intercellular adhesion molecule-1 (sICAM-1) correlate with the development of postinjury multiple organ failure. Soluble ICAM-1 secretion is known to be induced in endothelial cells and monocytes by diverse inflammatory stimuli. We have found that incubation of quiescent polymorpho...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/s0039-6060(96)80315-1

    authors: Barnett CC,Moore EE,Moore FA,Biffl WL,Partrick DA

    更新日期:1996-08-01 00:00:00

  • Intraoperative urinary output does not predict postoperative renal function in patients undergoing abdominal aortic revascularization.

    abstract::To determine whether intraoperative urinary output was predictive of postoperative renal function, mean urinary output and lowest hourly urinary output were measured in 137 patients during operation for aortic reconstruction. Pulmonary capillary wedge pressure was kept within normal limits. If urinary output was less ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Alpert RA,Roizen MF,Hamilton WK,Stoney RJ,Ehrenfeld WK,Poler SM,Wylie EJ

    更新日期:1984-06-01 00:00:00

  • Surgery for diverticulitis is associated with high risk of in-hospital mortality and morbidity in older patients with end-stage renal disease.

    abstract:INTRODUCTION:End-stage renal disease (ESRD) is associated with poor medical outcomes. This study aimed to compare early outcomes of elective and emergency operation for diverticulitis among older adults with and without a diagnosis of ESRD. METHODS:Patients 65 years of age and older with a primary diagnosis of diverti...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2014.03.034

    authors: Moran-Atkin E,Stem M,Lidor AO

    更新日期:2014-08-01 00:00:00

  • Hepatic insufficiency after portacaval shunting is prevented by prior intraportal pancreatic islet autotransplantation.

    abstract::The extrahepatic diversion of essential splanchnic hepatotrophic factors may cause the liver atrophy and insufficiency that follows portacaval shunting. To investigate this, control dogs with end-to-side portacaval shunts (control-PCS, n = 6) were compared with dogs shunted 1 month after intraportal pancreatic islet a...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Callery MP,Ricordi C,Scharp DW,Kamei T,Swanson CJ,Lacy PE,Flye MW

    更新日期:1989-08-01 00:00:00

  • Intraductal papillary mucinous neoplasm of the pancreas: associated cancers, family history, genetic predisposition?

    abstract:BACKGROUND:High rates of extrapancreatic malignancies (EPM) have been observed in patients with intraductal papillary mucinous neoplasm (IPMN). IPMN in patients with familial pancreatic cancer have also been reported. Our purpose was to evaluate the association of IPMN with EPM, malignancies in family members, and germ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2011.06.036

    authors: Lubezky N,Ben-Haim M,Lahat G,Marmor S,Solar I,Brazowski E,Nackache R,Klausner JM

    更新日期:2012-01-01 00:00:00

  • Team training can improve operating room performance.

    abstract:BACKGROUND:This study was conducted to determine if team training using a federally sponsored team training program improves operating room (OR) performance and culture. METHODS:The TeamSTEPPS program, a team training program designed and tested for health care applications, was provided to the OR staff. The training ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2011.07.076

    authors: Armour Forse R,Bramble JD,McQuillan R

    更新日期:2011-10-01 00:00:00

  • Cimetidine and gastric blood flow.

    abstract::The influence of cimetidine on blood flow to the gastric corpus and antrum of the dog was studied using the double isotope microsphere distribution technique. This H2 receptor antagonist caused no changes in blood flow to any portion of the stomach nor did it alter systemic circulatory parameters. The therapeutic effe...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Delaney JP,Michel HM,Bond J

    更新日期:1978-08-01 00:00:00

  • The effect of somatostatin analogue (SMS 201-995) on pancreatic blood flow.

    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:

    authors: Conway DR,Djuricin G,Prinz RA

    更新日期:1988-12-01 00:00:00

  • Decreased leukocyte adhesion with anti-CD18 monoclonal antibodies is mediated by receptor internalization.

    abstract:BACKGROUND:Adhesion of polymorphonuclear leukocytes (PMNs) to endothelial cells is mediated partially by CD11/CD18 integrins. The purpose of this study was to define (1) the response of PMNs to anti-CD18 monoclonal antibody binding, and (2) the mechanism responsible for anti-CD18 monoclonal antibody-mediated decreases ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Rubin BB,Rotstein OD,Lukacs G,Bailey D,Romaschin A,Walker PM

    更新日期:1992-08-01 00:00:00

  • Nelson's syndrome after Cushing's disease in childhood: a continuing problem.

    abstract::Nelson's syndrome--progressive cutaneous hyperpigmentation with x-ray film evidence of an expanding pituitary tumor--is now a well-recognized sequela of bilateral adrenalectomy for Cushing's disease. It is estimated to occur in 8% to 38% of adults. Because Cushing's disease is rare in children, a higher incidence of N...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Thomas CG Jr,Smith AT,Benson M,Griffith J

    更新日期:1984-12-01 00:00:00

  • The mechanisms of angiogenesis in hepatocellular carcinoma: angiogenic switch during tumor progression.

    abstract::Solid tumors constantly require a vascular supply for their progression and metastasis. Hepatocellular carcinoma (HCC) is known to gain its hypervascularity during the process of dedifferentiation and progression. Various angiogenic growth factors and inhibitors regulate this angiogenic switch of HCC. The known endoth...

    journal_title:Surgery

    pub_type: 杂志文章,评审

    doi:10.1067/msy.2002.119365

    authors: Sugimachi K,Tanaka S,Terashi T,Taguchi K,Rikimaru T,Sugimachi K

    更新日期:2002-01-01 00:00:00

  • Reappraisal of timing for exploration of civilian peripheral nerve injuries.

    abstract::Operative as well as electrophysiologic experience with 213 major nerve injuries over the last 8 years and primate experiments form the basis of this reappraisal. Those lesions in continuity resected (58 of 172) usually had no response to stimulation or nerve action potential (NAP) at 8 weeks or longer after injury bu...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Kline DG,Hackett ER

    更新日期:1975-07-01 00:00:00

  • Fat absorption after longitudinal pancreaticojejunostomy.

    abstract::This study was undertaken to determine whether fat absorption is improved following longitudinal pancreaticojejunostomy. Ten consecutive patients with chronic pancreatitis underwent measurement of fat absorption (fecal fat, 14C-labeled phenylacetic dipalmitate oil absorption test) before and after operation. Fecal fat...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Bradley EL 3rd,Nasrallah SM

    更新日期:1984-06-01 00:00:00

  • Insulin-like growth factor 1 signaling in human gastrointestinal carcinoid tumor cells.

    abstract::Background Insulin-like growth factor 1 (IGF-1) is an autocrine regulator of carcinoid tumors. Blockade of IGF-1 signaling has been proposed as a therapeutic target in the treatment of patients with carcinoid syndrome. We hypothesized that the induction of parallel raf-1/MEK1 pathways will block IGF-1-mediated chromog...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2004.06.061

    authors: Van Gompel JJ,Chen H

    更新日期:2004-12-01 00:00:00

  • Medullary thyroid carcinoma: results of a standardized surgical approach in a contemporary series of 80 consecutive patients.

    abstract:BACKGROUND:The surgical management and follow-up strategy in patients with medullary thyroid carcinoma (MTC) remain controversial because of the lack of data on the natural history of these tumors and their patterns of progression. METHODS:We reviewed the records of all patients who underwent a cervical operation for ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/s0039-6060(03)00408-2

    authors: Yen TW,Shapiro SE,Gagel RF,Sherman SI,Lee JE,Evans DB

    更新日期:2003-12-01 00:00:00

  • Therapeutic value of lymph node dissection during hepatectomy in patients with intrahepatic cholangiocellular carcinoma with negative lymph node involvement.

    abstract:BACKGROUND:Routine and radical lymph node dissection is a clinical concern for improving the surgical outcome in patients with intrahepatic cholangiocarcinoma (ICC). The therapeutic value of the procedure during hepatectomy has, however, not been evaluated. METHODS:Between January 1990 and December 2004, 104 patients ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2008.11.010

    authors: Shimada K,Sano T,Nara S,Esaki M,Sakamoto Y,Kosuge T,Ojima H

    更新日期:2009-04-01 00:00:00

  • Abdominal skin closure using subcuticular sutures prevents incisional surgical site infection in hepatopancreatobiliary surgery.

    abstract:BACKGROUND:Hepatopancreatobiliary surgery has a high incidence of postoperative morbidity, including incisional surgical site infection. Although several studies showed that subcuticular sutures reduced incisional surgical site infection in other fields of surgery, their impact on hepatopancreatobiliary surgery remains...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2018.04.002

    authors: Okubo S,Gotohda N,Sugimoto M,Nomura S,Kobayashi S,Takahashi S,Hayashi R,Konishi M

    更新日期:2018-08-01 00:00:00

  • Administration of a dipeptidyl peptidase IV inhibitor enhances the intestinal adaptation in a mouse model of short bowel syndrome.

    abstract:BACKGROUND:Glucagon-like peptide-2 induces small intestine mucosal epithelial cell proliferation and may have benefit for patients who suffer from short bowel syndrome. However, glucagon-like peptide-2 is inactivated rapidly in vivo by dipeptidyl peptidase IV. Therefore, we hypothesized that selectively inhibiting dipe...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2011.05.013

    authors: Okawada M,Holst JJ,Teitelbaum DH

    更新日期:2011-08-01 00:00:00

  • To plug or not to plug: a cost-effectiveness analysis for complex anal fistula.

    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

    authors: Adamina M,Hoch JS,Burnstein MJ

    更新日期:2010-01-01 00:00:00

  • Improved outcome of adult blunt splenic injury: a cohort analysis.

    abstract:BACKGROUND:The purpose of this study was to review our 15-year experience in the treatment of blunt splenic injury in adults. Our hypothesis was that the implementation of a change in practice, with stress on splenic preservation and splenic artery embolization for the management of splenic injury, would result in impr...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/j.surg.2006.07.005

    authors: Rajani RR,Claridge JA,Yowler CJ,Patrick P,Wiant A,Summers JI,McDonald AA,Como JJ,Malangoni MA

    更新日期:2006-10-01 00:00:00

  • Telomerase activity in the differential diagnosis of papillary carcinoma of the thyroid.

    abstract:BACKGROUND:Although fine-needle aspiration (FNA) is 90% sensitive in the detection of papillary carcinoma (PC) of the thyroid, its specificity has been reported as low as 52%. Consequently, patients who have an FNA suspicious for PC may undergo operation for a benign process. The ribonucleoprotein telomerase has been n...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1016/s0039-6060(97)90219-1

    authors: Saji M,Westra WH,Chen H,Umbricht CB,Tuttle RM,Box MF,Udelsman R,Sukumar S,Zeiger MA

    更新日期:1997-12-01 00:00:00

  • Virilizing adrenocortical adenoma: in vitro steroidogenesis, immunohistochemical studies of steroidogenic enzymes, and gene expression of corticotropin receptor.

    abstract:BACKGROUND:No reports have yet precisely determined corticotropin (ACTH) responsiveness in virilizing adrenocortical adenoma. METHODS:Five women with an androgen-secreting adrenal adenoma were reviewed. Three of them were examined by in vitro steroidogenesis. Two of these 3 patients were studied by immunohistochemistr...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Imai T,Tobinaga J,Morita-Matsuyama T,Kikumori T,Sasano H,Seo H,Funahashi H

    更新日期:1999-04-01 00:00:00

  • Effect of operative devascularization on estrogen and progesterone receptor levels in breast cancer specimens.

    abstract::To compare estrogen and progesterone receptor values between biopsy and mastectomy specimens, we prospectively studied 29 patients with breast cancer treated by incisional biopsy followed by mastectomy. The average tumor size was 5.4 +/- 0.5 cm and the mean age was 57.6 +/- 3.0 years. Nine patients were premenopausal ...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:

    authors: Teicher I,Tinker MA,Auguste LJ,Laufer H,Stein TA,Wise L

    更新日期:1985-10-01 00:00:00

  • Payer status is related to differences in access and outcomes of abdominal aortic aneurysm repair in the United States.

    abstract:BACKGROUND:The hypothesis of this study was that differences exist among patients with private insurance compared with patients with Medicaid or no insurance, regarding access to the timely treatment of abdominal aortic aneurysms (AAAs) and the outcomes of AAA repair. METHODS:The study comprised 5363 patients aged les...

    journal_title:Surgery

    pub_type: 杂志文章

    doi:10.1067/msy.2003.214

    authors: Boxer LK,Dimick JB,Wainess RM,Cowan JA,Henke PK,Stanley JC,Upchurch GR Jr

    更新日期:2003-08-01 00:00:00