Abstract:
:The alterations in metabolic (oxygen consumption [VO2] and carbon dioxide production [VCO2]) and hemodynamic (heart rate and blood pressure) parameters caused by various common intensive care activities were examined in a group of 23 mechanically-ventilated critically-ill patients. The observed variations in metabolic rate can be classified into four categories as follows: (a) the lowest energy expenditure, which was associated with sleeping in the majority (83 percent) of instances; (b) resting, which was defined as a state where the patient was lying motionless with eyes open and responding to surrounding events, where VO2 and VCO2 averaged 9.1 +/- 7.5(SD) percent and 7.5 +/- 7.3 percent, respectively, above the lowest values; (c) a variety of routine daily care activities (eg, bathing, performing a physical examination) that although not particularly painful, caused arousal from the resting state. During these situations, VO2 and VCO2 averaged about 20 percent above lowest values; and (d) chest physical therapy, which was associated with metabolic increases of 35 percent above lowest values as well as increases in both heart rate and blood pressure. This study demonstrates that routine daily ICU activities can significantly alter metabolic rate, and thus, it is important to couple such measurements with astute observations of the patients' activity state. In addition, we have defined an activity state--resting--that can be used in the calculation of energy expenditure as well as for intrapatient and interpatient comparisons.
journal_name
Chestjournal_title
Chestauthors
Weissman C,Kemper M,Damask MC,Askanazi J,Hyman AI,Kinney JMdoi
10.1378/chest.86.6.815subject
Has Abstractpub_date
1984-12-01 00:00:00pages
815-8issue
6eissn
0012-3692issn
1931-3543pii
S0012-3692(16)40254-0journal_volume
86pub_type
杂志文章相关文献
CHEST文献大全abstract:STUDY OBJECTIVE:To evaluate an equation that estimates resting energy expenditure from two easily obtained measurements--expired carbon dioxide and minute ventilation, and compare the results of this equation with standard methods of estimating and measuring caloric expenditure in mechanically ventilated patients. DES...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.2.544
更新日期:1994-02-01 00:00:00
abstract::Marked airway obstruction and interference with gas exchange was encountered following institution of general anesthesia for resection of a cystic subcarinal mass. Intraoperative bronchoscopy revealed marked airway compression. The cyst was decompressed using a transbronchial needle through a fiberbronchoscope. This a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.6.1490
更新日期:1990-06-01 00:00:00
abstract::Acute bacterial endocarditis developed in a 65-year-old man two years after surgical resection of a false aneurysm of the left ventricle. The patient had cerebral embolic manifestations, and coagulase-positive Staphylococcus aureus was cultured from each of six blood samples. A pericardial friction rub and a changing ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.2.227
更新日期:1977-02-01 00:00:00
abstract::A patient complained of angina pectoris nine months after surgical repair of an aortic right atrial fistula and mitral valve replacement. Subsequently, he was shown to have a new obstruction of the ostium of the left main coronary artery. This case illustrates the need to consider this syndrome in the differential dia...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.88.3.471
更新日期:1985-09-01 00:00:00
abstract::This study was designed to compare the efficacy of coronary thrombolysis obtained with i.v. administration of three dose regimens of recombinant tissue plasminogen activator (rtPA). Although many studies have confirmed the efficacy of thrombolytic therapy in treatment of acute myocardial infarction, few prospective st...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.109.2.510
更新日期:1996-02-01 00:00:00
abstract::A patient with rheumatic heart disease, mitral stenosis, and mitral insufficiency is described. The thrombosed giant left atrium paralyzed the left vocal cord and completely obstructed the bronchi to the middle and lower lobes of the right lung. The giant left atrium mimicked a mediastinal tumor on the chest x-ray fil...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.3.406
更新日期:1977-03-01 00:00:00
abstract::A postmyocardial infarction left ventricular pseudoaneurysm occurs when a rupture of the ventricular free wall is contained by overlying, adherent pericardium. A postinfarction aneurysm, in contrast, is caused by scar formation resulting in thinning of the myocardium. Although the usual treatment for patients with pse...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.111.5.1403
更新日期:1997-05-01 00:00:00
abstract::Atrioventricular nodal alternating Wenckebach periods were defined as episodes of 2:1 atrioventricular block in which there was a gradual increase in transmission intervals of conducted beats ending in two or three consecutively blocked atrial impulses. This is one of the mechanisms whereby 2:1 atrioventricular block ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.73.1.69
更新日期:1978-01-01 00:00:00
abstract::A 56-year-old woman presented to our hospital with a 4-month history of worsening chest pain. She denied having any respiratory symptoms, such as dyspnea, sputum, cough, or hemoptysis, or any history of smoking or exposure to dusts. One year previously she had a vertebral fracture. There was no specific family history...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2017.12.002
更新日期:2018-05-01 00:00:00
abstract::This prospective study compared two weaning modalities in COPD patients requiring mechanical ventilation (MV) for acute respiratory failure. Nineteen patients with COPD were studied when their precipitating illness was controlled. Although they satisfied the conventional bedside weaning criteria, they could not tolera...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.105.4.1204
更新日期:1994-04-01 00:00:00
abstract::To assess the clinical correlates and therapeutic outcome of new postoperative supraventricular tachyarrhythmias, 916 patients who were in sinus rhythm throughout the course of surgery were prospectively followed after major noncardiac surgery. The 35 patients (4 percent) who developed new postoperative supraventricul...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.73.4.450
更新日期:1978-04-01 00:00:00
abstract::COPD is a highly prevalent disorder that results from the interplay of genetic susceptibility and environmental exposures. Over the past 2 decades, significant technological advances have been made in genetic investigations of complex diseases, yet limited progress has been made in the identification of additional COP...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.09-0555
更新日期:2009-09-01 00:00:00
abstract::The effect on pulmonary fluid balance of adrenergic receptor agonist agents commonly employed in clinical sepsis has not been well characterized. Therefore, we tested the hypothesis that dobutamine would increase pulmonary microvasular fluid flux in experimental sepsis-induced lung injury. To define the effects of thi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.1.180
更新日期:1988-01-01 00:00:00
abstract::Myocardial ischemia results in altered left ventricular (LV) diastolic compliance, reflected by an abnormal mitral inflow pattern on Doppler echocardiography. To investigate the relationship of Doppler echocardiography and regional myocardial systolic function during dipyridamole infusion, we evaluated transmitral flo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.95.5.1037
更新日期:1989-05-01 00:00:00
abstract::The accumulation of thrombin at sites of vascular injury provides one of the chief means for recruiting platelets into a growing hemostatic plug. Studies completed over the past 10 years show that platelet responses to thrombin are mediated by a subset of G protein-coupled receptors known as protease-activated recepto...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.124.3_suppl.18s
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:It has been postulated that right ventricular (RV) function may improve after lung volume reduction surgery (LVRS) for severe emphysema due to improvement in lung elastic recoil. Improved lung elastic recoil after LVRS is hypothesized to "tether" open extraalveolar vessels, thereby leading to a decrease in p...
journal_title:Chest
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.07-0041
更新日期:2007-11-01 00:00:00
abstract::A 41-year-old woman with end-stage mitral and aortic stenosis developed the cycle of low cardiac output, peripheral vasoconstriction, increased core temperature, and cardiac decompensation. This was interrupted by core cooling utilizing iced gastric lavage. We propose that her severe hyperthermia was caused or abetted...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.72.1.107
更新日期:1977-07-01 00:00:00
abstract::The clinical and histopathologic features of pulmonary amyloidosis were reviewed in 22 patients with systemic amyloidosis who came to autopsy. Eleven of 12 patients (92 percent) with primary amyloidosis had prominent interalveolar amyloid deposits. Symptoms attributable to these deposits were found in four cases (33 p...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.74.5.543
更新日期:1978-11-01 00:00:00
abstract:OBJECTIVE:To ascertain the differences in smoking characteristics between a group of smokers with COPD and another group of healthy smokers, both of which were identified in a population-based epidemiologic study. DESIGN AND PARTICIPANTS:This is an epidemiologic, multicenter, population-based study conducted in seven ...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.119.5.1365
更新日期:2001-05-01 00:00:00
abstract:STUDY OBJECTIVES:Levofloxacin is a fluoroquinolone antimicrobial agent for which pharmacodynamic relationships between the maximum serum antibiotic concentration (Cmax)/minimum inhibitory concentration (MIC) ratio and/or the area under the serum concentration-time curve during a 24-h dosing period (AUC(0-24))/MIC ratio...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.128.4.2093
更新日期:2005-10-01 00:00:00
abstract::Nineteen consecutive patients with clinically suspected sarcoidosis underwent 67Ga-scintigraphy prior to transbronchial lung biopsy (TBLB) to determine if 67Ga uptake in lung parenchyma would increase the diagnostic yield of the biopsy procedure. Biopsies were obtained from the areas showing parenchymal uptake on the ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.82.1.7
更新日期:1982-07-01 00:00:00
abstract::Research on dominant oncogenes and tumor suppressor genes has characterized differences in genetic lesions between small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) and identified associations with clinical parameters. More than one half of all lung cancers contain a mutation of the p53 tumor suppre...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.103.1_supplement.1s
更新日期:1993-01-01 00:00:00
abstract::Increased (more positive) end-expiratory and decreased (more negative) end-inspiratory values for intrapleural pressure (PpI) invariably accompany acute bronchoconstriction. We hypothesize that both the increase in vital capacity (VC) and the decrease in residual volume (RV) observed after dilation of the central airw...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.76.4.425
更新日期:1979-10-01 00:00:00
abstract:STUDY OBJECTIVES:Poor dental hygiene has been linked to respiratory pathogen colonization in residents of long-term care facilities. We sought to investigate the association between dental plaque (DP) colonization and lower respiratory tract infection in hospitalized institutionalized elders using molecular genotyping....
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.5.1575
更新日期:2004-11-01 00:00:00
abstract::A 35-year-old man had a history of recurrent syncope for more than a decade. During a witnessed episode, an ambulatory electrocardiographic recording showed ventricular flutter/fibrillation that lasted for 2 1/2 minutes and terminated spontaneously without adverse neurologic sequelae. No structural heart disease and n...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.106.5.1601
更新日期:1994-11-01 00:00:00
abstract::Atrial fibrillation remains a common and challenging problem following cardiac surgery. The American College of Chest Physicians, through the Health and Science Policy Committee, established a panel to develop a set of clinical practice guidelines for the management or prophylaxis of atrial fibrillation or flutter in ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.2_suppl.17s
更新日期:2005-08-01 00:00:00
abstract::A prospective study of 129 consecutive thoracocentesis in 86 patients at a university medical center evaluated the clinical value, complications, and patient experience with thoracocentesis. Pleural fluid analysis in conjunction with the clinical presentation placed 78 pleural fluids into diagnostic categories: defini...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.91.6.817
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:The purpose of our study was to establish magnetic resonance imaging (MRI) criteria for the diagnosis of pulmonary vascular malformations (PVMs). MATERIALS AND METHODS:Since 1987, 11 patients have been referred for chest MRI at our institution because of findings suggestive of a PVM. They were evaluated with...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.5.1333
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:COPD and hypertension both increase the risk of congestive heart failure (CHF). Current clinical trials do not inform the selection of combination antihypertensive therapy among patients with COPD. We performed a comparative effectiveness study to investigate whether choice of dual agent antihypertensive the...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-1770
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:We suspected, based on clinical experience, that the prevalence of both intracardiac and pulmonary arteriovenous malformations (PAVMs) is higher than previously reported in a healthy population when using modern ultrasound technology combined with a rigorous saline contrast echocardiogram (SCE) protocol. We ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.09-2797
更新日期:2010-08-01 00:00:00