Abstract:
:Patients recovering from acute respiratory insufficiency are usually not extubated until they can ventilate adequately while breathing spontaneously at ambient end-expiratory pressure (T-tube). It is hypothesized that this period of T-tube breathing might be detrimental to gas exchange since the endotracheal tube abolishes the expiratory retard produced by the glottis and thereby inhibits the patient's ability to maintain adequate functional residual capacity (FRC). To test this hypothesis, pulmonary function of 17 patients was compared during T-tube breathing and Continuous Positive Airway Pressure (CPAP) and after extubation. Intrapulmonary shunt was higher (p less than 0.05) and arterial PO2 and FRC were lower (p less than 0.05) during T-tube breathing than during CPAP or after extubation. In contrast, shunt, PaO2 and FRC were similar during CPAP and after extubation. Furthermore, after extubation there was an increase (p less than 0.05) in mean expiratory airway pressure as compared to T-tube breathing. A comparison of patients extubated from T-tube with patients extubated from CPAP showed no difference in postextubation shunt, PaO2 or FRC. These data suggest that endotracheal intubation should be accompanied by low levels of CPAP and that patients should be extubated directly from CPAP. The practice of placing patients in T-tube prior to extubation should be abandoned as unnecessary and potentially harmful.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Annest SJ,Gottlieb M,Paloski WH,Stratton H,Newell JC,Dutton R,Powers SR Jrdoi
10.1097/00000658-198005000-00004subject
Has Abstractpub_date
1980-05-01 00:00:00pages
539-45issue
5eissn
0003-4932issn
1528-1140journal_volume
191pub_type
杂志文章abstract:BACKGROUND:While stereotactic ablative radiotherapy (SABR) is increasingly emerging as an alternative to surgery for node-negative non-small cell lung cancer (NSCLC), there is poor understanding of patients who may most benefit SABR compared to surgery. OBJECTIVE:This study examined the relationship between tumor size...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004730
更新日期:2021-01-07 00:00:00
abstract::The subcutaneous administration of insulin did not induce a significant effect on oxidative phosphorylation of the mitochondria from normal rat liver. However, in rats subjected to ligation of a branch of portal vein, the phosphorylative activity of the mitochondria from the ligated lobe deprived of portal blood fell ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197411000-00002
更新日期:1974-11-01 00:00:00
abstract:OBJECTIVE:To assess whether weekday of surgery influences long-term survival in esophageal cancer. BACKGROUND:Increased 30-day mortality rates have been reported in patients undergoing elective surgery later compared with earlier in the week. METHODS:This population-based cohort study included 98% of all esophageal c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001324
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:The American Joint Committee on Cancer (AJCC) staging system for gastric cancer bases N status on absolute number of metastatic nodes, regardless of the number of examined nodes. We examined a modified staging system utilizing node ratio (Nr), the ratio of metastatic to examined nodes. METHODS:A total of 18...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824857e2
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:To determine whether the immune system limits or improves the therapeutic efficacy of an adenovirus vector expressing the herpes simplex thymidine kinase (HSVtk) gene in a subcutaneous tumor model. BACKGROUND DATA:Enhanced immune reactions against tumors may be therapeutically useful. However, recent studies...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199509000-00008
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:We hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. BACKGROUND:Surgical readmissions have few known modifiable predictors. Pain experienced by patients may reflect surgical complications and/or inadequate or dif...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002372
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA:Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002089
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To review the current concepts in the mediastinal staging of nonsmall cell lung cancer (NSCLC), evaluating traditional and modern staging modalities. SUMMARY BACKGROUND DATA:Staging of NSCLC includes the assessment of mediastinal lymph nodes. Traditionally, computed tomography (CT) and mediastinoscopy are us...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/01.SLA.0000081086.37779.1a
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility and safety of laparoscopic liver resections. SUMMARY BACKGROUND DATA:The use of the laparoscopic approach for liver resections has remained limited for technical reasons. Progress in laparoscopic procedures and the development of dedicated technology have made it possible to conside...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200012000-00004
更新日期:2000-12-01 00:00:00
abstract::Nutritional status was investigated in 10 patients who had previously undergone total gastrectomy without evidence of malignancy. The ability of these patients to ingest and absorb adequate amounts of nutrients was examined. Metabolic balance studies were also performed to discover how effectively these patients coul...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197510000-00007
更新日期:1975-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the oncological outcomes of robotic total mesorectal excision (TME) at an NCI designated cancer center. SUMMARY BACKGROUND DATA:The effectiveness of laparoscopic TME could not be established, but the robotic-assisted approach may hold some promise, with improved visualiza...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002112
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND AND AIMS:The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low resting pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdominal portion of the LES...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e3e411
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To review retrospectively a 4-year experience with pediatric surgical networking at a major academic medical center in the Midwest. BACKGROUND:The growth of managed care in the United States during the past decade has had a major impact on the practice of medicine in general, but especially on academic medic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199909000-00006
更新日期:1999-09-01 00:00:00
abstract::During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accident...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198502000-00011
更新日期:1985-02-01 00:00:00
abstract::Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198808000-00004
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:To determine if 5-year surgeon cumulative and annual volumes predict improved early postoperative outcomes in patients with rectal cancer. BACKGROUND:Operative experience has been shown to effect surgical outcomes. The differential role of cumulative versus annual volume has not yet been explored for rectal ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001672
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:The authors investigate the recovery of gastrointestinal motility in the fed and fasted state after laparoscopic and open cholecystectomy. SUMMARY BACKGROUND DATA:Clinical recovery after laparoscopic cholecystectomy is known to be more rapid than after conventional open cholecystectomy. However, the actual e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199604000-00010
更新日期:1996-04-01 00:00:00
abstract::Pancreas divisum is an anatomic duct variant, which may predispose to pancreatitis. Most patients are managed conservatively, but some patients justify attempts to improve drainage. The correct surgical approach is not yet established, and there has been no series published concerning pancreatic resection in this cont...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198411000-00006
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVE:To determine the impact of a clinical pathway for elective infrarenal aortic reconstruction on outcome, resource utilization, and cost in a university medical center. SUMMARY BACKGROUND DATA:Clinical pathways have been reported to control costs, reduce resource utilization, and maintain or improve the qualit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199805000-00009
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Ventricular assist devices (VADs) have been used for temporary circulatory support pending transplantation or recovery of the native heart. Outcome in 38 patients treated at the authors' institution with VADs pending transplantation was analyzed to provide information relevant to the future use...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199706000-00007
更新日期:1997-06-01 00:00:00
abstract::The effect of OP-41483, a stable prostacyclin (PGI2) analog, on ischemic acute renal failure (ARF) was investigated in dogs. Administration of OP-41483 for three days after ischemia significantly increased renal cortical blood flow (RCBF) when compared with dogs treated with the saline vehicle. In the OP-41483-treated...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198807000-00009
更新日期:1988-07-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:High rate of complications has been reported following revascularization for acute limb ischemia (ALI). No adjuvant pharmacologic treatment, apart from anticoagulation and standard perioperative care, has been shown clinically effective. OBJECTIVE:Aim of this study was to evaluate the effects o...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000217555.49001.ca
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To investigate the pattern of nodal metastasis, morbidity, recurrence rates of papillary thyroid carcinoma (PTC), and parathyroid hormone (PTH) responses following neck dissection (ND) plus total thyroidectomy (TT). SUMMARY BACKGROUND DATA:While hypoparathyroidism develops after TT plus ND, little is known o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000250451.59685.67
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess feasibility and outcomes of a multicenter training program in laparoscopic pancreatoduodenectomy (LPD). BACKGROUND:Whereas expert centers have reported promising outcomes of LPD, nationwide analyses have raised concerns on its safety, especially during the learning curve. M...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002563
更新日期:2019-02-01 00:00:00
abstract::The role of surgery in the treatment of gastrinoma is unclear. The purpose of this study was to determine prospectively the surgical cure rate using a controlled clinical trial. Eleven patients who fit the entry criteria underwent abdominal exploration and attempted tumor resection for cure. A historical control group...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199001000-00002
更新日期:1990-01-01 00:00:00
abstract::Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out inta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcome of preoperative gemcitabine-based chemoradiation therapy (CRT) for borderline resectable pancreatic cancer (BRPC), focusing on the associations among the tumor-vascular relationship, surgical outcomes, and pattern of recurrence. SUMMARY BACKGROUND DATA:Among the various multimodal tre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001547
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:The HepatAssist liver support system is an extracorporeal porcine hepatocyte-based bioartificial liver (BAL). The safety and efficacy of the BAL were evaluated in a prospective, randomized, controlled, multicenter trial in patients with severe acute liver failure. SUMMARY BACKGROUND DATA:In experimental anim...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.sla.0000124298.74199.e5
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:To analyze the clinical course, treatment, complications, outcome, and quality of life (QOL) in patients with perineal/perianal rhabdomyosarcoma (PRMS) treated within the CWS-86, -91, -96, and -2002P trials. BACKGROUND:Although multiple international study trials exist for the treatment of rhabdomyosarcoma, ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0b013e3182a6f320
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the accuracy of abdominal ultrasonography (US) for screening and grading pediatric splenic injury. SUMMARY BACKGROUND DATA:The use of abdominal US has increased rapidly as a method of evaluating organ damage after blunt abdominal trauma. Despite US's increasing use, ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199704000-00010
更新日期:1997-04-01 00:00:00