Assessment of the development of choked flow during total liquid ventilation.

Abstract:

OBJECTIVE:The flow rate of a liquid drainage from the lungs is limited because of the elastic nature of the airways. This study was designed to clarify the relationship between intrapulmonary liquid volume and the development of the flow limitation or choked flow phenomenon as a function of expiratory flow rate during total liquid ventilation with perflubron. DESIGN:Prospective animal study. SETTING:University research laboratory. SUBJECTS:Rabbits with a weight of 3.2 +/- 0.3 kg. INTERVENTIONS:After the rabbits were killed, the lungs were filled to functional residual capacity with perflubron, followed by administration of an additional volume of 30, 45, or 60 mL of perflubron (initial volume = functional residual capacity + additional volume). MEASUREMENTS AND RESULTS:In one set of five animals, the intratracheal pressure at the occurrence of choked flow was established at -20 mm Hg. In another set of six animals, we demonstrated that the volume remaining in the lung at the point of development of choked flow (Vch) was stable for the first 40 mins after the animals were killed. Flow rates of 1.25, 2.5, 3.75, 5.0, 7.5, 10.0, and 12.5 mL/sec were then applied at an additional volume of 30, 45, or 60 mL to 34 animals. Vch approximately doubled as the flow rate increased from 1.25 mL/sec to 12.5 mL/sec (p <.001). At the same flow, Vch was higher for an additional volume of 60 mL than 30 mL when the flow was > or =2.5 mL/sec. CONCLUSIONS:From these data, we conclude that choked flow occurs at intratracheal pressure of less than -20 mm Hg, that Vch is stable for the first 40 mins after the animals are killed, and that Vch is a function of flow rate and initial volume.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Baba Y,Brant D,Brah SS,Grotberg J,Bartlett RH,Hirschl RB

doi

10.1097/01.CCM.0000104918.48411.91

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

201-8

issue

1

eissn

0090-3493

issn

1530-0293

journal_volume

32

pub_type

杂志文章
  • Prolonged mechanical ventilation alters diaphragmatic structure and function.

    abstract:OBJECTIVE:To review current knowledge about the impact of prolonged mechanical ventilation on diaphragmatic function and biology. MEASUREMENTS:Systematic literature review. CONCLUSIONS:Prolonged mechanical ventilation can promote diaphragmatic atrophy and contractile dysfunction. As few as 18 hrs of mechanical ventil...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0b013e3181b6e760

    authors: Powers SK,Kavazis AN,Levine S

    更新日期:2009-10-01 00:00:00

  • Sensitivity of routine intensive care unit surveillance for detecting myocardial ischemia.

    abstract:OBJECTIVE:To assess the effectiveness of routine intensive care unit surveillance compared with frequent 12-lead electrocardiogram monitoring for detecting electrocardiogram evidence suggestive of prolonged myocardial ischemia in vascular surgery patients. DESIGN:Prospective cohort trial. SETTING:Intensive care unit....

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000084857.87446.DD

    authors: Martinez EA,Kim LJ,Faraday N,Rosenfeld B,Bass EB,Perler BA,Williams GM,Dorman T,Pronovost PJ

    更新日期:2003-09-01 00:00:00

  • Aerosolized antibiotics in mechanically ventilated patients: delivery and response.

    abstract:OBJECTIVES:To determine whether aerosolized antibiotics can be delivered efficiently to the lower respiratory tract in mechanically ventilated patients and to define possible clinical responses to these agents. DESIGN:Prospective serial study with cases as their own control. SETTING:A 10-bed respiratory care unit for...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-199801000-00013

    authors: Palmer LB,Smaldone GC,Simon SR,O'Riordan TG,Cuccia A

    更新日期:1998-01-01 00:00:00

  • A randomized trial of recombinant human granulocyte-macrophage colony stimulating factor for patients with acute lung injury.

    abstract:RATIONALE:Despite recent advances in critical care and ventilator management, acute lung injury and acute respiratory distress syndrome continue to cause significant morbidity and mortality. Granulocyte-macrophage colony stimulating factor may be beneficial for patients with acute respiratory distress syndrome. OBJECT...

    journal_title:Critical care medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/CCM.0b013e31822d7bf0

    authors: Paine R 3rd,Standiford TJ,Dechert RE,Moss M,Martin GS,Rosenberg AL,Thannickal VJ,Burnham EL,Brown MB,Hyzy RC

    更新日期:2012-01-01 00:00:00

  • Old Mice Demonstrate Organ Dysfunction as well as Prolonged Inflammation, Immunosuppression, and Weight Loss in a Modified Surgical Sepsis Model.

    abstract:OBJECTIVES:Our goal was to "reverse translate" the human response to surgical sepsis into the mouse by modifying a widely adopted murine intra-abdominal sepsis model to engender a phenotype that conforms to current sepsis definitions and follows the most recent expert recommendations for animal preclinical sepsis resea...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003926

    authors: Stortz JA,Hollen MK,Nacionales DC,Horiguchi H,Ungaro R,Dirain ML,Wang Z,Wu Q,Wu KK,Kumar A,Foster TC,Stewart BD,Ross JA,Segal M,Bihorac A,Brakenridge S,Moore FA,Wohlgemuth SE,Leeuwenburgh C,Mohr AM,Moldawer LL,E

    更新日期:2019-11-01 00:00:00

  • Effects of naloxone and morphine on acute hypoxic survival in mice.

    abstract:OBJECTIVE:To investigate a role of the opiate system during acute hypoxic hypoxia, the effects of naloxone and morphine on hypoxic survival rate were investigated in awake adult mice. DESIGN:Prospective, randomized, animal trial. SETTING:University research laboratory. SUBJECTS:Male dd-Y mice (n = 864 in experiment ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199909000-00035

    authors: Endoh H,Taga K,Yamakura T,Sato K,Watanabe I,Fukuda S,Shimoji K

    更新日期:1999-09-01 00:00:00

  • Economic implications of an evidence-based sepsis protocol: can we improve outcomes and lower costs?

    abstract:OBJECTIVE:To determine the financial impact of a sepsis protocol designed for use in the emergency department. DESIGN:Retrospective analysis of a before-after study testing the implications of sepsis protocol. SETTING:Academic, tertiary care hospital in the United States. PATIENTS:Persons with septic shock presentin...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000261886.65063.CC

    authors: Shorr AF,Micek ST,Jackson WL Jr,Kollef MH

    更新日期:2007-05-01 00:00:00

  • Physicians' decision-making roles for an acutely unstable critically and terminally ill patient.

    abstract:OBJECTIVES:There is substantial variation in use of life sustaining technologies in patients near the end of life but little is known about variation in physicians' initial ICU admission and intubation decision making processes. Our objective is to describe variation in hospital-based physicians' communication behavior...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0b013e318287f0dd

    authors: Uy J,White DB,Mohan D,Arnold RM,Barnato AE

    更新日期:2013-06-01 00:00:00

  • Pressure-flow relationships of the pulmonary circulation during endotoxin infusion in intact dogs.

    abstract:BACKGROUND AND METHODS:We aimed to characterize the effects of an endotoxin insult (Escherichia coli 0127:B8) on the relationships between pulmonary vascular pressure and flow in intact dogs. To achieve this goal, multipoint plots of total pressure gradient, arterial pressure gradient, and venous pressure gradient vs. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199207000-00018

    authors: D'Orio V,Fatemi M,Marnette JM,Mendes P,Saad G,Martinez C,Marcelle R

    更新日期:1992-07-01 00:00:00

  • Endocardial and transcutaneous cardiac pacing, calcium chloride, and epinephrine in postcountershock asystole and bradycardias.

    abstract::Clinically, asystole or a bradyarrhythmia may follow countershock of ventricular fibrillation (VF) in up to 40% of attempts. This study evaluated the effects of artificial cardiac pacing, calcium chloride (CaCl2), and epinephrine in postcountershock asystole/bradycardia. Micromanometer catheters were positioned in the...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198509000-00001

    authors: Niemann JT,Adomian GE,Garner D,Rosborough JP

    更新日期:1985-09-01 00:00:00

  • Effects of hyperventilation on conjunctival oxygen tension in humans.

    abstract::A polarographic conjunctival oxygen sensor was used to measure oxygen tension in a tissue bed supplied by the internal carotid artery. The shared vascular source of the conjunctiva and brain suggests that conjunctival PO2 monitoring may provide an index of cerebral perfusion. We studied the effects of hyperventilation...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198601000-00003

    authors: Nisam M,Albertson TE,Panacek E,Rutherford W,Fisher CJ Jr

    更新日期:1986-01-01 00:00:00

  • Prospectively validated prediction of physiologic variables and organ failure in septic patients: The Systemic Mediator Associated Response Test (SMART).

    abstract:OBJECTIVE:Conventional outcomes research provides only percentage risk of such end points as mortality rate, utilization of resources, and/or broad groupings of multiple organ system dysfunction. These prognostications generally are not applicable to individual patients. The purpose of the present study was to determin...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-200205000-00014

    authors: Slotman GJ

    更新日期:2002-05-01 00:00:00

  • Intensive communication: four-year follow-up from a clinical practice study.

    abstract:PURPOSE:To determine the durability of the effects of a change in practice designed to promote the use of advanced supportive technology when it is of benefit but to limit its burdens when it is ineffective. We have reported that institution of a process of intensive communication reduced length of intensive care unit ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000065279.77449.B4

    authors: Lilly CM,Sonna LA,Haley KJ,Massaro AF

    更新日期:2003-05-01 00:00:00

  • Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: a propensity-matched analysis.

    abstract:BACKGROUND:Septic shock represents the major cause of infection-associated mortality in the intensive care unit. The possibility that combination antibiotic therapy of bacterial septic shock improves outcome is controversial. Current guidelines do not recommend combination therapy except for the express purpose of broa...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0b013e3181eb3ccd

    authors: Kumar A,Zarychanski R,Light B,Parrillo J,Maki D,Simon D,Laporta D,Lapinsky S,Ellis P,Mirzanejad Y,Martinka G,Keenan S,Wood G,Arabi Y,Feinstein D,Kumar A,Dodek P,Kravetsky L,Doucette S,Cooperative Antimicrobial Thera

    更新日期:2010-09-01 00:00:00

  • Activated protein C in normal human pregnancy and pregnancies complicated by severe preeclampsia: a therapeutic opportunity?

    abstract:OBJECTIVES:Given the efficacy and safety of recombinant human activated protein C (rhAPC) in the systemic inflammatory response syndrome, this study was designed to review the evidence for a role for APC in the pathogenesis of preeclampsia. Preeclampsia is a proinflammatory and procoagulant state, and it is a pregnancy...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:10.1097/00003246-200208000-00035

    authors: von Dadelszen P,Magee LA,Lee SK,Stewart SD,Simone C,Koren G,Walley KR,Russell JA

    更新日期:2002-08-01 00:00:00

  • Critical Care Bed Capacity in Asian Countries and Regions.

    abstract:OBJECTIVE:To assess the number of adult critical care beds in Asian countries and regions in relation to population size. DESIGN:Cross-sectional observational study. SETTING:Twenty-three Asian countries and regions, covering 92.1% of the continent's population. PARTICIPANTS:Ten low-income and lower-middle-income eco...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004222

    authors: Phua J,Faruq MO,Kulkarni AP,Redjeki IS,Detleuxay K,Mendsaikhan N,Sann KK,Shrestha BR,Hashmi M,Palo JEM,Haniffa R,Wang C,Hashemian SMR,Konkayev A,Mat Nor MB,Patjanasoontorn B,Nafees KMK,Ling L,Nishimura M,Al Bahrani

    更新日期:2020-05-01 00:00:00

  • Composition of fresh frozen plasma.

    abstract::We analyzed 35 samples of fresh frozen plasma (FFP), finding mean concentrations of 535 mg/dl glucose, 172 mEq/L sodium, 73 mEq/L chloride, 3.5 mEq/L potassium, 15 mEq/L bicarbonate, and 5.5 g/dl protein with 60% albumin. Thus, FFP is a hyperosmolal, hyperglycemic, hypernatremic, and hypochloremic solution which may b...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198602000-00015

    authors: Ewalenko P,Deloof T,Peeters J

    更新日期:1986-02-01 00:00:00

  • Prone-position ventilation induces sustained improvement in oxygenation in patients with acute respiratory distress syndrome who have a large shunt.

    abstract:OBJECTIVES:Prone-position ventilation (PPV) induces acute improvement in oxygenation in many patients with acute respiratory distress syndrome (ARDS), with some maintaining their oxygenation even after they were returned to the supine position, but it is unclear what clinical factors determine the sustained oxygenation...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-200207000-00008

    authors: Lee DL,Chiang HT,Lin SL,Ger LP,Kun MH,Huang YC

    更新日期:2002-07-01 00:00:00

  • Does noninvasive positive pressure ventilation improve outcome in acute hypoxemic respiratory failure? A systematic review.

    abstract:CONTEXT:The results of studies on noninvasive positive pressure ventilation (NPPV) for acute hypoxemic respiratory failure unrelated to cardiogenic pulmonary edema have been inconsistent. OBJECTIVE:To assess the effect of NPPV on the rate of endotracheal intubation, intensive care unit and hospital length of stay, and...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccm.0000148011.51681.e2

    authors: Keenan SP,Sinuff T,Cook DJ,Hill NS

    更新日期:2004-12-01 00:00:00

  • Resuscitation with aged blood exacerbates liver injury in a hemorrhagic rat model.

    abstract:OBJECTIVE:Blood loss and transfusion are frequent among patients undergoing liver surgery. Concerns have been raised about the safety and efficacy of transfusing stored blood. The influence of transfusing fresh vs. stored blood on the liver has not been studied to date. We tested the hypothesis that transfusion of stor...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182711b38

    authors: Matot I,Katz M,Pappo O,Zelig O,Corchia N,Yedgar S,Barshtein G,Bennett-Guerrero E,Abramovitch R

    更新日期:2013-03-01 00:00:00

  • Metabolic support in sepsis and multiple organ failure: more questions than answers ...

    abstract::The metabolic support of critically ill patients is a relatively new topic of active research and discussion, and surprisingly little is known about the effects of critical illness on metabolic physiology and activity. The metabolic changes seen in critical illness are highly complex, and how and when to treat them ar...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.CCM.0000278601.93369.72

    authors: Vincent JL

    更新日期:2007-09-01 00:00:00

  • Cardiogenic shock.

    abstract::Cardiogenic shock is the most common cause of death in patients hospitalized with acute myocardial infarction and is associated with a poor prognosis. More than 75% of cases are due to extensive left ventricular infarction and ventricular failure. Other causes include right ventricular infarction and papillary muscle ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.CCM.0000296268.57993.90

    authors: Topalian S,Ginsberg F,Parrillo JE

    更新日期:2008-01-01 00:00:00

  • Intensive care unit: how stressful for physicians?

    abstract::The ICU has been considered a psychologically stressful environment. Although numerous studies have investigated this stress in ICU nurses, virtually none have examined how stressful the ICU is for physicians. This prospective study compares housestaff physicians' ratings of stress in the ICU to other medical-surgical...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198602000-00004

    authors: Eisendrath SJ,Link N,Matthay M

    更新日期:1986-02-01 00:00:00

  • Importance of platelets and fibrinogen in neutrophil-endothelial cell interactions in septic shock.

    abstract:OBJECTIVE:To examine the role of platelets, fibrin, and adhesion molecules in mediating neutrophil-endothelial cell interactions in septic shock. DESIGN:Controlled experiments using phase contrast microscopy to examine neutrophil, platelet, and endothelial cell interactions in flowing cell suspensions under simulated ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000139918.80602.57

    authors: Kirschenbaum LA,McKevitt D,Rullan M,Reisbeck B,Fujii T,Astiz ME

    更新日期:2004-09-01 00:00:00

  • Survey of critical care management of comatose, head-injured patients in the United States.

    abstract:OBJECTIVE:This survey was designed to study current practices in the monitoring and treatment of patients with severe head injury in the United States. DATA SOURCES:The collected data represent answers to telephone interviews of nurse managers, clinical specialists, and staff nurses specializing in neurotrauma care at...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00003246-199503000-00023

    authors: Ghajar J,Hariri RJ,Narayan RK,Iacono LA,Firlik K,Patterson RH

    更新日期:1995-03-01 00:00:00

  • A Dysregulated Balance of Proinflammatory and Anti-Inflammatory Host Cytokine Response Early During Therapy Predicts Persistence and Mortality in Staphylococcus aureus Bacteremia.

    abstract:OBJECTIVES:The contribution of individual immune response to Staphylococcus aureus bacteremia on outcome has not been well studied. The objective was to relate the host cytokine response to outcome of Staphylococcus aureus bacteremia. DESIGN:Prospective observational study. SETTING:Three U.S. university-affiliated me...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001465

    authors: Minejima E,Bensman J,She RC,Mack WJ,Tuan Tran M,Ny P,Lou M,Yamaki J,Nieberg P,Ho J,Wong-Beringer A

    更新日期:2016-04-01 00:00:00

  • Characteristics and Outcomes of HIV-Infected Patients With Severe Sepsis: Continued Risk in the Post-Highly Active Antiretroviral Therapy Era.

    abstract:OBJECTIVES:Although highly active antiretroviral therapy has led to improved survival in HIV-infected individuals, outcomes for HIV-infected patients with sepsis in the post-highly active antiretroviral therapy era are conflicting. Access to highly active antiretroviral therapy and healthcare disparities continue to af...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001003

    authors: Cribbs SK,Tse C,Andrews J,Shenvi N,Martin GS

    更新日期:2015-08-01 00:00:00

  • Cerebral effects of resuscitation with hypertonic saline and a new low-sodium hypertonic fluid in hemorrhagic shock and head injury.

    abstract:OBJECTIVES:A 2400-mOsm/L hypertonic solution (isosal) with a lower sodium content, compared with conventional 7.5% hypertonic saline, was formulated using a mixture of sodium chloride, glucose, and mixed amino acids. This solution was developed to minimize hypernatremia during resuscitation. We assessed the effects of ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199607000-00027

    authors: Sheikh AA,Matsuoka T,Wisner DH

    更新日期:1996-07-01 00:00:00

  • Diabetes mellitus does not adversely affect outcomes from a critical illness.

    abstract:OBJECTIVE:Chronic diabetes mellitus (DM) is a known cause of multisystem injury. The effect of DM in acute critical illness may also be detrimental, but is not specifically known. We hypothesized that the preexisting diagnosis of DM is an independent risk factor for mortality in critically ill patients. DESIGN:Paralle...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181b9eaa5

    authors: Graham BB,Keniston A,Gajic O,Trillo Alvarez CA,Medvedev S,Douglas IS

    更新日期:2010-01-01 00:00:00

  • Distribution and pathophysiology of acute lobar collapse in the pediatric intensive care unit.

    abstract:OBJECTIVE:The high incidence of lower lobe collapse in adult intensive care patients is well described. We aimed to document the incidence and distribution of acute lobar collapse in the pediatric intensive care setting. The influence of anatomical and pathophysiological differences between the adult and pediatric resp...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199908000-00035

    authors: Thomas K,Habibi P,Britto J,Owens CM

    更新日期:1999-08-01 00:00:00