Abstract:
OBJECTIVE:High-frequency oscillation has been proposed for use in adult acute respiratory distress syndrome. However, limited data are available on the effect of pressure amplitude and rate (Hz) on tidal volumes delivered during high-frequency oscillation in adults. DESIGN:Prospective, animal model, lung injury study. SETTING:Large-animal laboratory of a university-affiliated medical center. SUBJECTS:Nine sheep (29.2 +/- 2.4 kg). INTERVENTIONS:Severe lung injury was induced by repeated saline lung lavage. After stabilization, high-frequency oscillation was initiated at a mean airway pressure equal to the point of maximum curvature on the deflation limb of the pressure-volume curve (26 +/- 1.9 cm H2O). Tidal volume at all combinations of rates of 4, 6, 8, and 10 Hz, pressure amplitudes of 30, 40, 50, and 60 cm H2O, and inspiratory/expiratory ratios of 1:1 and 1:2 (using the Sensormedics 3100B oscillator) were measured. Flow was measured by a pneumotachometer, amplified and digitized at 1000 Hz. Three breaths were analyzed at each setting. MEASUREMENTS AND MAIN RESULTS:At both inspiratory/expiratory ratios, tidal volume was directly proportional to pressure amplitude and inversely proportional to frequency. During an inspiratory/expiratory ratio of 1:1, at 60 cm H2O pressure amplitude and 4 Hz, a tidal volume of 129.1 +/- 34.8 mL (4.4 +/- 1.2 mL/kg) was delivered. CONCLUSIONS:At low rates and high-pressure amplitudes in this model, tidal volumes approaching conventional mechanical ventilation can be delivered during high-frequency oscillation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Sedeek KA,Takeuchi M,Suchodolski K,Kacmarek RMdoi
10.1097/00003246-200301000-00035subject
Has Abstractpub_date
2003-01-01 00:00:00pages
227-31issue
1eissn
0090-3493issn
1530-0293journal_volume
31pub_type
杂志文章abstract:OBJECTIVE:To evaluate a new technique for pressure-volume curve tracing. DESIGN:Prospective experimental study. SETTING:Animal research laboratory. SUBJECTS:Six anesthetized rats. INTERVENTIONS:Two pressure-volume curves were obtained by means of the super-syringe method (gold standard) and the continuous positive ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000090003.87219.AA
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:To determine the frequency of advance directives or directives disclosed by healthcare agents and their influence on decisions to withdraw/withhold life-sustaining care in neurocritically ill adults. DATA SOURCES:PubMed, Embase, and Cochrane databases. STUDY SELECTION:Screening was performed using predefin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004388
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:Muscle weakness associated with critical illness can be due to the illness itself, immobilization associated with it, and/or to concomitant use of drugs that affect neuromuscular transmission. This study investigated the contribution of immobilization per se to the muscle dysfunction, as well as the associat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199902000-00031
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:To compare the responses of noninvasively measured tissue oxygen saturation (StO2) and calculated muscle oxygen tension (PmO2) to standard hemodynamic variables for early detection of imminent hemodynamic instability during progressive central hypovolemia in humans. DESIGN:Prospective study. SETTING:Researc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000295586.83787.7E
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:The first 70 years of critical care can be considered a period of "industrial revolution-like" advancement in terms of progressing the understanding and care of critical illness. Unfortunately, like the industrial revolution's impact on the environment, advancing ICU care of increasingly elderly, immunosuppre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004783
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:Although hepatic cytochrome P-450 protein concentrations are altered following endotoxin shock, changes in P-450 isoforms in sepsis have not been fully investigated. The aim of this study was to determine whether the major P-450 isoform in rat liver (i.e., CYP1A2) is down-regulated during the progression of s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000109453.57709.E2
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine whether anandamide, an endogenous cannabinoid receptor ligand, is involved in the pathogenesis of septic encephalopathy. DESIGN:Prospective, controlled study. SUBJECTS:Male Wistar rats (7 wks old) were randomly divided into four groups as follows: group 1, control (...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000187010.14426.cc
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:Cortisol clearance is reduced in sepsis and may contribute to the development of impaired adrenocortical function that is thought to contribute to the pathophysiology of critical illness-related corticosteroid insufficiency. We sought to assess adrenocortical function using computer-assisted numerical modelin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000721
更新日期:2015-03-01 00:00:00
abstract::A patient with brainstem infarction met the clinical criteria for brain death but had persistent EEG activity, complicating our decision to withdraw life support. We evaluated cerebral blood flow with xenon-enhanced computed tomography (Xe/CT), which documented the absence of posterior circulation flow and persistent,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00014
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVES:To describe long-term survival in patients with severe acute respiratory distress syndrome and assess differences in patient characteristics and outcomes among those who receive rescue therapies (prone position ventilation, inhaled nitric oxide, or inhaled epoprostenol) versus conventional treatment. DESIGN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000322
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To determine the effects of accidental injury of varying severity on interleukin (IL)-1 alpha, IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha), and endotoxin release. DESIGN:Prospective, multi-unit, longitudinal study. SETTING:Emergency Departments and intensive care units of two university hospitals. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199306000-00010
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:Limited data are available on the influence of sedation for critical care therapy with the widely used anesthetic propofol on recovery from acute traumatic brain injury. To establish the influence of propofol on endogenous neurogenesis and functional recovery after traumatic brain injury, rats were sedated wi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a639fd
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:To determine whether mean arterial blood pressure excursions below the lower limit of cerebral blood flow autoregulation during cardiopulmonary bypass are associated with acute kidney injury after surgery. SETTING:Tertiary care medical center. PATIENTS:Four hundred ten patients undergoing cardiac surgery w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31826ab3a1
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To evaluate whether current criteria for the diagnosis of brain death fulfill the requirement for the "irreversible cessation of all functions of the entire brain, including the brainstem." DATA SOURCES:Clinical, philosophical, legal, and public policy literature on the subject of brain death. DATA EXTRACTI...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199212000-00018
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVES:Radial artery applanation tonometry allows completely noninvasive continuous cardiac output estimation. The aim of the present study was to compare cardiac output measurements obtained with applanation tonometry (AT-CO) using the T-Line system (Tensys Medical, San Diego, CA) with cardiac output measured by i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000979
更新日期:2015-07-01 00:00:00
abstract::Although systolic dysfunction of the left ventricle has been characterized in septic shock (SS) and sepsis without shock (SWS), diastolic abnormalities are less well characterized. Diastolic filling was determined using pulsed Doppler transmitral spectral tracings in 13 patients with SS, ten patients with SWS, and 33 ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199007000-00005
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:To compare intraosseous with central venous blood samples for biochemical analyses and hemoglobin levels during cardiopulmonary resuscitation (CPR) and during cardiopulmonary resuscitation with infusion of sodium bicarbonate, epinephrine, and saline boluses through the intraosseous site. DESIGN:Prospective, ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199906000-00039
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To compare the classification performance of the Revised Atlanta Classification, the Determinant-Based Classification, and a new modified Determinant-Based Classification according to observed mortality and morbidity. DESIGN:A prospective multicenter observational study conducted in 1-year period. SETTING:F...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001565
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility, biochemical efficacy, and safety of liberal versus conventional glucose control in ICU patients with diabetes. DESIGN:Prospective, open-label, sequential period study. SETTING:A 22-bed mixed ICU of a tertiary hospital in Australia. PATIENTS:We compared 350 consecutive patients w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003087
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:Hyponatremia occurs in up to 30% of patients with pneumonia and is associated with increased morbidity and mortality. The prevalence of hyponatremia associated with coronavirus disease 2019 and the impact on outcome is unknown. We aimed to identify the prevalence, predictors, and impact on outcome of mild, m...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000004605
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:To provide an overview of key elements of the Affordable Care Act. To evaluate ways in which the Affordable Care Act will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the Affordable Care A...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001431
更新日期:2016-03-01 00:00:00
abstract::By definition, the acute respiratory distress syndrome is associated with diffuse cellular infiltration and proteinaceous edema. It is generally believed that the widespread injury that characterizes acute respiratory distress syndrome is a process that is launched almost synchronously throughout the lung, caused by b...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181f20f01
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:Restoration of myocardial blood flow after ischemia triggers an inflammatory response involving toll-like receptors. Toll-like receptor 2 deficiency is associated with a reduced infarct size after myocardial ischemia and reperfusion. Because a marked mortality was observed in C3HeN wild-type mice, which was a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181ef455b
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVES:Sepsis remains a serious clinical problem despite intensive research efforts and numerous attempts to improve outcome by modifying the inflammatory response. Substance P, the principal ligand for the neurokinin-1 receptor, is a potent proinflammatory mediator that exacerbates inflammatory responses and cardi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002075
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:Patients requiring admission to an ICU may subsequently experience cognitive decline. Our objective was to investigate longitudinal cognitive trajectories in older adults hospitalized in ICUs. We hypothesized that individuals hospitalized for critical illness develop greater cognitive decline compared with t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003829
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:The main objective of the study was to determine the prevalence of venous thromboembolism events in patients infected with severe acute respiratory syndrome coronavirus 2 requiring venovenous extracorporeal membrane oxygenation. The secondary objective was to compare venous thromboembolism events and coagula...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004504
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:The difficult airway is a common problem in adult critical care patients. However, the challenge is not just the establishment of a safe airway, but also maintaining that safety over days, weeks, or longer. AIMS:This review considers the management of the difficult airway in the adult critical care enviro...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31817d7ae1
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To determine a meta-analytical definition of the discriminant power of Ranson's signs in the prediction of acute pancreatitis severity and outcome, and of their information content, also compared with clinical judgment. DATA SOURCES:Two hundred eleven studies since 1974, reporting any predictive system for a...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-199910000-00035
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:Head-to-head comparison of the success rate of jejunal placement of a new electromagnetically visualized jejunal tube with that of the endoscopic technique in critically ill patients. DESIGN:: Prospective, randomized clinical trial. SETTING:Two intensive care units at a university hospital. PATIENTS:: A to...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e3181fb7b5f
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous refe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181930174
更新日期:2009-01-01 00:00:00