Intensive care medicine
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Intensive care medicine · Aug 1998
Electrical impedance tomography in monitoring experimental lung injury.
To apply electrical impedance tomography (EIT) and the new evaluation approach (the functional EIT) in monitoring the development of artificial lung injury. ⋯ The development of the local impairment of pulmonary ventilation and the formation of lung oedema could be followed by EIT in an experimental model of lung injury. This technique may become a useful tool for monitoring local pulmonary ventilation in intensive care patients suffering from pulmonary disorders associated with regionally reduced ventilation, fluid accumulation and/or cell membrane changes.
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To elucidate the risk factors for the development of acute renal failure (ARF) in severe trauma. ⋯ The identified risk factors for post-traumatic acute renal failure may help the provision of future strategies.
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Intensive care medicine · Aug 1998
Case ReportsAnticoagulative effect of nitric oxide inhalation in ARDS.
Some studies have suggested that nitric oxide (NO) may cause platelet dysfunction. We present an ARDS patient who need this treatment, with a transient alteration of platelet function and a significant prolongation of bleeding time.
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Intensive care medicine · Aug 1998
In vitro activity of fleroxacin against multiresistant gram-negative bacilli isolated from patients with nosocomial infections.
In order to evaluate the in vitro activity of fleroxacin against nosocomial gram-negative organisms, 263 multiresistant gram-negative bacilli (203 Enterobacteriaceae and 60 non-fermenting gram-negative bacilli) were isolated from adult patients with nosocomial infections. The different patterns of resistance to eight different antimicrobial agents (ampicillin, carbenicillin, piperacillin, cephalothin, cefamandole, ceftazidime, gentamicin and amikacin) were determined by minimum inhibitory concentration (MIC), using the agar dilution method. The most prevalent multiresistant species isolated were Klebsiella pneumoniae (28.9%), Escherichia coli (24%) and Pseudomonas aeruginosa (12.2%). ⋯ The resistance to fluoroquinolones detected in this study was no cause for alarm (3%). Consequently, fleroxacin maintains a remarkable activity against Enterobacteriaceae and remains highly active against other gram-negative bacilli. Nevertheless, actions directed at preventing or limiting resistance will be crucial to maintain the viability of fluoroquinolones as important therapeutic agents.
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The aim of this study was to show the feasibility of a slow, continuously increasing level of positive end-expiratory pressure (PEEP) (ramp manoeuvre) in selecting best PEEP and to evaluate whether best PEEP, as defined by maximal oxygen transport, coincides with best systemic arterial oxygenation or best compliance. ⋯ Best PEEP according to oxygen transport is lower than best PEEP according to compliance and PaO2; the use of PEEP as a ramp might prevent unnecessarily high levels of PEEP.