Intensive care medicine
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Intensive care medicine · Apr 2002
Comparative StudyComparison of different methods for measuring intra-abdominal pressure.
Intra-abdominal pressure (IAP) can be measured in different ways but is usually measured indirectly via the urinary bladder. The aim of the study was to: 1) compare urinary bladder pressure, femoral vein pressure, and inferior caval vein pressure with IAP at different levels of IAP; and 2) try to find an optimal amount of fluid to be instilled into the urinary bladder before measurement of the bladder pressure, and to compare changes in blood flow in the femoral vein with that in the caval vein at different pressure levels. ⋯ In our porcine model, and increasing the IAP by means of instillation of Ringer's solution, a reliable estimation of the IAP was obtained by measuring the pressure in the urinary bladder, the femoral vein or the inferior caval vein. The IAP estimated indirectly as the urinary bladder pressure is affected by the amount of fluid in the bladder, which should not exceed 10-15 ml. The decrease in femoral vein blood flow reflects the changes in inferior caval vein flow during increased IAP.
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Intensive care medicine · Apr 2002
Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery.
We hypothesized that measuring stroke volume variation (SVV) during mechanical ventilation by continuous arterial pulse contour analysis allows the accurate prediction and monitoring of changes in cardiac index (CI) in response to volume administration. ⋯ SVV may help to determine the preload condition of ventilated patients following cardiac surgery and to predict and continuously monitor effects of volume administered as part of their hemodynamic management.
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Intensive care medicine · Apr 2002
Comparative StudyEvaluation of ventilators used during transport of ICU patients -- a bench study.
To evaluate portable ventilators. ⋯ The small portable ventilators presently investigated varied between each other and were less accurate than ICU ventilators.
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Intensive care medicine · Apr 2002
Case ReportsTranscatheter closure of a patent arterial duct in a patient on veno-arterial extracorporeal membrane oxygenation.
The presence of a patent arterial duct may complicate the course of the patient on veno-arterial extracorporeal membrane oxygenation (ECMO). While surgical ligation has been traditionally used as a definitive treatment for this problem, transcatheter closure may have advantages. This is the first report of transcatheter occlusion of a patent arterial duct in an infant on ECMO support.
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Intensive care medicine · Apr 2002
Mechanical ventilation alters the immune response in children without lung pathology.
This study was undertaken to examine the hypothesis that mechanical ventilation in association with anesthesia would alter the cytokine profile in infants without preexisting lung pathology. ⋯ Two hours of servoflurane and mechanical ventilation using a tidal volume of 10 ml/kg is associated with remarkable changes in the immune response in infants without preexisting lung pathology undergoing cardiac catheterization. In the lungs the immune balance favors a proinflammatory response pattern without detectable concentrations of anti-inflammatory mediators. The Th1 immune response by peripheral blood leukocytes was decreased. The observed change in Th1/Th2 balance in favor of Th2 cytokine activity may be a systemic adaptation to the proinflammatory milieu in the lung.