Intensive care medicine
-
Intensive care medicine · Dec 1996
New aspects of pulmonary mechanics: "slowly" distensible compartments of the respiratory system, identified by a PEEP step maneuver.
The aims of the present study were 1) to evaluate a method for identification of "slowly" distensible compartments of the respiratory system (rs), which are characterized by long mechanical time constants (RC) and 2) to identify "slowly" distensible rs-compartments in mechanically ventilated patients. ⋯ The gas distribution properties of the respiratory system can be easily studied by a PEEP-step maneuver. The relative contribution of the "slow" units to the total increase of lung volume following a PEEP step could be adequately assessed. "Slowly" distensible rs-compartments could be detected in patients with severe and mild lung injury, however significantly more ARDS patients revealed "slow" rs-compartments in PEEP-decreasing steps. The influence of "slowly" distensible rs-compartments on pulmonary gas exchange is unknown and has yet to be studied.
-
Intensive care medicine · Dec 1996
Initial postoperative serum lactate levels predict survival in children after open heart surgery.
To evaluate the relationship between postoperative serum lactate levels and outcome in children undergoing open heart surgery. ⋯ Initial postoperative serum lactate levels after pediatric open heart surgery may be predictive of outcome. Lactate levels are also higher in patients who go on to develop multiple organ system failure. Elevated postoperative lactate levels may reflect intraoperative tissue hypoperfusion, and measures aimed at increasing oxygen delivery, with normalization of lactate, may improve patient outcome.
-
Intensive care medicine · Dec 1996
Intrapleural administration of streptokinase in complicated purulent pleural effusion: a CT-guided strategy.
To determine the usefulness and the results of a strategy using intrapleural streptokinase (SK) instillation guided by repeated computed tomography (CT) scan examinations in pleural empyemas unresponsive to chest tube drainage. ⋯ CT-guided SK instillation in pleural empyema appears to be safe, and allowed complete resolution in 87.5% of our patients.
-
Intensive care medicine · Dec 1996
Randomized Controlled Trial Comparative Study Clinical TrialEffects of continuous (CPAP) and bi-level positive airway pressure (BiPAP) on extravascular lung water after extubation of the trachea in patients following coronary artery bypass grafting.
To evaluate the effects of continuous positive airway pressure (CPAP) and bi-level positive airway pressure (Bi-PAP) on extravascular lung water during weaning from mechanical ventilation in patients following coronary artery bypass grafting. ⋯ Mask CPAP and nasal BiPAP after extubation of the trachea prevent the increase in extravascular lung water during weaning from mechanical ventilation. This effect is seen for at least 1 h after the discontinuation of CPAP or BiPAP treatment. Further studies have to evaluate the clinical relevance of this phenomenon.