Intensive care medicine
-
Intensive care medicine · Apr 1996
Effects of different triggering systems and external PEEP on trigger capability of the ventilator.
The triggering capability of both the pressure and flow triggering systems of the Servo 300 ventilator (Siemens-Elema, Sweden) was compared at various levels of positive end-expiratory pressure (PEEP), airway resistance (R(aw)), inspiratory effort and air leak, using a mechanical lung model. ⋯ With respect to triggering delay, the triggering capabilities of the pressure and flow sensing systems were comparable with and without PEEP and/or high airway resistance at the same sensitivity level, unless low inspiratory drive and air leak were present. In terms of pressure differentials, the flow triggering system may require less inspiratory effort to trigger the ventilator than that of the pressure triggering system with a comparable triggering time. However, this difference may be extremely small.
-
Intensive care medicine · Mar 1996
Effects of atrial natriuretic peptide on acute renal impairment in patients with heart failure after cardiac surgery.
To investigate the effects of IV infusion of atrial natriuretic peptide (human ANP 1-28) on renal function in patients with acute heart failure and renal impairment after cardiac surgery. ⋯ ANP improved renal function and decreased elevated renal vascular resistance in patients with renal dysfunction after cardiac surgery. The improvement in renal blood flow and glomerular filtration rate may be of potential therapeutic value to prevent or treat exaggerated renal vasoconstriction in patients with acute renal impairment following cardiac surgery.
-
Intensive care medicine · Mar 1996
Randomized Controlled Trial Multicenter Study Clinical TrialThe automatic selection of ventilation parameters during the initial phase of mechanical ventilation.
To test a method that allows automatic set-up of the ventilator controls at the onset of ventilation. ⋯ The AutoInit ventilator settings, which were automatically derived, were acceptable for all patients for a period of 20 min and were not found to be inferior to the control ventilator settings. This makes the AutoInit method potentially useful as an automatic start-up procedure for mechanical ventilation.
-
Intensive care medicine · Mar 1996
Clinical Trial Controlled Clinical TrialPhysiological effects of reduced tidal volume at constant minute ventilation and inspiratory flow rate in acute respiratory distress syndrome.
To assess the effect of changes in tidal volume (VT) with a constant inspiratory flow and minute ventilation (VE) on gas exchange and oxygen transport in acute respiratory distress syndrome (ARDS). ⋯ Tidal volumes can be reduced to 6-8 ml/kg in ARDS patients without compromising oxygen transport, while adequate CO2 elimination can be maintained.
-
Intensive care medicine · Mar 1996
Randomized Controlled Trial Comparative Study Clinical TrialComputed tomography vs clinical and multidisciplinary procedures for early evaluation of severe abdomen and chest trauma--a cost analysis approach.
To compare contrast computed tomography (CT) for evaluating abdominal and vascular chest injuries after emergency room resuscitation with multidisciplinary management based on bedside procedure (BP), e.g., peritoneal lavage, abdomen ultrasonography urography and, if indicated, CT and/or aortography or transesophageal echocardiography. ⋯ This cost-minimization study suggests that CT is a more cost-effective method for the post-emergency room resuscitation evaluation of severe abdominal blunt trauma than the multidisciplinary BP. Chest CT is a screening method for mediastinal hematoma but not for etiology.