Intensive care medicine
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This is a very brief, superficial and biased discussion of the pathophysiologic changes in shock. It was designed to provide some insight into the very complex changes that occur, with particular attention to a few examples of the impaired cell metabolism, including changes in ATP, cAMP, and calcium. Although inadequate tissue perfusion through nutrietn capillaries is the main etiologic factor in most types of shock, it is not the primary problem in many patients, particularly those with early or hyperdynamic sepsis. The importantance of oxygen consumption and the possible benefits of higher hemoglobin levels are discussed to some extent because of their possible clinical application.
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Intensive care medicine · Nov 1979
Case ReportsDifferential ventilation in unilateral lung disease: effects on respiratory mechanics and gas exchange.
Conventional PEEP ventilation has been recently reported to be deleterious in some cases of ARF with unilateral pneumonia. In such respect, two cases of unilateral bacterial pneumonia were intubated with a Carlens tracheal tube. Measurement of tidal volume, static compliance, and functional residual capacity of each lung showed marked inequality. ⋯ Evident improvement in blood gases was obtained within 24 hours, as tidal volume, static compliance, and FRC of the diseased lung were markedly improved. In one case equalisation of V/Q ratio was documented using the 81m Kr method. Final recovery was obtained in one case.