Critical care medicine
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Critical care medicine · Oct 1998
Editorial Comment ReviewOn the accuracy of intra-arterial pressure measurement: the pressure gradient effect.
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Critical care medicine · Oct 1998
Comparative StudyRadial artery pressure monitoring underestimates central arterial pressure during vasopressor therapy in critically ill surgical patients.
Radial artery pressure is known to differ from central arterial pressure in normal patients (distal pulse amplification) and in the early postcardiopulmonary bypass period. The adequacy of the radial artery as a site for blood pressure monitoring in critically ill patients receiving high-dose vasopressors has not been carefully examined. ⋯ Radial artery pressure underestimates central pressure in hypotensive septic patients receiving high-dose vasopressor therapy. Clinical management, based on radial pressures, may lead to excessive vasopressor administration. Awareness of this phenomena may help minimize adverse effects of these potent agents by enabling dosage reduction.
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Critical care medicine · Oct 1998
Comparative StudyNeutrophil accumulation is reduced during partial liquid ventilation.
This study evaluates the ability of perflubron to inhibit pulmonary neutrophil accumulation during partial liquid ventilation (PLV) in the setting of acute lung injury. ⋯ These data suggest that both partial liquid ventilation and PEEP result in a reduction in neutrophil accumulation in the setting of acute lung injury.
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Critical care medicine · Oct 1998
Comparative StudyPartial liquid ventilation reduces pulmonary neutrophil accumulation in an experimental model of systemic endotoxemia and acute lung injury.
To determine whether pulmonary neutrophil sequestration and lung injury are affected by partial liquid ventilation with perfluorocarbon in a model of acute lung injury (ALI). ⋯ Partial liquid ventilation decreases pulmonary neutrophil accumulation, as shown by decreased neutrophil counts and MPO activity, in an experimental animal model of ALI induced by systemic endotoxemia. The attenuation in pulmonary leukostasis in animals treated with PLV is equivalent to that obtained by a ventilation strategy that targets lung recruitment, such as HFOV.
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Critical care medicine · Oct 1998
Comparative StudyExtreme hypoventilation reduces ventilator-induced lung injury during ventilation with low positive end-expiratory pressure in saline-lavaged rabbits.
To compare the degrees of ventilator-induced lung injury caused by two ventilation protocols. ⋯ These findings suggest that a very low tidal volume reduces ventilator-induced lung injury in saline-lavaged rabbits during ventilation at low lung volume.