Critical care medicine
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Critical care medicine · Jul 2000
Pulmonary surfactant is altered during mechanical ventilation of isolated rat lung.
To test the hypothesis that the lung injury induced by certain mechanical ventilation strategies is associated with changes in the pulmonary surfactant system. ⋯ A short period of injurious mechanical ventilation can cause a decrease in lung compliance that is associated with a large influx of proteins into the alveolar space and with alterations of the pulmonary surfactant system. The changes of surfactant in these experiments are different from those seen in acute lung injury, indicating that they may represent an initial response to mechanical ventilation.
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Critical care medicine · Jul 2000
Combined therapy with zaprinast and inhaled nitric oxide abolishes hypoxic pulmonary hypertension.
To determine whether the combination of the phosphodiesterase 5 inhibitor zaprinast and inhaled nitric oxide (NO) decreases hypoxic pulmonary hypertension in the rat. ⋯ Treatment with inhaled NO for 5 mins before but not during hypoxia is as effective as inhaled NO during hypoxia. Inhaled NO and zaprinast both decrease the pulmonary hypertensive response to hypoxia, and the combination abolishes the response. The combination of a phosphodiesterase 5 inhibitor and inhaled NO may have clinical applicability in the treatment of pulmonary hypertension.
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Critical care medicine · Jul 2000
Ventilatory support by tracheal gas insufflation and chest vibration during bronchoconstriction.
To determine whether chest wall vibration with tracheal gas insufflation during bronchoconstriction maintains gas exchange at lower airway and intrathoracic pressures than those that occur during positive pressure ventilation. ⋯ Tracheal gas insufflation with chest vibration supports gas exchange with permissive hypercapnia only during moderate, not severe, bronchoconstriction. Gas exchange was achieved at lower airway and intrathoracic pressures than those that developed during mechanical ventilation. The alveolar hypoventilation that occurred during insufflation with vibration indicates impaired CO2 elimination and suggests increased resistance to CO2 transport. This ventilation technique may confer therapeutic advantages over mechanical ventilation in the treatment of asthma.