Critical care medicine
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Critical care medicine · Feb 1997
Intensive care physicians' insufficient knowledge of right-heart catheterization at the bedside: time to act?
To evaluate French, Swiss, and Belgian intensive care physicians' knowledge about the pulmonary artery catheter. ⋯ Knowledge of right-heart pulmonary artery catheterization is not uniformly good among ICU physicians. Accreditation policies and teaching practices concerning this technique need urgent revision.
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Critical care medicine · Feb 1997
Comparative StudyReduced airway resistance and work of breathing during mechanical ventilation with an ultra-thin, two-stage polyurethane endotracheal tube (the Kolobow tube).
To compare dynamic pulmonary function studies using the ultrathin walled Kolobow endotracheal tube, with conventional endotracheal tubes of similar external diameter on rabbits during mechanical ventilation. To test the hypothesis that the increased internal diameter of the Kolobow tube will result in decreased airway resistance and work of breathing. ⋯ The use of the ultrathin walled Kolobow endotracheal tube resulted in significant decreases in airway resistance and work of breathing, which has the potential for improving the ventilatory mechanics in very small premature newborns.
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Critical care medicine · Feb 1997
The unassisted respiratory rate/tidal volume ratio accurately predicts weaning outcome in postoperative patients.
To evaluate the accuracies of the respiratory rate/tidal volume ratio (rate/volume ratio), minute volume, and negative inspired force in predicting weaning outcome in postoperative mechanically ventilated patients. ⋯ The rate/volume ratio measured at the beginning and after 30 mins of weaning is more highly predictive of weaning outcome than the negative inspired force and minute volume. The principal weakness of the rate/volume ratio is false-positive results.
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Critical care medicine · Feb 1997
Comparative StudyHigh-frequency oscillatory ventilation with partial liquid ventilation in a model of acute respiratory failure.
To determine whether there is an improvement in oxygenation when partial liquid ventilation and high-frequency oscillatory ventilation are combined in the treatment of acute lung injury, compared with high-frequency oscillatory ventilation alone. ⋯ The combination of low-dose perflubron with high-frequency oscillatory ventilation leads to more rapid improvement in arterial oxygenation than high-frequency oscillatory ventilation alone, in a piglet model of acute lung injury. Although the group receiving high-frequency oscillatory ventilation alone eventually achieved PaO2 values that were equivalent to the group receiving high-frequency ventilation and perflubron, the combination of perflubron with high-frequency oscillatory ventilation may permit effective oxygenation and ventilation at lower mean airway pressures by facilitating alveolar expansion and decreasing intrapulmonary shunt.
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Critical care medicine · Feb 1997
Comparative StudyDifferential effects of nitric oxide synthase modulation on porcine systemic and pulmonary circulation in vivo.
To study and compare the effects of inhibiting endothelial nitric oxide synthase on systemic and pulmonary circulation in an in vivo model. ⋯ A basal release of nitric oxide contributes to the maintenance of normal vascular tone in the anesthetized pig. Stimulation of endothelial nitric oxide synthase by acetylcholine did not result in any further pulmonary vasodilation as was seen in the systemic circulation. Inhibition of nitric oxide synthase had a greater effect on pulmonary pressure than on systemic pressure. However, this difference was abolished by the administration of indomethacin. Increased nitric oxide release or acetylcholine itself seems to stimulate the production of a vasoconstricting prostanoid in the pulmonary circulation.