Archive for the ‘Pulmonary function’ Category - Part 3

Pulmonary and Extrapulmonary Effects of Increased Colloid Osmotic Pressure During Endotoxemia in Rats: Materials and Methods

Anesthesia, Surgery, and Fluid, Balance The experimental protocol for this study was approved by the Institutional Animal Care and Use Committee of the Miami Children’s Hospital, Miami, FL. Young albino Sprague-Dawley rats (weight range, 250 to 350 g) were anesthetized with 50 mg/kg pentobarbital intraperitoneally. In the supine position, a tracheostomy was performed and an […]

Pulmonary and Extrapulmonary Effects of Increased Colloid Osmotic Pressure During Endotoxemia in Rats:

According to Starling principles, the plasma COP is one of the major factors affecting fluid flux across the capillaries. However, the role of COP in modulating the fluid flux across the capillary membrane in critically ill patients is controversial. Two reviews’ concluded that albumin-treated patients have a 4 to 6% excess mortality rate compared to […]

Pulmonary and Extrapulmonary Effects of Increased Colloid Osmotic Pressure During Endotoxemia in Rats

Colloid osmotic pressure (COP) is generated across membranes that are permeable to water and low-molecular-weight substances but that are impermeable to large molecular compounds, such as plasma proteins. Fluid administration is a fundamental part of resuscitation therapy, which is performed by using either crystalloid or colloid solutions. Crystalloid solutions, such as Ringer’s lactate solutions and […]

Pulmonary and Extrapulmonary Effects of Increased Colloid Osmotic Pressure During Endotoxemia in Rats: Extrapulmonary Effects of COP

Hetastarch and pentastarch infusion in hypopro-teinemic sheep, unlike our endotoxemic albumin-treated rats, have produced a limited transvascular fluid filtration in the lung and soft tissue compared to crystalloid infusion. This, however, was explained by the augmentation of plasma COP and by the plasma-to-lymph oncotic pressure gradient, where capillary integrity was maintained. Conflicting reports of the […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (21)

Nevertheless, it remains quite possible that another technique, particularly PSV,* where the airway pressure mostly depends on the patients demand for air during the inspiratory time, would be better tolerated than AC-IPPV; in IPPV inspiration stops when a preset volume or pressure is reached; this feature can sometimes induce an active expiratory effort, which can […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (20)

It is therefore possible that by adding this extra amount of nurse/patient ratio for one or a few patients, a given ICU might become “saturated” and that the treatment of all patients in this ICU could be compromised; a superimposed ratio of around 0.20 may represent almost 50 percent of the average nursing task force […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (19)

There are few data on the amount of time spent by ICU teams with patients classically intubated and mechanically ventilated that we could use for comparison with the amount of extra work caused by acute NPPV; however, we know that stable ICU patients, assessed by TISS and APACHE 221 scores of 19.0 ± 6.7 and […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (18)

Today, we are faced with a scarcity of both experienced ICU nurses and financial resources, this being particularly crucial in North America, from what we can perceive from Europe; in recent years the average number of nursing hours for ICU patients has decreased drastically (ie, around 40 percent) for patients with a similar degree of […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (17)

Secondly, when the electromyographic activity of the diaphragm was recorded in a few acutely ill patients submitted to NPPV the mean amplitude of this signal decreased more in restrictive than in obstructive disease at a similar level of nasal mask pressure delivered by the respirator. It seems therefore that if one of the goals of […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (16)

Discussion Several elements of information can be derived from our study. First, NPPV is feasible in acute respiratory failure, when only the possibility of lowering an increased PaC02 is considered; however, in some patients, particularly the obstructive group, intubation appears to be ultimately unavoidable. It is unlikely that this technique will be considered as a […]

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