Chest
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Recent international emergency cardiovascular care (ECC) and cardiopulmonary resuscitation (CPR) guidelines have recommended that health-care professionals allow family members to be present during resuscitation attempts. To assess whether critical care professionals support these recommendations, we surveyed health-care professionals for their opinions regarding family-witnessed resuscitation (FWR). ⋯ Our evaluation indicated that the majority of critical care professionals surveyed do not support the current recommendations provided by the ECC and CPR guidelines of 2000.
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Measurement of extravascular lung water (EVLW) as a clinical tool for the assessment of pulmonary function has been found to be more appropriate than oxygenation parameters or radiographic techniques. In this study, we analyzed the prognostic value of EVLW in critically ill patients. ⋯ EVLW correlated well with survival (ie, nonsurvivors had significantly higher EVLW values than survivors) and is an independent predictor of prognosis.
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Although the pathogenesis of interstitial pneumonia and pulmonary fibrosis are not well understood, it has been reported that inflammatory cells, especially neutrophils, and the injurious substances produced by them play important roles in the progression of interstitial pneumonia and subsequent fibrosis. Erythromycin and other 14-membered ring macrolides (14-MRMLs) have been reported to improve the survival of patients with diffuse panbronchiolitis by antineutrophil and several other anti-inflammatory mechanisms. The present study was undertaken to investigate the effects of 14-MRMLs on an experimental model of bleomycin-induced acute lung injury and subsequent fibrosis in mice. ⋯ These findings indicate that attenuation of inflammatory cell migration into the airspace by 14-MRMLs, especially of neutrophils and macrophages, resulted in inhibition of lung injury and subsequent fibrosis. 14-MRMLs clearly attenuated the expression of VCAM-1 mRNA during the early phase of bleomycin-induced lung injury, and this might be one mechanism of inhibition of neutrophil and macrophage migration into the airspace by 14-MRMLs. This may be one mechanism of the anti-inflammatory and antifibrotic effects of 14-MRMLs. These findings suggest that prophylactic administration of 14-MRMLs may be clinically efficacious in preventing acute exacerbation of interstitial pneumonia and acute lung injury.