Intensive care medicine
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Intensive care medicine · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of respiratory rate on gas trapping during low volume ventilation of patients with acute lung injury.
Reduction in tidal volume (Vt) associated with increase in respiratory rate to limit hypercapnia is now proposed in patients with acute lung injury (ALI). The aim of this study was to test whether a high respiratory rate induces significant intrinsic positive end-expiratory pressure (PEEPi) in these patients. ⋯ An increase in respiratory rate used to avoid Vt reduction-induced hypercapnia may induce substantial gas trapping and PEEPi in patients with ALI.
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Intensive care medicine · Aug 2002
Oxygenation index, an indicator of optimal distending pressure during high-frequency oscillatory ventilation?
To test the hypothesis that, during high-frequency oscillatory ventilation (HFOV) of pigs with acute lung injury, the oxygenation index (OI = Paw*FIO(2)*100/PaO(2)) is minimal at the lowest continuous distending pressure (Paw), where the physiological shunt fraction is below 0.1 (Paw(optimal)). ⋯ The minimal OI is indicative for the Paw where oxygenation is optimal during HFOV in surfactant-depleted pigs.
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Intensive care medicine · Aug 2002
Comparative StudyExogenous surfactant reduces ventilator-induced decompartmentalization of tumor necrosis factor alpha in absence of positive end-expiratory pressure.
To determine the effect of pretreatment with exogenous surfactant on ventilator-induced decompartmentalization of TNF-alpha. ⋯ An excess of active surfactant decreases transfer of cytokines across the alveolar-capillary membrane similar to PEEP. The combination of PEEP and surfactant reduces decompartmentalization of TNF-alpha even further.