Critical care medicine
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Critical care medicine · Jan 1997
Tracheal gas insufflation during pressure-control ventilation: effect of using a pressure relief valve.
Pressure-control ventilation minimizes alveolar overdistention by limiting peak airway pressure, but a consequence of this pressure limitation may be a reduction in tidal volume with subsequent hypercarbia. Tracheal gas insufflation (TGI) can be used in combination with pressure-control ventilation to augment CO2 elimination. During pressure-control ventilation with continuous TGI, we observed that peak airway pressure increased above the set inspiratory pressure. Based on this observation, we investigated the ability of the pressure-control ventilator circuit to compensate for continuous TGI and the effect of insertion of a pressure relief valve to eliminate over-pressurization. ⋯ A pressure relief valve is a necessary adjunct to maintain peak airway pressure at set inspiratory pressure and keep total inspiratory tidal volume constant when continuous TGI is administered in conjunction with pressure-control ventilation.
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Critical care medicine · Jan 1997
Effect of continuous venovenous hemofiltration with dialysis on lactate clearance in critically ill patients.
To evaluate the effect of continuous venovenous hemofiltration with dialysis on lactate elimination by critically ill patients. ⋯ Continuous venovenous hemofiltration with dialysis cannot mask lactate overproduction, and its blood concentration remains a reliable marker of tissue oxygenation in patients receiving this renal replacement technique.
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Critical care medicine · Jan 1997
Comparative StudyDelivery of metered dose inhaler aerosols to paralyzed and nonparalyzed rabbits.
To assess whether paralysis alters pulmonary deposition of albuterol delivered by metered dose inhaler and spacer to small animals. ⋯ Metered dose inhaler delivery of aerosolized medications to ventilated rabbits is significantly enhanced if respiration is not controlled. This observation might have implications for the delivery of therapeutic aerosols to newborns and young infants receiving slow, intermittent, mandatory ventilation.
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Critical care medicine · Jan 1997
Mortality is directly related to the duration of mechanical ventilation before the initiation of extracorporeal life support for severe respiratory failure.
To investigate the relationship between the period of mechanical ventilation before extracorporeal life support and survival in patients with respiratory failure. ⋯ In severe acute respiratory failure treated with lung rest and extracorporeal life support, a predicted 50% mortality rate was associated with 5 days of preextracorporeal life support mechanical ventilation.
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Critical care medicine · Jan 1997
Letter Comparative StudyVolume-controlled versus biphasic positive airway pressure.