Critical care medicine
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Critical care medicine · Mar 2003
Bacterial colonization of the respiratory tract following tracheal intubation-effect of gravity: an experimental study.
To explore the role of the horizontal orientation of endotracheal tube and neck on bacterial colonization of the respiratory tract in anesthetized sheep on mechanical ventilation, without use of antibiotics. ⋯ The horizontal orientation of the endotracheal tube and neck, through lateral body rotation, showed no altered airway colonization and maintained excellent gas exchange and lung function in our animal model.
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Critical care medicine · Mar 2003
Early multiple organ failure after recurrent endotoxemia in the presence of vasoconstrictor-masked hypovolemia.
Critically ill patients who develop multiple organ failure during systemic inflammatory states are often predisposed to hypovolemia and vasoconstrictor therapy. Although numerous investigations have evaluated the sequelae of systemic inflammation, no data are available on the contribution of chronic vasoconstrictor-masked hypovolemia to organ dysfunction and morphology. ⋯ Hypovolemia can be masked when volume status is monitored by filling pressures. In this new model of endotoxemia-associated multiple organ failure, chronic vasoconstrictor-masked hypovolemia turned systemic inflammation into a life-threatening condition with renal and cardiovascular failure. Cardiomyocyte necroses were caused by vasoconstrictor-masked hypovolemia but were unrelated to cardiovascular failure.