摘要:

Unstable inspiratory pressure may reduce the benefits of intermittent mandatory ventilation and impose a greater work of breathing than some patients can tolerate. The authors evaluated a continuous flow intermittent mandatory ventilation with continuous positive airway pressure apparatus provided with a 10-L high compliance reservoir bag, separated from the ventilator circuit by a one-way valve. A pulmonary simulator was tested to generate a wide range of inspiratory peak flow rates. Pressures and flow rates were examined in different sections of the system, using PEEP levels up to 15 mm Hg and different fresh gas flow rates. The circuit offers many advantages, particularly considering the low inspiratory pressure drop and the low fresh gas flow rates needed for optimal function.

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This report documents the validity of clinical measurements of oxygen consumption (Vo2) and carbon dioxide production (Vco2) made with a new metabolic gas monitor (MGM) suitable for use in critically ill patients receiving mechanical ventilatory support. Paired samples of inspired and expired gases were obtained, and exhaled minute volume was measured in 12 patients receiving supplemental oxygen, intermittent mandatory ventilation, and PEEP. Gas volume was measured with a calibrated spirometer and oxygen and CO2fractions were measured by mass spectrometry. Measured and derived values were compared to those obtained from the MGM connected in series with the ventilator circuit. There were no statistically significant differences between values obtained from the mass spectrometer/spirometer vs. the MGM in exhaled volume (8.60 ± 3.81 vs. 8.58 ± 3.72 [SD] L/min), fraction of inspired oxygen (0.451 ± 0.011 vs. 0.452 ± 0.010), fraction of expired oxygen (0.413 ± 0.013 vs. 0.415 ± 0.012), Vo2(290 ± 113 vs. 275 ± 88 ml/min), Vco2(245 ± 95 vs. 247 ± 96 ml/min), or respiratory quotient (0.85 ± 0.14 vs. 0.88 ± 0.08). The fraction of expired CO2measured by the MGM was significantly greater (0.034 ± 0.006 vs. 0.035 ± 0.006;p<.001) than that measured by mass spectrometer/spirometer. Twelve additional patients were studied to compare metabolic measurements made on 45% oxygen with those made at other fraction of inspired oxygen values. There was no significant difference between values measured on 45% oxygen and those measured on 30% to 50% oxygen. These data suggest that when a proper interface is obtained between the patient, ventilator, and device, the MGM will yield clinically valid determinations of Vo2and Vco2in critically ill patients receiving supplemental oxygen PEEP, and mechanical ventilation.

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In four postoperative cardiac patients during controlled ventilation, acute circulatory failure was associated with decreases in end-tidal CO2(Petco2) and cardiac index. Closed cardiac compression caused an increase in both Petco2and cardiac index, with complete restoration to baseline values after successful CPR. Our data indicate that Petco2measurements during controlled ventilation in acute circulatory failure patients may be used as an indirect noninvasive tool to monitor the patient's hemodynamic status during CPR.

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Two cystic fibrosis (CF) patients with severe pulmonary disease and malnutrition were followed during a course of long-term home total parenteral nutrition (TPN), which included iv fat emulsion. They gained 7 and 12 kg in body weight, respectively, and their ability to participate in daily activities increased. Progressive exercise testing before and during TPN showed a marked increase in maximal work load: 100% and 30%, respectively. At any given work load, oxygen uptake was increased while the respiratory quotient remained lower after the course of TPN. We believe that the lower respiratory quotient and greater oxygen consumption during exercise were due to a reduction in anaerobic metabolism after TPN.

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Pulmonary embolus as a cause of disseminated intravascular coagulation has only recently been recognized. The hemorrhagic disorder reported in the past was associated with little or no bleeding. We report a case of pulmonary embolus associated with life-threatening disseminated intravascular coagulation.

ISSN:0090-3493    

出版商:OVID    

年代:1987

数据来源: OVID