摘要:

Patients admitted to the ICU have a higher risk of nosocomial infection than other hospitalized patients. Whereas general medical/surgical ward patients have a 6% overall risk of acquiring an infection during their hospital stay, critically ill patients in the ICU have an 18% risk (p< 0.001). During this 2-year study, 440 of 2441 patients admitted to an ICU developed nosocomial infections. Patients who had prolonged ICU stays and those on the obstetrics and gynecology, orthopedics, and general surgery services were more likely to become infected. The most common bloodstream pathogens wereStaphylococcus epidemidis, Staphylococcus aureus, andSerratiaandPseudomonasspecies.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The effect of PEEP on cardiac performance was evaluated in 21 patients with left ventricular (LV) dysfunction. Twenty-three data sets were divided into three groups according to pulmonary arterial wedge pressure (PAWP). In three of four group A data sets (PAWP = 12 mm Hg), cardiac output (CO) decreased when PEEP was added. In four of six group B data sets (PAWP = 14–18 mm Hg) and in 12 of 13 group C data sets (PAWP ≥ 19 mm Hg), CO increased with addition of PEEP. In group C, the mean increase in CO was 500 ml/min, and the mean level of best PEEP was 3.9 cm H2O. When PAWP exceeded 18 mm Hg, PEEP was safe and in many instances augmented CO.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Thoracic gas volume (TGV) and specific airway conductance (SGaw) were measured in 6 infants, 21–42 weeks of age, who had been mechanically ventilated during the neonatal period. SGaw was significantly decreased while TGV was normal. Administration of a nebulized β2-sympathomimetic stimulant did not improve lung function. It is concluded that inhalation of β2stimulant drugs is not effective in improving airway obstruction in infants with postventilation-elevated airway resistance and that this is likely to be of structural origin.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Impedance respiratory monitoring is the standard technique for detecting apnea in infants. A miniature microphone/amplifier system has been used to sense breath sounds over the trachea in order to detect both central and obstructive apnea episodes in infants and children. The tracheal microphone has several advantages over other devices that sense airflow (thermistors, CO2sampling catheters) because it is not easily dislodged during restless sleep. This simple device may be used in monitoring of neonates and infants; it may eventually replace Impedance monitoring.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The cardiovascular effects of dobutamine (7 μg/kg · min iv) and of additional N-allyl-clonidine (St 567, alinidine; 0.3 mg/kg iv), a compound which selectively inhibits the chronotropic effects of various stimulants, were studied in 9 patients scheduled for major abdominal surgery. Dobutamine increased cardiac index (CI), mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP), and heart rate, but failed to change the left ventricular stroke volume (LVSV) significantly. Alinidine decreased cardiac rate and increased LVSV index and left ventricular stroke work index (LVSWI), whereas CI, MAP, and MPAP remained virtually unaffected. Similar results were obtained when the combination of dobutamine and alinidine was given to 4 patients in neuroleptanesthesia. Thus, the decrease in preload which is associated with tachycardia seems to modify the increase in LVSV in response to inotropic stimulation with dobutamine.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The relative vasodilating properties of isoproterenol, dopamine, and dobutomine on hypoxic pulmonary vasoconstriction were examined in isolated pig lungs, ventilated and perfused in situ. The flow-resistant properties of the pulmonary circulation were assessed by measuring the relationship between pulmonary arterial pressure (PAP) and flow (Q). Hypoxia (a decrease in inspired O2tension from 200 torr to 50 torr) caused a rightward shift and decreased in the slope of this relationship. This increased PAP an average of 18.8 torr when measured at a blood flow of 1 L/min. Isoproterenol and dobutamine inhibited hypoxic pulmonary vasoconstriction, whereas dopamine had no effect. Because of its relative freedom from adverse side-effects in clinical trials, dobutamine should be considered in patients with hypoxic pulmonary vasoconstriction and right heart failure.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Experimental endotoxic shock in normocapnic dogs decreases cerebral blood flow (CBF) and increases cerebral metabolic rate of oxygen (CMRO2). In 6 animals, an iv injection of 1.0–1.5 mg/kg ofEscherichia coliendotoxin was followed by iv infusion of dopamine HC1 at a rate of 3–24 μg/kg · min. Doses of only 5 fig/kg · min maximally increased both CBF and CMRO2. There were no significant changes in cardiac output and whole body oxygen consumption. Mean aortic pressure and mean pulmonary artery pressure increased slightly after doses of 20 μg/kg · min. Results indicate that damage to the blood-brain barrier (BBB) after endotoxin administration allowed circulating monoamines to directly influence cerebral metabolism.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Several recent articles have suggested the use of mean airway pressure (Paw) as an index of the physiological effect of ventilating pressures. To facilitate the understanding of this parameter, operational formulas are derived by applying the explicit, mathematical definition of Paw to several clinically relevant pressure waveforms. These formulas are then generalized to apply to any wave shape. It is shown that any pressure waveform can be characterized by a waveform constant K, knowledge of which permits the estimation of Paw using information from either airway pressure recordings or the control settings and pressure gauges on conventional ventilators.

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1982

数据来源: OVID