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  • Articles: DFG German National Licenses  (2)
  • Key words Surfactant – ARDS  (1)
  • Rat  (1)
  • 1
    ISSN: 1432-1238
    Keywords: Key wordsK. pneumoniae ; Bacteremia ; Mechanical ventilation ; Blood gases ; Animal ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To determine the effect of peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP) on the development of bacteremia with Klebsiella pneumoniae after mechanical ventilation of intratracheally inoculated rats. Design: Prospective, randomized, animal study. Setting: Experimental intensive care unit of a University. Subjects: Eighty male Sprague Dawley rats. Interventions: Intratracheal inoculation with 100 μl of saline containing 3.5–5.0 × 105 colony forming units (CFUs) K. pneumoniae/ml. Pressure-controlled ventilation (frequency 30 bpm; I/E ratio = 1 : 2; FIO2 = 1.0) for 180 min at the following settings (PIP/PEEP in cmH2O): 13/3 (n = 16); 13/0 (n = 16); 30/10 (n = 16) and 30/0 (n = 16), starting 22 h after inoculation. Arterial blood samples were obtained and cultured before and 180 min after mechanical ventilation and immediately before sacrifice in two groups of non-ventilated control animals (n = 8 per group). After sacrifice, the lungs were homogenized to determine the number of CFUs K. pneumoniae. Measurements and results: The number of CFUs recovered from the lungs was comparable in all experimental groups. After 180 min, 11 animals had positive blood cultures for K. pneumoniae in group 30/0, whereas only 2, 0 and 2 animals were positive in 13/3, 13/0 and 30/10, respectively (p 〈 0.05 group 30/0 versus all other groups). Conclusions: These data show that 3 h of mechanical ventilation with a PIP of 30 cmH2O without PEEP in rats promotes bacteremia with K. pneumoniae. The use of 10 cmH2O PEEP at such PIP reduces ventilation-induced K. pneumoniae bacteremia.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensivmedizin und Notfallmedizin 36 (1999), S. S070 
    ISSN: 1435-1420
    Keywords: Schlüsselwörter Surfactant – respiratorische Insuffizienz ; Key words Surfactant – ARDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Independent of the cause, in ARDS there is a disturbed permeability of the alveolo-capillary membrane with influx of plasma proteins. These plasma proteins can inhibit the surfactant system, and therefore, in ARDS there is always a pathologically changed surface tension at the air-liquid interface because of the capillary leakage. This decreased surface tension is most easily normalized by application of exogenous surface active material. Numerous case reports but also the first clinical studies confirm this rational treatment concept.
    Notes: Zusammenfassung Unabhängig von der Ätiologie liegt beim ARDS immer eine Permeabilitätsstörung der alveolarkapillaren Membran mit Einstrom von Plasmaproteinen vor. Da diese Proteine jedoch zu einer funktionellen Hemmung des Surfactant-Systems führen, folgt daraus, daß bei jeder akuten respiratorischen Insuffizienz mit einem kapillären “leakage” auch immer pathologisch veränderte Oberflächenspannungen an der Grenzfläche Alveolarepithel-Luft vorliegen. Letztere lassen sich am einfachsten durch die exogene Zufuhr von oberflächenaktivem Material wieder normalisieren. Zahlreiche Fallbeispiele aber auch erste Studien bestätigen dieses rationale Therapiekonzept.
    Type of Medium: Electronic Resource
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