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  • 1
    ISSN: 1432-1238
    Keywords: Monitoring ; Differential lung ventilation ; Compliance ; Airway resistance ; Pulmonary contusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fifteen polytrauma patients with asymmetric pulmonary contusion were treated with differential lung ventilation (DLV) for a mean of 106 hours (range 24–298, median 83). The differential time constant (Tc), compliance (Ct), inspiratory and expiratory airway resistance (Rawinsp, Rawexp) and peak-airway pressure (Pawpeak) were monitored to evaluate the function of each lung. Values measured after starting DLV were compared to those obtained prior to stopping DLV in order to analyse whether these parameters had returned to symmetrical values when recommencement of conventional mechanical ventilation was considered on clinical parameters and also whether these could be useful criteria for weaning from DLV. The significant difference in Tc of the contused lung compared to the contralateral lung after starting DLV is mainly determined by altered Ct resulting from contusion. During DLV improvement of Ct resulted in identical Tc of both lungs prior to stopping DLV. Changes in the Rawinsp contributed little to changes in Tc. Identical Tc prior to stopping DLV coincided with identical Pawpeak on symmetrical ventilator settings. These data suggest that when less advanced monitoring equipment is available, the differential Pawpeak might be used as a measure of differential lung mechanics in asymmetrical pulmonary contusion.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 17 (1991), S. 98-102 
    ISSN: 1432-1238
    Keywords: Pulmonary blood flow ; non-invasive ; Cardiac output ; non-invasive ; Fick formula ; CO2 elimination/end-tidal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two different methods of CO2-derived non-invasive assessment of the pulmonary blood flow were evaluated. The principle of the formula, as proposed by Gedeon et al., is based on a rapid change in arterial CO2 content and subsequent changes in endtidal PCO2 and CO2 elimination. Both methods were compared to thermodilution cardiac output in 44 postoperative patients after CABG. The first method consisted of a short period of hyperventilation followed by hypoventilation. Comparison with the thermodilution cardiac output showed a low correlation coefficient: using a measured arterial —end-tidal PCO2 difference (E)r=0.397 was found. Entering a fixed E of 0.53 kPa resulted inr=0.454. These disappointing figures may be explained by procedural mistakes. The second method, based on partial rebreathing by means of adding an additional dead space of 220 ml for 30–45 s, correlated very well with the thermodilution findings. Correlation coefficients ofr=0.925 (measured E) andr=0.925 (fixed E) were found. Considering the simplicity of the method, the additional dead space approach seems to be an easy and reliable way to determine pulmonary blood flow.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Airway resistance ; Respiratory therapy ; Bronchodilator agents ; Mucolytic agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nebulisation of a 10% solution of Mesna (Mistabron) in 10 postoperatively ventilated patients without preexisting pulmonary disease caused a significant increase in inspiratory resistance. This increase is effectively blocked by addition of a bronchodilator (i.e. Salbutamol) to the aerosol. No significant changes in airway resistance were observed in the 10 patients receiving salbutamol alone or isotonic saline. The expiratory resistance did not change suggesting that only the larger airways are involved in the constrictive effect of the drug. Although no patient showed clinical signs of bronchospasm, it is worth considering that even in patients without history of obstructive pulmonary disease nebulisation of Mesna should be performed in combination with a bronchodilator.
    Type of Medium: Electronic Resource
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