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  • 1
    Electronic Resource
    Electronic Resource
    Radiolabeling of the hydrophobic components of lung surfactant with 3-(trifluoromethyl)-3-(m-[^1^2^5I]iodophenyl)diazirine
    Amsterdam : Elsevier
    Analytical Biochemistry 193 (1991), S. 310-315 
    Details
    ISSN: 0003-2697
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1016/0003-2697(91)90027-Q
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  • 2
    Electronic Resource
    Electronic Resource
    Die Therapie des ARDS (1994)
    Springer
    Der Anaesthesist 43 (1994), S. 364-375 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter: ARDS – Inhalation von Stickstoffmonoxid – Intravenöser Membranoxygenator (IVOX) – Surfactantersatztherapie ; Key words: ARDS – Nitric oxide inhalation – Intravenous membrane oxygenator (IVOX) – Surfactant replacement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Conventional treatment of the adult respiratory distress syndrome (ARDS) includes pressure-limited ventilation, permissive hypercapnia, posture changes, aggressive dehydration, selective lung ventilation, and extracorporeal gas exchange. New strategies such as nitric oxide inhalation, the implantation of an intravenous membrane oxygenator (IVOX), and surfactant replacement are currently under evaluation. Nitric oxide (NO) is an important endothelium-derived relaxing factor that is rapidly inactivated by binding to haemoglobin. Inhaling this substance has been shown to induce selective vasodilatation of ventilated lung regions. Thus, inhaled NO reduces pulmonary hypertension, increases right heart ejection fraction, and improves arterial oxygenation by redistributing blood flow away from areas with intrapulmonary shunts to areas with a normal ventilation/perfusion ratio. Dose-response analysis has revealed that effective doses for improvement of oxygenation are lower than for reduction of mean pulmonary artery pressure. The use of a miniaturised membrane lung, IVOX, for intracaval oxygen and carbon dioxide exchange is a new approach to augment gas exchange. The IVOX is inserted via an introducer into the femoral vein and is designed for placement in the full length of the vena cava. Initial experiences with this device show that the currently used prototype provides a maximum of one-third of basal gas exchange. Therefore, a more efficient device will be needed to significantly reduce high inspired oxygen concentrations and airway pressures. Moreover, there exists evidence that IVOX causes caval obstruction. Lung surfactant recovered in BAL from patients with ARDS demonstrates that fractional contents of phosphatidylcholine and phosphatidylglycerol are reduced, and that the total concentration of apoproteins is decreased. Furthermore, the surfactant surface tension-lowering activity is abnormal. Thus, administration of exogenous surfactant may have therapeutic benefits. However, the optimal surfactant preparation, the optimal amount required to restore lung surfactant activity, and the optimal method to deliver it to patients with ARDS are unknown and currently under evaluation.
    Notes: Zusammenfassung. Ergänzend zu etablierten Therapiemaßnahmen werden bei der Behandlung des schweren akuten Lungenversagens des Erwachsenen neue Methoden wie die Inhalation von Stickstoffmonoxid (NO), die passagere Implantation eines intravenösen Membranoxygenators sowie die Gabe von Surfactant erprobt. Im Gegensatz zu intravenös infundierten Vasodilatatoren führt die Inhalation von niedrig konzentriertem NO zu einer selektiven Vasodilatation ventilierter Lungengebiete. Der pulmonalarterielle Druck sinkt, und der PaO2 steigt aufgrund einer Optimierung der Ventilations-Perfusionsverhältnisse. Alternativ zur extrakorporalen CO2-Elimination ermöglicht ein passager in die Vena cava implantierbarer Membranoxygenator eine Unterstützung des Gasaustauschs. Die begrenzten CO2- wie auch O2-Transferraten des zur Zeit erprobten Prototypen erlauben jedoch keine wesentliche Reduktion der zur ausreichenden Oxygenierung und CO2-Elimination notwendigen hohen inspiratorischen Sauerstoffkonzentrationen und hohen Atemwegsdrücke. Veränderungen des Surfactantsystems mit einer Inaktivierung und Verlust von Surfactant läßt eine exogene Substitution therapeutisch sinnvoll erscheinen. Trotz eindeutiger Erfolge in der Neonatologie liegen über eine Surfactantersatztherapie im ARDS bis auf wenige Fallberichte kaum Daten vor. Fragen betreffend der optimalen Präparation, Dosis, Applikation und des richtigen Zeitpunkts der Anwendung sind Gegenstand der aktuellen Forschung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050069
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  • 3
    Electronic Resource
    Electronic Resource
    Postoperative Analgesie bei Kindern nach Hernioplastie Wundinstillation mit verschiedenen Konzentrationen von Bupivacain: eine Pilotstudie (1999)
    Springer
    Der Anaesthesist 48 (1999), S. 439-443 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Hernioplastie ; Wundinstillation ; Bupivacain ; Postoperative Schmerztherapie ; Kinderchirurgie ; Key words Hernioplasty ; Wound instillation ; Bupivacaine ; Postoperative pain therapy ; Pediatric surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Wound instillation seems to be an easy and preferable way to achieve postoperative analgesia in pediatric hernioplasty. This prospective, randomized and double-blinded pilot-study was initiated to gain preliminary information in order to define the appropriate concentration of local anaesthetic for efficient posthernioplastic analgesia. Method: 29 children aged 3.1 to 13.7 (5.25 (3.8–8.2) years were randomly assigned to receive either 0.2 ml/kg bupivacaine 0.125% (n = 10), bupivacaine 0.25% (n = 10) or bupivacaine 0.5% (n = 9). The local anesthetic (LA) was instillated intraoperatively before wound closure above the external oblique muscle and below Scarpa’s fascia. After entering the post-anesthetic care unit (PACU) pain was assessed by a trained nurse using the linear analogue pain scale (LAPS) in intervals of 15 min. Patients were observed in the PACU for 30–60 min. Pain was further evaluated for 5.5(3–6) h in the ward every hour. In day-only patients the parents were contacted 24 h postoperatively to obtain additional information. Results: From the beginning of the observation period the 0.5% group tended to have less pain than the others in the PACU. The 0.125% and 0.25% group required earlier supplementary analgetics. In addition, the 0.5% group needed once (1/9) supplementary analgesics, the 0.25% group five times (5/10) and the 0.125% group six times (6/10). None of these results is statistically significant, though they appear to be clinically relevant. Discussion: Wound instillation with 0.2 ml of bupivacaine 0.5% seems to be easy to perform, safe and efficient in controlling posthernioplastic pain. Because of the small numbers of patients included however, no statistically significant differences were observed between the groups. Neither in the LAPS on arrival and observation at the PACU nor in the need for supplementary analgesics. Despite lacking significance the clinical impression suggests a difference to be validated by larger studies. Our data implies that wound instillation with 0.2 ml/kg bupivacaine 0.5% should be regarded for routine usage.
    Notes: Zusammenfassung Zielsetzung: Nach Operation einer Hernia inguinalis mit oder ohne Hydrozele wurde eine Wundinstillation mit jeweils 0,2 mg/kg Bupivacain 0,125, 0,25 oder 0,5% durchgeführt, um die benötigte Konzentration an lokalem Betäubungsmittel für eine suffiziente postoperative Analgesie zu ermitteln. Methodik: 29 Kinder im Alter von 3–13 Jahren wurden in diese prospektive, randomisierte Doppelblindstudie aufgenommen. Ergebnisse: Nach Gabe von 0,5% Bupivacain zeigten die Patienten postoperativ zwar später und weniger Bedarf an zusätzlichem Schmerzmittel (Paracetamol supp.) als bei Verwendung von Bupivacain 0,125 oder 0,25% mit p = 0,71 wurde jedoch keine Signifikanz erreicht. Aufgrund einer effizienten Schmerztherapie mit peripheren Analgetika veränderten sich die mittels einer linearen analogen Schmerzskala (LAPS) beurteilten Schmerzwerte der Patienten im Verlauf zumeist gleichartig. Eine stärkere analgetische Potenz von Bupivacain 0,5% gegenüber den geringeren Konzentrationen deutet sich an, durch die geringen Fallzahlen (pro Gruppe 9–10 Patienten) ist sie nicht signifikant. Schlußfolgerung: Die Wundinstillation ist sicher, technisch einfach und effektiv. Nach Bestätigung im Rahmen von größeren Folgestudien sollte sie sich als Alternative zu invasiveren Verfahren in der postoperativen Schmerztherapie etablieren können.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050727
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  • 4
    Electronic Resource
    Electronic Resource
    Die Therapie des ARDS (1994)
    Springer
    Der Anaesthesist 43 (1994), S. 298-308 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter: ARDS – Drucklimitierte Beatmung – Bauchlage – Dehydratation – Extrakorporaler Gasaustausch ; Key words: ARDS – Pressure-limited ventilation – Prone position – Dehydration – Extracorporeal gas exchange
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Recent studies and reviews continue to report a high mortality associated with the acute respiratory distress syndrome (ARDS), which involves a severe inflammatory reaction within the whole lung that is frequently associated with multiple-organ failure. Important factors contributing to the poor results in severe ARDS are the aggressive procedures required to maintain sufficient arterial oxygenation, such as mechanical ventilation with high inspiratory pressures and high inspired oxygen concentrations (FiO2) which themselves contribute to the progression of the disease. As no specific therapy that reduces or prevents the general inflammatory reaction is known, current therapy is limited to procedures that minimize peak inspiratory pressures and FiO2. Therefore, pressure- and volume-limited ventilation modes with positive end-expiratory pressure, controlled hypercapnia, differential lung ventilation when appropriate, positioning (particularly prone), and aggressive dehydration are used. Should these procedures fail to improve arterial gas exchange, the patients may be additionally treated by veno-venous extracorporeal gas exchange. To reduce the risk of severe haemorrhagic complications due to high levels of systemic heparinization, systems internally coated with covalently bound heparin, which allow a lower level of systemic anticoagulation, should be used. From April 1989 to August 1993, 89 patients were transferred to our intensive care unit for treatment of severe ARDS; 52 were treated by combining the described conventional methods without artificial gas exchange (survival rate 88%) and 37 additionally underwent artificial gas exchange (survival rate 57%). The overall survival rate was 75%. On the basis of these experiences, we conclude that this step-by-step approach may improve survival in patients with severe ARDS.
    Notes: Zusammenfassung. Die Therapie des schweren akuten Lungenversagens des Erwachsenen (acute respiratory distress syndrome=ARDS) umfaßt bis heute vorwiegend unterstützende, auf eine Normalisierung des Gasaustauschs ausgerichtete Maßnahmen. Druckbegrenzte Beatmung mit positiv endexspiratorischem Druck in Verbindung mit permissiver Hyperkapnie, seitendifferenter Beatmung, Seiten- und Bauchlagerung und Dehydratation zielen auf eine Reduktion der zur Aufrechterhaltung annähernd normaler Blutgase notwendigen hohen Atemwegsspitzendrücke und inspiratorischen Sauerstoffkonzentrationen und somit auf eine Abschwächung iatrogener Faktoren, die wesentlich zur Progression der Lungenschädigung beitragen können. Extrakorporale Verfahren zur Unterstützung des Gasaustauschs sollten dann in Betracht gezogen werden, wenn mit diesen etablierten Behandlungsregimen keine Besserung des pulmonalen Gasaustauschs erzielt werden kann und wenn die Prognose der Grunderkrankung als günstig anzusehen ist. Mit diesem Therapiekonzept konnte im eigenen Patientengut eine Überlebensrate von 75% (67 von 89 Patienten) erreicht werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050061
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  • 5
    Electronic Resource
    Electronic Resource
    Klinische Aspekte des akuten Lungenversagens des Erwachsenen (ARDS) (1996)
    Springer
    Der Anaesthesist 45 (1996), S. 2-18 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Acute respiratory distress syndrome (ARDS) ; extrakorporale Membranoxygenierung (ECMO) ; Überlebensraten ; Beatmung ; PEEP ; permissive Hyperkapnie ; Stickstoffmonoxid (NO) ; Key words Acute respiratory distress syndrome ; Extracorporeal membrane oxygenation ; Survival rates ; Mechanical ventilation ; PEEP ; Permissive hypercapnia ; Nitric oxide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Acute respiratory distress syndrome (ARDS) is rare but beset with a high mortality rate. In recent years, however, a trend towards higher survival rates has been observed. High inspiratory oxygen concentrations, large tidal volumes, and high peak inspiratory airway pressures applied during mechanical ventilation have been identified as harmful to the lung and can contribute to the progression of ARDS. This had led to reconsideration of the sequelae of ventilatory therapy. Mechanical ventilation and other adjunctive strategies in ARDS have changed from the conventional approach aiming at normalisation of physiological ventilatory parameters to an elaborated approach that intends to protect the ventilated lung, prevent oxygen toxicity, recruit the infiltrated atelectatic and consolidated lung and reduce the anatomical and alveolar dead space. This new approach consists of various forms of pressure-controlled mechanical ventilation with PEEP and permissive hypercapnia, body position changes, and inhalation of nitric oxide. Should these procedures fail to improve impaired gas exchange, extracorporeal membrane oxygenation is an additional therapeutic option. None of these therapeutic procedures, however, has been tested against traditional standard treatment in a classical randomised controlled trial. The following review focuses on the latest insights into the pathophysiology, diagnosis, and treatment of ARDS.
    Notes: Zusammenfassung Das akute Lungenversagen des Erwachsenen ist selten, aber auch heute noch mit einer sehr hohen Letalität belastet, wenngleich sich in den letzten Jahren ein Trend zu verbesserten Überlebensraten abzuzeichnen beginnt. Neuere Studien haben gezeigt, daß die bis vor kurzem noch in der Behandlung des ARDS angewendete Beatmungstherapie mit großen Atemzugvolumina, hohen Beatmungsdrücken und hohen inspiratorischen Sauerstoffkonzentrationen die erkrankte Lunge weiter schädigen kann. Diese Erkenntnisse haben zu einem Umdenken in der Behandlung geführt. Vorrangiges Ziel ist heute nicht mehr, die Wiederherstellung und Aufrechterhaltung physiologischer Normwerte für Sauerstoff- und Kohlendioxidpartialdrücke sowie arteriellen pH zu erreichen, sondern die Lunge vor beatmungsinduzierten Schäden zu schützen. Hierzu hat sich ein erweitertes Behandlungskonzept, bestehend aus verschiedenen Formen der drucklimitierten Beatmung mit PEEP und permissiver Hyperkapnie, Lagerungsmaßnahmen, Inhalation von Stickstoffmonoxid und – zumindest in Europa – extrakorporaler Membranoxygenierung als erfolgreich erwiesen, ohne daß die Effizienz jeder einzelnen Methode in kontrollierten randomisierten Studien bewiesen worden wäre. In dem vorliegenden Übersichtsartikel werden die neuesten Entwicklungen aufgezeigt, diskutiert und im Hinblick auf ihre klinische Effizienz bewertet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050234
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  • 6
    Electronic Resource
    Electronic Resource
    Morphological changes in chest radiographs of patients with acute respiratory distress syndrome (ARDS) (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1152-1156 
    Details
    ISSN: 1432-1238
    Keywords: Key words Acute respiratory distress syndrome (ARDS) ; Chest radiography ; Extracorporeal membrane oxygenation ; Lung biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To determine whether the quality of infiltrations in chest radiographs can accurately predict the histological extent of fibrotic change in patients with acute respiratory distress syndrome (ARDS). Design: Retrospective clinical investigation. Setting: Intensive care unit (ICU) of a university teaching hospital. Patients and methods: Of 47 patients treated with extracorporeal membrane oxygenation (ECMO) for severe ARDS over a 5-year period, 23 patients underwent open lung biopsy at thoracotomy for treatment, mostly of pneumothorax. Chest films obtained by portable chest roentgenography preceding the operation were reviewed retrospectively and compared to the histomorphological results of the lung specimen. Results: Chest radiographs displayed mixed alveolar-reticular opacification in 60.2 %, alveolar patterns in 22.9 % and reticular opacities in 10.5 %. In 0.4 % there were no infiltrates, 6 % could not be evaluated because of insufficient quality. There was no relevant difference between the right and left lungs. Subdividing patients into two groups according to the histological results of either absent or mild (1) or severe (2) lung fibrosis, we found an alveolar haziness in 12.3 % in group 1 compared with 28.2 % in group 2, while reticular characteristics were identified in 13 % and 11 %, respectively. Conclusions: The most common opacity in chest radiographs of patients with severe ARDS treated with ECMO is mixed alveolar-reticular opacification. Severe lung fibrosis is not positively correlated with a reticular radiographic pattern. ECMO does not lead to specific radiological changes in conventional radiograms, contrary to clinical findings that treatment with ECMO might induce pleural or pulmonic haemorrhage, especially in the earlier days when systemic heparinization had to be used instead of the heparin-coated tube-surfacing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050738
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  • 7
    Electronic Resource
    Electronic Resource
    Value of abdominal computed tomography (CT) concerning the prognosis in patients with acute respiratory distress syndrome (ARDS) (1999)
    Springer
    Intensive care medicine 25 (1999), S. A330 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00003770
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  • 8
    Electronic Resource
    Electronic Resource
    Long-term inhalation with evaluated low doses of nitric oxide for selective improvement of oxygenation in patients with adult respiratory distress syndrome (1993)
    Springer
    Intensive care medicine 19 (1993), S. 443-449 
    Details
    ISSN: 1432-1238
    Keywords: Adult respiratory distress syndrome ; ARDS ; Nitric oxide ; Endothelium-derived relaxing factor ; EDRF ; Inhalation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate the lowest dose of inhaled nitric oxide (NO) in patients with adult respiratory distress syndrome (ARDS), which is able to improve arterial oxygenation more than 30% compared to baseline data. Design Prospective, clinical study. Setting Anesthesiological ICU in a university hospital. Patients 3 consecutive patients with severe ARDS according to clinical and radiological signs. Interventions Pressure-controlled ventilation with positive endexpiratory pressure of 8–12 cm H2O. Inhalation of NO was performed with a blender system and a Servo 300 ventilator. The lowest effective NO dose was defined by titrating the inspiratory NO dose until reaching a 30% improvement of PaO2/FiO2. This dose was used for the following continuous long-term NO inhalation; controls of efficacy by investigation of hemodynamics and blood gas exchange were performed initially and 2 times per patient after intervals of 3–5 days. Measurements and results Initial NO concentrations were found to be effective at 60, 100, and 230 parts per billion (ppb). In all measurements, arterial oxygenation was found to be elevated by NO inhalation with the initially evaluated dose compared to baseline data; in parallel, the venous admixture $$\left( {{{\dot Q_{va} } \mathord{\left/ {\vphantom {{\dot Q_{va} } {\dot Q_t }}} \right. \kern-\nulldelimiterspace} {\dot Q_t }}} \right)$$ was reduced. The O2 delivery increased, although O2 consumption and hemodynamics did not change. In 1 patient, interruption of NO inhalation caused remarkable increase of pulmonary resistance. Conclusions The improvement of oxygenation by NO inhalation in ARDS does not require reduction of pulmonary resistance and can be performed using low doses in the ppb range, which has to be considered as probably non-toxic.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01711084
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  • 9
    Electronic Resource
    Electronic Resource
    A new method for PO.1 measurement using standard respiratory equipment (1995)
    Springer
    Intensive care medicine 21 (1995), S. 554-560 
    Details
    ISSN: 1432-1238
    Keywords: Airway occlusion pressure ; Mechanical ventilation ; Weaning ; Respirator technology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The airway occlusion pressure, P0.1, is an index for the neuro-muscular activation of the respiratory system. It has been shown to be a very useful indicator for the ability of patients receiving ventilatory support to be weaned from mechanical ventilation. Since the standard measurement technically complex, it is not widely available for clinical purposes. For that reason a P0.1 measurement technique was developed as an integrated function in a standard respirator (Evita, Dräger, Lübeck, Germany). This technique is easy to use and does not need any further equipment. We validated this new technique by comparing it to standard P0.1 measurements in a mechanical lung model as well as in ventilated patients. In the lung model we found a correlation between the Evita measurement and standard measurements ofr=0.99. In 6 ventilated patients the correlation wasr=0.78. Since the Evita P0.1 and the standard measurement had to be performed during two different breaths, this little poorer correlation in patients may be due to a significant breath-by-breath variability in P0.1. Comparing the Evita P0.1 and the standard measurement within one breath resulted in a clearly better correlation (r=0.89). We conclude that this new measurement technique provides and easy and accurate P0.1 measurement using standard respiratory equipment when tested in a lung model. In patient measurements the method is less precise, which is probably due to the variable waveforms of the inspiratory driving pressure seen in patients, for example when intrinsic PEEP is present. However, the new method makes the P0.1 measurement as a “bed-side” method clinically available, although the values should be interpreted cautiously.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700159
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  • 10
    Electronic Resource
    Electronic Resource
    Effect of N-nitroso-N-methylurethane on gas exchange, lung compliance, and surfactant function of rabbits (1996)
    Springer
    Intensive care medicine 22 (1996), S. 345-352 
    Details
    ISSN: 1432-1238
    Keywords: Key words Pulmonary surfactants ; Respiratory distress syndrome ; adult ; N-nitroso-N-methylurethane ; Pulmonary compliance ; Rabbit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To define the effect of N-nitroso-N-methylurethane (NNNMU) on pulmonary gas exchange, compliance and the biochemical and functional properties of the lung surfactant system. Design: Four days after inducing lung injury, gas exchange and pulmonary compliance were studied and a bronchoalveolar lavage was taken. Setting: Experimental laboratory of a university department of medicine, division of pulmonary and critical care medicine. Animals: Ten rabbits after they had received an injection of NNNMU and five control animals. Interventions: Controlled mechanical ventilation and bronchoalveolar lavage. Measurements and results: Measurements of gas exchange (using the multiple inert gas elimination technique), hemodynamics and pulmonary compliance were performed during ventilatory and hemodynamic steady state. A bronchoalveolar lavage (BAL) was taken after sacrificing the animal. BAL samples were processed for cell count and biochemical and functional surfactant analysis. Animals injected with NNNMU developed mild, but significant reduction in PaO2, while maintaining eucapnia during spontaneous air breathing. ˙V/˙Q distributions and arterial blood gases were similar in all animals when ventilated mechanically with a fixed tidal volume. Compliance of the lung and phospholipid levels in lavage of NNNMU animals was significantly lower than in control animals (CON). Function of surfactant recovered from animals receiving NNNMU was decreased significantly where compared to CON. Thus, NNNMU resulted in a lowered lavage surfactant phospholipid content, impaired surfactant function, decreased compliance and hypoxemia during spontaneous ventilation. However, gas exchange was similar to that of control animals during mechanical ventilation. Conclusion: We conclude that NNNMU-induced gas exchange abnormalities present after 4 days are mild and are reversed by fixed volume mechanical ventilation despite marked alteration in surfactant function and lung compliance. These observations further define properties of a lung injury model that is of value in the study of surfactant replacement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700457
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