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  • 1
    Electronic Resource
    Electronic Resource
    Spectroscopic studies of cyclometalated platinum(II) complexes: optical absorption and emission of single-crystal cis-bis(benzo[h]quinolinato)platinum(II) (1989)
    s.l. : American Chemical Society
    Inorganic chemistry 28 (1989), S. 1053-1059 
    Details
    ISSN: 1520-510X
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1021/ic00305a012
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  • 2
    Electronic Resource
    Electronic Resource
    Spectroscopic studies of cyclometalated palladium(II) complexes: optical absorption and emission of single-crystal cis-bis(benzo[h]quinolinato)palladium(II) (1989)
    s.l. : American Chemical Society
    Inorganic chemistry 28 (1989), S. 742-746 
    Details
    ISSN: 1520-510X
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1021/ic00303a026
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  • 3
    Electronic Resource
    Electronic Resource
    Pulmonary scintigraphy at the bedside in intensive care patients with suspected pulmonary embolism (1995)
    Springer
    Intensive care medicine 21 (1995), S. 723-728 
    Details
    ISSN: 1432-1238
    Keywords: Pulmonary embolism ; Pulmonary scintigraphy ; Intensive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Performance of pulmonary scintigraphy (PS) for suspected pulmonary embolism (PE) in ICU patients normally involves the added risk of transporting unstable patients to the nuclear medicine unit (NMU) and poses technical difficulties in ventilating intubated patients. This retrospective study addresses the feasibility of performing PS as the bedside. Material and methods During a 2-year period, all ICU patients with suspected PE underwent PS at the bedside, performed with a mobile gamma-camera.99mTc-labelled albumin macroaggregates were used for the perfusion studies. Gasified99mTc or81mKr gas was administered by an adapting technique in intubated patients. Results 45 patients were studied, 29 (64%) of whom were intubated and 21 (47%) of whom were in shock. PE was confirmed or excluded by PS in 49% of patients. Angiography was performed in 4 patients (8%). In the rest, a combination of low clinical and low or very low PS probabilities rendered PE highly unlikely. There was no evidence of PE in the subsequent follow-up. Conclusions In ICU patients with suspected PE, PS can be performed at the bedside with a mobile gamma-camera. The risk of transporting unstable patients can thus be avoided.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01704739
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  • 4
    Electronic Resource
    Electronic Resource
    Effects of rapid permissive hypercapnia on hemodynamics, gas exchange, and oxygen transport and consumption during mechanical ventilation for the acute respiratory distress syndrome (1996)
    Springer
    Intensive care medicine 22 (1996), S. 182-191 
    Details
    ISSN: 1432-1238
    Keywords: Permissive hypercapnia ; Mechanical ventilation ; Alveolar hypoventilation ; Oxygen transport ; Oxygen consumption ; DO2/VO2 relationship ; Hemoglobin dissociation curve ; ARDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To measure the effects of rapid permissive hypercapnia on hemodynamics and gas exchange in patients with acute respiratory distress syndrome (ARDS). Design Prospective study.Setting: 18-bed, medical intensive care unit, university hospital. Patients 11 mechanically ventilated ARDS patients. Intervention Patients were sedated and ventilated in the controlled mode. Hypercapnia was induced over a 30–60 min period by decreasing tidal volume until pH decreased to 7.2 and/or P50 increased by 7.5 mmHg. Settings were then maintained for 2 h. Results Minute ventilation was reduced from 13.5±6.1 to 8.2±4.1l/min (mean±SD), PaCO2 increased (40.3±6.6 to 59.3±7.2 mmHg), pH decreased (7.40±0.05 to 7.26±0.05), and P50 increased (26.3±2.02 to 31.1±2.2 mmHg) (p〈0.05). Systemic vascular resistance decreased (865±454 to 648±265 dyne·s·cm−5, and cardiac index (CI) increased (4±2.4 to 4.7±2.4 l/min/m2) (p〈0.05). Mean systemic arterial pressure was unchanged. Pulmonary vascular resistance was unmodified, and mean pulmonary artery pressure (MPAP) increased (29±5 to 32±6 mmHg,p〈0.05). PaO2 remained unchanged, while saturation decreased (93±3 to 90±3%,p〈0.05), requiring an increase in FIO2 from 0.56 to 0.64 in order to maintain an SaO2〉90%. PvO2 increased (36.5±5.7 to 43.2±6.1 mmHg,p〈0.05), while saturation was unmodified. The arteriovenous O2 content difference was unaltered. Oxygen transport (DO2) increased (545±240 to 621±274 ml/min/m2,p〈0.05), while the O2 consumption and extraction ratio did not change significantly. Venous admixture (Qva/Qt) increased (26.3±12.3 to 32.8±13.2,p〈0.05). Conclusions These data indicate that acute hypercapnia increases DO2 and O2 off-loading capacity in ARDS patients with normal plasma lactate, without increasing O2 extraction. Whether this would be beneficial in patients with elevated lactate levels, indicating tissue hypoxia, remains to be determined. Furthermore, even though hypercapnia was well tolerated, the increase in Qva/Qt, CI, and MPAP should prompt caution in patients with severe hypoxemia, as well as in those with depressed cardiac function and/or severe pulmonary hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712235
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  • 5
    Electronic Resource
    Electronic Resource
    The repeated measurement of vital capacity is a poor predictor of the need for mechanical ventilation in myasthenia gravis (1995)
    Springer
    Intensive care medicine 21 (1995), S. 663-668 
    Details
    ISSN: 1432-1238
    Keywords: Myasthenia gravis ; Vital capacity ; Mechanical ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Testing the hypothesis that, in myasthenia gravis (MG), repeated measurements of vital capacity (VC) and various parameters derived from this measurement [median or lowest value of measured VCs during hospitalization, VC values〈20ml/kg body weight (BW) or〈13ml/kg BW, or an index assessing the variability of VC values during the whole ICU stay] could predict the need for intubation and mechanical ventilation (MV), as has been shown in other neuromuscular diseases with respiratory failure.Design: Retrospective study with medical chart revision of all the patients with MG and respiratory failure admitted to our intensive care unit between 1985 and 1993.Setting: Medical intensive care unit (15 beds) of a nuniversity hospital.Patients and methods: Five patients suffering from ten episodes of acute respiratory failure due to their decompensated MG. Repeated measurements of arterial blood gases and VC by trained respiratory therapists, at least every 4h.Results: There was no difference in any of these parameters between patients eventually requiring MV (four episodes) and those in whom mechanical ventilation was not necessary (six episodes).Conclusions: VC repeated measurements is a poor predictor of the need for further MV in MG patients. This can probably be ascribed to the erratic nature of MG, a disease whose course is largely influenced by many parameters (infection, treatment modifications, initiation of corticosteroid therapy, stress, psychological factors, etc.). Early admissions to the ICU of MG patients with respiratory dysfunction is thus recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01711545
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  • 6
    Electronic Resource
    Electronic Resource
    Effects of rapid permissive hypercapnia on hemodynamics, gas exchange, and oxygen transport and consumption during mechanical ventilation for the acute respiratory distress syndrome (1996)
    Springer
    Intensive care medicine 22 (1996), S. 182-191 
    Details
    ISSN: 1432-1238
    Keywords: Key words Permissive hypercapnia ; Mechanical ventilation ; Alveolar hypoventilation ; Oxygen transport ; Oxygen consumption ; DO2/VO2 relationship ; Hemoglobin dissociation curve ; ARDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To measure the effects of rapid permissive hypercapnia on hemodynamics and gas exchange in patients with acute respiratory distress syndrome (ARDS). Design: Prospective study. Setting: 18-bed, medical intensive care unit, university hospital. Patients: 11 mechanically ventilated ARDS patients. Intervention: Patients were sedated and ventilated in the controlled mode. Hypercapnia was induced over a 30–60 min period by decreasing tidal volume until pH decreased to 7.2 and/or P50 increased by 7.5 mmHg. Settings were then maintained for 2 h. Results: Minute ventilation was reduced from 13.5±6.1 to 8.2±4.1 l/min (mean±SD), PaCO2 increased (40.3±6.6 to 59.3± 7.2 mmHg), pH decreased (7.40±0.05 to 7.26±0.05), and P50 increased (26.3±2.02 to 31.1± 2.2 mmHg) (p〈0.05). Systemic vascular resistance decreased (865±454 to 648±265 dyne·s·cm–5, and cardiac index (CI) increased (4±2.4 to 4.7±2.4 l/min/m2) (p〈0.05). Mean systemic arterial pressure was unchanged. Pulmonary vascular resistance was unmodified, and mean pulmonary artery pressure (MPAP) increased (29±5 to 32± 6 mmHg, p〈0.05). PaO2 remained unchanged, while saturation decreased (93±3 to 90±3%, p〈0.05), requiring an increase in FIO2 from 0.56 to 0.64 in order to maintain an SaO2〉90%. PvO2 increased (36.5±5.7 to 43.2± 6.1 mmHg, p〈0.05), while saturation was unmodified. The arteriovenous O2 content difference was unaltered. Oxygen transport (DO2) increased (545±240 to 621± 274 ml/min/m2, p〈0.05), while the O2 consumption and extraction ratio did not change significantly. Venous admixture (Qva/Qt) increased (26.3±12.3 to 32.8±13.2, p〈0.05). Conclusions: These data indicate that acute hypercapnia increases DO2 and O2 off-loading capacity in ARDS patients with normal plasma lactate, without increasing O2 extraction. Whether this would be beneficial in patients with elevated lactate levels, indicating tissue hypoxia, remains to be determined. Furthermore, even though hypercapnia was well tolerated, the increase in Qva/Qt, CI, and MPAP should prompt caution in patients with severe hypoxemia, as well as in those with depressed cardiac function and/or severe pulmonary hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712235
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  • 7
    Electronic Resource
    Electronic Resource
    Relationship between pulmonary oxygen consumption, lung inflammation, and calculated venous admixture in patients with acute lung injury (1996)
    Springer
    Intensive care medicine 22 (1996), S. 277-285 
    Details
    ISSN: 1432-1238
    Keywords: Acute lung injury ; Pulmonary oxygen consumption ; DO2/VO2 relationship ; Venous admixture ; IL-6 ; Elastase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To determine in patients with acute lung injury whether increased pulmonary oxygen consumption (VO2pulm), computed as the difference between oxygen consumption measured by indirect calorimetry (VO2meas) and calculated by the reverse Fick method (VO2Fick), would: (1) correlate with the degree of lung inflammation assessed by bronchoalveolar lavage (BAL); (2) lead to an overestimation of calculated venous admixture (Qva/Qt). Design Prospective study. Setting University hospital, medical intensive care unit. Intervention None. Measurements and results In nine mechanically ventilated patients with acute lung injury (Apache II 12±5, lung injury score 2±0.6, mean±SD), whole-body VO2 (VO2wb) was determined simultaneously by indirect calorimetry and the reverse Fick technique, after which BAL was immediately performed. VO2meas was significantly higher than VO2Fick (128±24 and 102±18 ml/min per m2, respectively,p〈0.001). Median VO2pulm was 25.3 ml/min per m2 (range 1.98–51.5), thus representing 19±11% of VO2wb. Total BAL cellularity was increased in all patients (median 47, range 24–200×104/ml), as was the total polymorphonuclear (PMN) count (median 78 range 5–93×104/ml). Macrophage counts were in the normal range. There were raised BAL levels of interleukin-6 (IL-6) (median 945, range 23–1800 ng/ml) and elastase (median 391, range 5–949 ng/ml). Median protein levels were 270 μg/ml (range 50–505). There was no correlation between VO2pulm and BAL cellularity, PMNs, elastase, IL-6, or protein. Qva/Qt was 31.7±8%. Qva/Qt, corrected for the presence of VO2pulm, (Qva/Qtcorr), was 30.3±8% (p〈0.01 vs Qva/Qt), a 4.2% overestimation due to VO2pulm. There was no correlation between Qva/Qt or Qva/Qtcorr and VO2pulm. Conclusions In mechanically ventilated patients with acute lung injury, VO2pulm was increased and led to a 19% underestimation of VO2wb determined by the reverse Fick method, as well as to a 4.2% overestimation of calculated Qva/Qt. Lung inflammatory activity was increased, as assessed by BAL cellularity, IL-6 and elastase levels. However, there was no correlation between VO2pulm and the intensity of pulmonary inflammation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700447
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  • 8
    Electronic Resource
    Electronic Resource
    Relationship between pulmonary oxygen consumption, lung inflammation, and calculated venous admixture in patients with acute lung injury (1996)
    Springer
    Intensive care medicine 22 (1996), S. 277-285 
    Details
    ISSN: 1432-1238
    Keywords: Key words Acute lung injury ; Pulmonary oxygen consumption ; DO2/VO2 relationship ; Venous admixture ; IL-6 ; Elastase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective: To determine in patients with acute lung injury whether increased pulmonary oxygen consumption (VO2pulm), computed as the difference between oxygen consumption measured by indirect calorimetry (VO2meas) and calculated by the reverse Fick method (VO2Fick), would: (1) correlate with the degree of lung inflammation assessed by bronchoalveolar lavage (BAL); (2) lead to an overestimation of calculated venous admixture (Qva/Qt). Design: Prospective study. Setting: University hospital, medical intensive care unit. Intervention: None. Measurements and results: In nine mechanically ventilated patients with acute lung injury (Apache II 12±5, lung injury score 2±0.6, mean±SD), whole-body VO2 (VO2wb) was determined simultaneously by indirect calorimetry and the reverse Fick technique, after which BAL was immediately performed. VO2meas was significantly higher than VO2Fick (128±24 and 102±18 ml/min per m2, respectively, p〈0.001). Median VO2pulm was 25.3 ml/min per m2 (range 1.98–51.5), thus representing 19±11% of VO2wb. Total BAL cellularity was increased in all patients (median 47, range 24–200 ×104/ml), as was the total polymorphonuclear (PMN) count (median 78 range 5–93×104/ml). Macrophage counts were in the normal range. There were raised BAL levels of interleukin-6 (IL-6) (median 945, range 23–1800 ng/ml) and elastase (median 391, range 5–949 ng/ml). Median protein levels were 270 μg/ml (range 50–505). There was no correlation between VO2pulm and BAL cellularity, PMNs, elastase, IL-6, or protein. Qva/Qt was 31.7±8%. Qva/Qt, corrected for the presence of VO2pulm, (Qva/Qtcorr), was 30.3±8% (p〈0.01 vs Qva/Qt), a 4.2% overestimation due to VO2pulm. There was no correlation between Qva/Qt or Qva/Qtcorr and VO2pulm. Conclusions: In mechanically ventilated patients with acute lung injury, VO2pulm was increased and led to a 19% underestimation of VO2wb determined by the reverse Fick method, as well as to a 4.2% overestimation of calculated Qva/Qt. Lung inflammatory activity was increased, as assessed by BAL cellularity, IL-6 and elastase levels. However, there was no correlation between VO2pulm and the intensity of pulmonary inflammation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700447
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  • 9
    Electronic Resource
    Electronic Resource
    Quadriparesia following permissive hypercapnia and inhalational anesthesia in a patient with severe status asthmaticus (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1001-1001 
    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/BF02044136
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  • 10
    Electronic Resource
    Electronic Resource
    Immunonutrition in the critically ill (1999)
    Springer
    Intensive care medicine 25 (1999), S. 631-633 
    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/s001340050916
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