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  • 1
    Electronic Resource
    Electronic Resource
    Advantage of buffered solutions or automated capnometry in air-filled balloons for use in gastric tonometry (1997)
    Springer
    Intensive care medicine 23 (1997), S. 423-427 
    Details
    ISSN: 1432-1238
    Keywords: Key words Intramucosal pH ; Gastric tonometry ; Blood gas analyzer ; Automated capnometry ; Carbon dioxide ; Steady-state equilibration time
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To test accuracy, reproducibility and time constants of pCO2 measurement with the tonometric technique, using different media for filling the silastic balloon (saline, phosphate buffer, citrate buffer, air) and employing different analyzer devices (ABL3, ABL330, Nova Stat 5, automated capnometry). Design: Comparative laboratory study of different tonometric techniques, measuring test solutions with known pCO2 values due to pre-equilibration with three different pCO2 concentrations. Setting: Clinical laboratory of a university hospital intensive care unit. Measurements and results: The use of saline, as suggested for routine tonometry, led to negative bias values throughout, i. e. underestimation of pCO2 values, the extent of which depended on the blood gas analyzer device employed. Registration of the equilibration kinetics showed that full equilibration demanded 90 min regardless of the environmental pCO2 level. Replacing saline by buffered electrolyte solutions resulted in a significant improvement of bias, but did not change the kinetics of pCO2 equilibration. The employment of air-filled balloons, combined with automated capnometry, led to very low bias values, approaching zero, for all pCO2 levels, along with excellent precision. Time constants of equilibration were dramatically reduced, with full equilibration being achieved within 12.5 min. Conclusions: Buffered electrolyte solutions are preferable to saline for achieving reliable pCO2 measurements in gastric tonometry. Air-filled balloons, combined with automated capnometry, present excellent accuracy and reproducibility together with short equilibration times, thus offering “on-line” monitoring of even rapid changes in environmental pCO2.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050351
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  • 2
    Electronic Resource
    Electronic Resource
    Vasodilatative Prostanoide von der Infusion zum Aerosol: neue Perspektiven für das ARDS und die primäre pulmonale Hypertonie (1997)
    Springer
    Intensivmedizin und Notfallmedizin 34 (1997), S. 370-380 
    Details
    ISSN: 1435-1420
    Keywords: Key words Acute/adult respiratory distress syndrome ; prostacyclin ; primary pulmonary hypertension ; nitric oxide ; Schlüsselwörter Acute/adult respiratory distress syndrome ; Prostazyklin ; Primäre pulmonale Hypertonie ; Stickstoffmonoxid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Trotz ihrer ausgeprägten vasodilatativen Potenz in der pulmonalen Strombahn sind die Indikationen zur intravenösen Applikation der vasodilatativen Prostanoide PGE1 und PGI2 durch fehlende pulmonale und intrapulmonale Selektivität begrenzt. Ein therapeutischer Ansatz stellt die ambulante intravenöse Dauertherapie bei Patienten mit primärer pulmonaler Hypertonie (PPH) vor (Herz-)Lungentransplantation dar. Bei Patienten mit adult respiratory distress syndrome (ARDS) führen PGE1 und PGI2 zu einer Abnahme des gesamtperipheren Widerstandes (fehlende pulmonale Selektivität), und die generelle pulmonale Vasodilatation induziert oder verstärkt Ventilations-Perfusions-Verteilungsstörungen mit begleitender Verschlechterung des Gasaustausches (fehlende intrapulmonale Selektivität). Die transbronchiale PGI2-Applikation (Aerosol) dagegen erzielt eine pulmonale und intrapulmonale Selektivität, die ein fast identisches Wirkungsprofil erreicht, wie der selektive pulmonale Vasodilatator Stickstoffmonoxid (NO). Darüber hinaus liegen erste Langzeiterfahrungen mit der repetitiven Aerosol-Applikation des länger wirkenden Iloprost bei Patienten mit schwerster pulmonaler Hypertonie vor.
    Notes: Summary The vasodilatory prostanoids PGE1 and PGI2 possess strong vasodilatory potency in the pulmonary circulation. Their application is, however, limited by the lack of pulmonary and intrapulmonary selectivity. By use of chronic ambulatory PGI2-infusion, patients with primary pulmonary hypertension (PPH) may be bridged for (heart-) lung transplantation. In patients with adult respiratory distress syndrome (ARDS), PGE1 and PGI2 lower the pulmonary vascular resistance, but may also decrease the systemic pressure (limited pulmonary selectivity) and increase ventilation-perfusion-mismatch, accompanied by an impairment of gas exchange (limited intrapulmonary selectivity). Application of PGI2 via the transbronchial route (aerosol) may achieve pulmonary and intrapulmonary selectivity with an efficacy profile comparable to that of the selective pulmonary vasodilator nitric oxide (NO). Repetitive aerosol application of the stable PGI2 analogue iloprost is under consideration for long-term treatment of patients with severe pulmonary hypertension such as primary pulmonary hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900050063
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  • 3
    Electronic Resource
    Electronic Resource
    Therapie des ARDS (1999)
    Springer
    Intensivmedizin und Notfallmedizin 36 (1999), S. 104-125 
    Details
    ISSN: 1435-1420
    Keywords: Key words Acute/adult respiratory distress syndrome ; nitric oxide ; prostacyclin ; surfactant ; mechanical ventilation ; liquid ventilation ; membrane oxygenation? ; Schlüsselwörter Acute/adult respiratory distress syndrome ; Stickstoffmonoxid ; Prostazyklin ; Surfactant ; mechanische Beatmung ; Liquidventilation ; extrakorporale Membranoxygenierung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Diese Übersicht faßt die aktuell diskutierten Therapiestrategien beim ARDS vor dem Hintergrund ihrer klinischen Etablierbarkeit zusammen. Die vorgestellten Behandlungskonzepte reichen von antiinflammatorischen Therapieansätzen über Stickstoffmonoxid und Surfactant bis zu neuen Beatmungsstrategien.
    Notes: Summary This review summarizes actually discussed therapeutic strategies in ARDS and their possible role for clinical use. The presented therapeutic modalities include antiinflammatory treatment, nitric oxide and surfactant and new ventilation regimes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900050218
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    Paper (German National Licenses)
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