Abstract
Abstract Objective. To evaluate the effects of prone position on hepato-splanchnic hemodynamics, metabolism and gut mucosal energy balance. Design. Prospective clinical study. Setting. Medical intensive care unit in a university hospital. Patients. Eleven hemodynamically stable patients with acute lung injury (ALI) requiring mechanical ventilation. Intervention. Patients were studied in the supine position, after 90 min in the prone position and after 90 min of supine repositioning. Measurements and results. In addition to global hemodynamics we measured intra-abdominal pressure (IAP, bladder), hepato-splanchnic blood flow (HSBF, steady state indocyanine green technique using a hepatic vein catheter) and gastric mucosal-arterial PCO2 gap (PCO2 gap, automated air tonometry). Systemic hemodynamics did not change during the whole study. Prone positioning did not significantly affect IAP. HSBF as well as splanchnic oxygen consumption remained unaltered, too. Similarly, neither liver lactate uptake nor indocyanine green extraction were influenced by positional changes. Finally, stable regional hemodynamics were accompanied by an unchanged PCO2 gap. Conclusion. We conclude that if IAP and systemic hemodynamics remain unaffected, the prone position in ALI patients compromises neither hepato-splanchnic perfusion nor gastric mucosal energy balance.
Highlights
In our experience, very often, even with a nonrebreathing mask (NRM), high oxygen delivery to patient with the existent materials is insufficient
In patients with a relative drop in Pitot tube flowmeter (PT) of ten or more percent between day 1 and 3 mortality was significantly higher than in patients with a lower or no decrease irrespective of absolute PT values
P109 How we reduce allogenic blood transfusions in the patients undergoing surgery of ascending aorta D Radojevic, Z Jankovic, B Calija, M Jovic, B Djukanovic
Summary
Very often, even with a nonrebreathing mask (NRM), high oxygen delivery to patient with the existent materials is insufficient. There is evidence that increasing the dose of continuous renal replacement therapy (CRRT) is associated with improved survival in critically ill patients with acute renal failure (ARF) [1]. The aim of this study is to investigate if there is any difference in patients’ characteristics in ICU between COPD and nonCOPD diseases caused chronic respiratory failure and require mechanical ventilation during acute exacerbations. Noninvasive positive pressure ventilation (NPPV) has been reported to be beneficial in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD), and to facilitate weaning In this trial we assessed the possible benefit of early NPPV in patients with blunt chest trauma and acute respiratory failure. The aim of this study was to compare the pharmacokinetic and pharmacodynamic parameters and the clinical efficacy of a continuous infusion of cefepime versus an intermittent regimen in critically ill adults patients with gram negative bacilli infection. The purpose of the study is to identify the factors associated with DNR status in our institution
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