Abstract

Suctioning of artificial airways is a necessary procedure but is not without risk. Hypoxaemia is a recognised complication. Several small studies have suggested that closed suction catheters offer benefits over open suction because disconnection from the ventilator circuit is not required [1], thereby maintaining ventilation, FIO2 and PEEP. Other studies have sought to prove the maintenance of lung volume and cardiovascular stability with closed suction [2]. There is little evidence that closed suction systems offer clinical advantage over open suction in terms of arterial oxygenation. No published study had compared changes in PaO2/FIO2 post suction. We performed a study in critically ill adults to identify any differences in PaO2/FIO2 between closed and open suction for a given PEEP.

Highlights

  • Intra-abdominal pressure (IAP) is an important parameter and prognostic indicator of the patient’s underlying physiologic status [1]

  • Smaller aerosol particles resulted in greater drug delivery in vitro when using the modified Aeroneb Pro during controlled mechanical ventilation (CMV)

  • We retrospectively reviewed 107 procedures performed on 48 patients in the period between March 2000 and November 2001

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Summary

Introduction

Intra-abdominal pressure (IAP) is an important parameter and prognostic indicator of the patient’s underlying physiologic status [1]. The aim of this study was to assess the respiratory effects of sufentanil and remifentanil in postsurgical critically ill patients during spontaneous ventilation since the drugs show pharmacokinetic and pharmacodynamic properties which make them attractive for intensive care use. Preliminary evidence suggests that hU-II levels during cardiac surgery are increased in patients with myocardial dysfunction [2] It is not known, if hU-II plasma concentrations are related to pulmonary capillary wedge pressure (PCWP) as an estimate of left ventricular filling pressure. AAF in cardiac surgery postoperative period has been implicated as a complication that leads to longer ICU and hospital stay and to augmented costs It has not been associated with increased mortality rates. We aimed to investigate the effects of use of preoperative and early postoperative standard and immunonutrient products on immune system and acute inflammatory response in the patients undergoing gastrointestinal malignancy surgery.

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