Influence of positive end-expiratory pressure on cyclic recruitment and derecruitment during one breathing cycle in porcine acute lung injury

Is Sulyok,R Ullrich,Ku Klein,S Bohme,J Baumgardner,K Markstaller,O Kimberger,A Johannes

doi:10.1186/cc13470

Abstract

Cyclic recruitment and derecruitment (R/D) of lung parenchyma during mechanical ventilation are responsible for atelectrauma. Theoretically, cyclic R/D can lead to varying degrees of pulmonary shunt fraction throughout the respiratory cycle. Measurements of dynamic pulmonary shunt fraction could help in assessing the degree of cylic R/D. However, common methods of measuring pulmonary shunt do not allow for dynamic serial measurements during one respiratory cycle. In this study, we measured serial dynamic pulmonary shunt fractions during one breathing cycle and investigated the effect of positive end-expiratory pressure (PEEP) on cyclic R/D in artificially ventilated pigs before and after saline washout induced acute lung injury.

Highlights

We aimed to audit the prescribing practice on a busy 14-bedd general ICU, and develop standardised practices and tools to improve safety
Pediatric pharmacists have been an integral part of the PICU rounds since 2002, their role has evolved over the course of years
From 1 January 2003 through 31 December 2012 pharmacists made 24,207 clinical interventions in the PICU and 19,252 of those interventions resulted in changes in medication therapy or therapy monitoring

Summary

Introduction

We aimed to audit the prescribing practice on a busy 14-bedd general ICU, and develop standardised practices and tools to improve safety. The objective of our study was to implement a Post Arrest Consult Team (PACT) and improve the quality of care for admitted OHCA patients This retrospective audit evaluated adult patients who suffered in-hospital cardiac arrest (IHCA) against the recent National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report [1]. It looked at the recognition of the acutely unwell, the interventions made, the decisions taken from admission through to the post-arrest period and the outcomes following cardiopulmonary resuscitation (CPR). Methods We conducted a chart review of all patients admitted to the Department of Critical Care (DCC) at our hospital following cardiac arrest over 2 years in 2010 to 2012 (Group 1). Methods A retrospective review was conducted looking at SICU patients managed with a normothermia protocol, with particular

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