We wished to measure changes in lung volume (Δ LV), airway pressures, and oxygenation during tracheal suctioning performed with a CSS and with an open suction system (OSS). We enrolled 7 adult patients, sedated and paralyzed, VCV ventilated by a SERVO 900C ventilator (Siemens, Sweden) with PEEP ≥ 5 cmH2O and FiO2 ≥ 0.4. Keeping all remaining ventilarory settings unchanged, we set trigger sensitivity at -2 cmH2O, inspiratory time at 25%, inspiratory pause at 10%. We performed four suctioning manouvers at 20 min intervals using alternatively a CSS and an OSS. With both systems, we used 12 F size catheters. We performed no pre-oxygenation manouvers. Suction was applied for 20 s at a pressure of 100 cmH2O. We continuously recorded signals of respiratory inductance pletismography (RIP. Respitrace Plus. NIMS, FL), arterial oxygen saturation (O2Sat) by pulse oxymetry, and airway pressures. We obtained Δ LV as the change in the RIP signal measured during VCV and during suction. We measured Respiratory Rate (RR), peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), and mean airway pressure(MAP) during VCV and during suction with the CSS.


  • Ill patients requiring intensive care are at risk of iatrogenic ocular damage

  • Intensive Care Unit (ICU) management of critically ill patients often includes the requirement for tracheostomy and feeding access, most often a pecutaneous endoscopic gastrostomy (PEG)

  • Percutaneous tracheostomy is performed routinely in many medical intensive care unit (ICU) settings, in high risk surgical and trauma patients who often have unstable cervical spine injury and tissue edema, direct visualization of the cervical structures and trachea is imperative during tracheostomy

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Ill patients requiring intensive care are at risk of iatrogenic ocular damage. We designed an experimental situation where external cardiac pressure conditions were controlled and adjusted to physiological extremes to mimic clinically relevant situations, while cardiac performance was assessed using left ventricular pressure–volume relationships (LVPVR) which are relatively preload and afterload independent This prospective, controlled study was undertaken to evaluate the response to therapy aimed at achieving supranormal cardiac and oxygen transport values (cardiac index >4.5 l/min/m2, oxygen delivery >600 l/min/m2, and oxygen consumption >170 l/min/m2) in patients older than 60 or with previous severe cardiorespiratory illnesses, who have undergone elective extensive ablative surgery planned for carcinoma or abdominal aortic aneurism. Whilst some human studies conducted in the critically ill and in high risk surgical patients have suggested that dopexamine may cause an increase in tonometrically measured gastric intra-mucosal pH (pHi) and an improvement in clinical outcome, this has not been confirmed in other randomised trials. In the present study the association of platelet function to inflammatory markers indicating disease severity was investigated


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