Abstract
Superimposed high-frequency jet ventilation (SHFJV) is a special form of combined high-frequency jet ventilation described in other studies as an effective respiratory therapy of acute lung injury (ALI) patients. We compared this technique with conventional mechanical ventilation in oleic-acid-induced ALI piglets over a study period of 5 hours. After ALI induction, 18 pigs were randomly assigned to three groups. A SHFJV group with a high-frequency (500 bpm) and a low-frequency (15–20 bpm) jet stream and a PEEP of 10 cmH2O; a CPPV group (continuous positive pressure ventilation) presenting VT = 10 ml/kg, I:E = 1:1, PEEP = 10 cmH2O; and a IPPV group (control group; intermittent positive pressure ventilation) VT = 10 ml/kg, I:E = 1:1, zero PEEP. SHFJV animals showed an earlier and more efficient improvement in oxygenation compared with group B (90 vs 180 min; PaO2 70.5 ± 11.3 vs 41.2 ± 7.9 kPa) despite lower mean airway pressures applied (16 ± 1.4 vs 22 ± 1.8 mbar). CO2 elimination was also more effective (6.0 ± 1.4 vs 8.2 ± 1.6) although peak airway pressures were the lowest (30 ± 3.8 vs 45 ± 4.6 mmHg). SHFJV may therefore be useful in ALI management.
Highlights
Tight blood glucose (BG) control has been shown to videos of the alveolar dynamics
Computer-advised insulin infusion in postoperative cardiac surgery patients: a randomized prospective controlled multicenter trial quality the alveoli are observed at an open chest wall under a glass plate representing an artificial situation. To circumvent this restriction we developed a method of intravital endoscopy and tested it on an animal rat model
J Cordingley1, J Plank2, J Blaha3, M Wilinska4, L Chassin4, Methods In cooperation with Schoelly GmbH (Denzlingen, C Morgan1, S Squire1, M Haluzik3, J Kremen3, S Svacina3, Germany) we developed an endoscope with an outer tube diameter
Summary
Tight blood glucose (BG) control has been shown to videos of the alveolar dynamics. The thorax remains intact.decrease morbidity and mortality in critically ill patients [1] but is Results Figure 1 shows a tissue area after lavage of 0.8 mm difficult to achieve using standard insulin infusion protocols. Results Patient characteristics (mean ± SD): age 57.4 ± 15.4 years, 28 female, 52 male, APACHE II score 28.2 ± 6.6; number of organ failures 4.0 ± 1.12; preceding ICU period 8.5 ± 9.3 days; continuous sedation with midazolam 31.2 ± 34.2 mg/hour, fentanyl 0.12 ± 0.08 mg/hour, propofol 45.6 ± 105.2 mg/hour; sedation assessment according to RS 5.65 ± 0.63, CPS 5.15 ± 1.67, CKS 0.65 ± 0.69, CS 9.34 ± 2.13 und LSS 1.78 ± 1.69, RASS –4.50 ± 1.27, FiO2 0.52 ± 0.17, PEEP 8.2 ± 2.4 cmH2O, ventilatory frequency 20.5 ± 4.8/min, pressure control 16.8 ± 4.4 cmH2O, tidal volume 540 ± 115 ml, TVV 2525.6 ± 11,366 ml (minimum 1.52; maximum 91,586). We hypothesized that S100β levels correlate with this tumor’s preoperative characteristics and with perioperative neurological injury despite its supratentorial location and non-neural origin
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