The effects of airway pressure and inspiratory time on bacterial translocation.

Background: Mechanical ventilation with high peak inspiratory pressure (PIP) induces lung injury and bacterial translocation from the lung into the systemic circulation. We investigated the effects of increased inspiratory time on translocation of intratracheally inoculated bacteria during mechanical ventilation with and without extrinsic positive end-expiratory pressure (PEEP).

Methods: Rats were ventilated in pressure-controlled mode with 14 cm H2O PIP, 0 cm H2O PEEP, I:E ratio 1/2, and Fio2 1.

BIS guided sedation with propofol during spinal anaesthesia: influence of anaesthetic level on sedation requirement.

Background: In this prospective, clinical study we tested the hypothesis whether two different doses of spinal administered bupivacaine and accordingly, two different levels of spinal anaesthesia can affect the dose requirement of propofol during BIS guided sedation.

Methods: Fifty women undergoing vaginal hysterectomy (high spinal group, HS) or transvaginal tape (TVT) procedure for urinary incontinence (low spinal group, LS) under spinal anaesthesia were enrolled to the study. In group HS, 17.

Assessment of the success of cardiopulmonary resuscitation attempts performed in a Turkish university hospital.

The success rate of cardiopulmonary resuscitation (CPR) may differ from institution to institution, even within different sites in the same institution. A variety of factors may influence the outcome. In this study, we assessed the adequacy of CPR attempts guided by the current standards and aimed to define the factors influencing the outcome following in-hospital cardiac arrest.

Time required for equilibration of arterial oxygen pressure after setting optimal positive end-expiratory pressure in acute respiratory distress syndrome.

Objective: To evaluate the time course of Pao2 change following the setting of optimal positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome (ARDS).

Design: Prospective clinical study.

Setting: Multidisciplinary intensive care unit of a university hospital.

[A comparison of the effects of 50 % oxygen combined with CPAP to the non-ventilated lung vs. 100 % oxygen on oxygenation during one-lung ventilation].

Objective: In a prospective, randomised, double-blind study the effects of FiO (2) of 0,5 with CPAP and a FiO (2) of 1.0 without CPAP on oxygenation and pulmonary shunt during one-lung ventilation (OLV) were examined.

Methods: In 20 patients undergoing thoracotomy (ASA II/III) two sequential ventilation methods were used during OLV: a) FiO (2) of 1.

Effects of sustained inflation and postinflation positive end-expiratory pressure in acute respiratory distress syndrome: focusing on pulmonary and extrapulmonary forms.

Objective: To investigate whether the response to sustained inflation and postinflation positive end-expiratory pressure varies between acute respiratory distress syndrome with pulmonary (ARDS(exp)) and extrapulmonary origin (ARDS(exp)).

Design: Prospective clinical study.

Setting: Multidisciplinary intensive care unit in a university hospital.

Effects of intramuscular administration of lidocaine or bupivacaine on induction and maintenance doses of propofol evaluated by bispectral index.

Background: Interest in combining local and general anaesthesia has lead to studies investigating possible interactions. In a prospective, randomized, double-blind study, we tested whether local anaesthetics administered i.m.

Evaluation of effects of magnesium sulphate in reducing intraoperative anaesthetic requirements.

Background: The present randomized, placebo-controlled, double-blind study was designed to assess the effect of peroperatively administered i.v. magnesium sulphate on anaesthetic and analgesic requirements during total i.

[Is jejunal feeding efficient in critically ill patients?].

Background: The aim of this study is to compare the results of jejunal and gastric nutrition in the ICU.

Methods: Caloric intake and nutritional complications were recorded for ten days period in patients receiving gastric (n = 21) and jejunal (n = 22) feeding.

Results: Caloric requirements were reached on the 3rd day of nutrition in 86% of jejunal and 28% of gastric feeding patients (p 0.

[Percutaneous endoscopic gastrostomy in the ICU].

Aspiration pneumonia due to gastroesophageal reflux is a frequent complication in ICU. The most commonly chosen method for long-term enteral access is gastrostomy and this method also reduces the risk of aspiration and shortens the hospital stay. We evaluated 31 patients in whom PEG was performed between 1997-98 in our unit.

Techniques and complications of one-lung ventilation in children with suppurative lung disease: experience in 15 cases.

Objective: To evaluate lung isolation with Fogarty catheters and to analyze respiratory consequences of one-lung ventilation (OLV) in children with suppurative lung disease.

Design: Prospective.

Setting: University hospital.

Ketamine infusion versus isoflurane for the maintenance of anesthesia in the prebypass period in children with tetralogy of Fallot.

Objective: To evaluate the use of ketamine in comparison with isoflurane in the maintenance of anesthesia in children with tetralogy of Fallot.

Design: Prospective, randomized study.

Setting: University hospital.

Risk factors for early-onset, ventilator-associated pneumonia in critical care patients: selected multiresistant versus nonresistant bacteria.

Background: Ventilator-associated pneumonia is the leading nosocomial infection in critically ill patients. The frequency of ventilator-associated pneumonia caused by multidrug-resistant bacteria has increased in recent years, and these pathogens cause most of the deaths attributable to pneumonia. The authors, therefore, evaluated factors associated with selected multidrug-resistant ventilator-associated pneumonia in critical care patients.

Comparison of volume controlled with pressure controlled ventilation during one-lung anaesthesia.

Pressure controlled ventilation (PCV) is an alternative mode of ventilation which is used widely in severe respiratory failure. In this study, PCV was used for one-lung anaesthesia and its effects on airway pressures, arterial oxygenation and haemodynamic state were compared with volume controlled ventilation (VCV). We studied 48 patients undergoing thoracotomy.

Comparison of pressure- and flow-triggered pressure-support ventilation on weaning parameters in patients recovering from acute respiratory failure.

Objective: To compare the effects of pressure- and flow-triggered pressure-support ventilation on weaning parameters during recovery from acute respiratory failure.

Design: Prospective, randomized, clinical trial.

Setting: Intensive care unit in a university hospital.

Respiratory and haemodynamic effects of conventional volume controlled PEEP ventilation, pressure regulated volume controlled ventilation and low frequency positive pressure ventilation with extracorporeal carbon dioxide removal in pigs with acute ARDS.

The purpose of this study was to evaluate whether any benefit of low frequency positive pressure ventilation with extracorporeal carbon dioxide removal (LFPPV-ECCO2R) existed over either volume controlled ventilation (VCV) with measured best-PEEP or pressure regulated volume controlled ventilation (PRVCV) with an inspiration/expiration (I/E) ratio of 4:1, with respect to arterial oxygenation, lung mechanics and haemodynamics, in acute respiratory failure. Fifteen adult pigs were used for the study. Respiratory failure was induced by surfactant depletion by repeated lung lavage.

Intratracheal perfluorocarbon administration as an aid in the ventilatory management of respiratory distress syndrome.

Background: Respiratory distress syndrome carries a high morbidity and mortality when treated with mechanical ventilation with positive end-expiratory pressure. Perfluorocarbon liquids are employed in liquid ventilation due to low surface tension and high gas solubility. To assess whether intratracheal administration of the perfluorocarbon, perflubron, in combination with conventional mechanical ventilation could be of therapeutic benefit in respiratory distress syndrome, the authors tested the effects of different doses of intratracheal perflubron administration on gas exchange and lung mechanics in adult animals with respiratory failure during a 6-h observation period.