A recruitment breath manoeuvre directly after endotracheal suction improves lung function: an experimental study in pigs.

Background: Atelectasis occurs after a well performed endotracheal suction. Clinical studies have shown that recruitment manoeuvres added after endotracheal suction during mechanical ventilation restore lung function. Repetitive lung over-distension is, however, harmful for the lung, and the effects of adding a larger breath, recruitment breath, directly after repeated endotracheal suction were therefore investigated.

Elemental composition of airway surface liquid in the pig determined by x-ray microanalysis.

The ionic composition of the airway surface liquid (ASL) is of importance in cystic fibrosis and exercise-induced asthma. However, literature data on the composition of the ASL vary markedly. The aim of the study was to determine the composition of the ASL, using two different methods involving minimal manipulation.

Post-suction recruitment manoeuvre restores lung function in healthy, anaesthetized pigs.

Endotracheal suction can cause partial lung collapse and hypoxia and alter lung mechanics. We investigated the effects of adding a recruitment manoeuvre directly after endotracheal suction to restore lung volume in volume-controlled ventilation and pressure-controlled ventilation modes. Five anaesthetized pigs were investigated.

Side effects of endotracheal suction in pressure- and volume-controlled ventilation.

Study Objectives: To investigate the effects of endotracheal suction in volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) with an open suction system (OSS) or a closed suction system (CSS).

Design: Randomized comparison.

Setting: Animal research laboratory.

Effectiveness and side effects of closed and open suctioning: an experimental evaluation.

Objective: To compare the effectiveness of closed system suctioning (CSS) and open system suctioning (OSS) and the side effects on gas exchange and haemodynamics, during pressure-controlled ventilation (PCV) or continuous positive airway pressure (CPAP).

Design: Bench test and porcine lung injury model.

Participants: Twelve bronchoalveolar saline-lavaged pigs.

The influence of distal runoff on patency of infrainguinal vein bypass grafts.

This retrospective study was conducted to analyze a new concept of evaluation of the effect of distal runoff on patency in infrainguinal bypass surgery for arterial insufficiency. Distal runoff was evaluated on postreconstruction angiograms in 191 limbs undergoing femoropopliteal and femorodistal reconstruction. Runoff was characterized as good, fair, or poor.

A multivariate analysis of factors affecting patency of femoropopliteal and femorodistal bypass grafting.

Background: The most important factors that determine the outcome after femoropopliteal and femorodistal arterial reconstruction are still controversial. This report analysis the factors that determine the early and late patency of distal arterial reconstruction.

Patients And Methods: A retrospective analysis of patency after femorodistal arterial reconstruction with a new method for evaluation of angiographic runoff was performed for 336 arterial reconstructions.

Influence of twist on vein and PTFE graft hemodynamics: an ex vivo experimental study.

Objective: In an ex vivo infusion model, the effect of different factors affecting the critical level of twist in vein and PTFE grafts was analysed.

Setting: University Hospital, Department of Surgery.

Experimental Design: Saline perfusion of grafts with various diameter and length under constant high (90 ml/min) and low (50 ml/min) flow rates against various peripheral resistance was performed.

The use of below-knee percutaneous transluminal angioplasty in arterial occlusive disease causing chronic critical limb ischemia.

Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI).

Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n = 39) or in combination with PTA of the superficial and/or popliteal artery (n = 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI.

Patterns of atherosclerotic occlusive disease of lower leg and pedal arteries in hypertensive patients undergoing infrainguinal bypass procedures.

Objective: To analyse the atherosclerotic involvement of lower leg and foot arteries in patients undergoing infrainguinal bypass grafting.

Setting: Department of Surgery, University Hospital.

Patients: Among 282 limbs (267 patients), fifty limbs belonged to hypertensive nondiabetics (Group A), 39 to hypertensive diabetics (Group B), 129 to normotensive nondiabetics (Group C) and 64 to normotensive diabetics (Group D).

A modified technique of ultrasonic triplex scanning of the lower extremity arteries.

This study was undertaken to evaluate the utility of a modified technique of triplex scanning of the lower extremity arteries in 20 subjects without any clinical signs of arterial disease. The distal aorta and iliac arteries were examined with the subject in supine position and lying slightly on the opposite side. By moderate compression of the probe towards the psoas muscle and directing it over the iliac arteries with slight medial retraction of the abdomen, satisfactory visualization of the common and external arteries with 7.

Reduction of requirement for leg vascular surgery during long-term treatment of claudicant patients with ticlopidine: results from the Swedish Ticlopidine Multicentre Study (STIMS).

Objective: To study the effect of long-term treatment of the platelet inhibitor ticlopidine as secondary prevention against the need of vascular surgery in patients with intermittent claudication.

Design: The Swedish Ticlopidine Multicentre Study (STIMS), was conducted in six medical and surgical clinics of university hospitals in Sweden.

Methods: 687 claudicants were randomised to ticlopidine 250 mg bd or placebo and vascular surgery events were recorded prospectively over a 7-year period.

Comparative analysis of patency, limb salvage and survival in diabetic and non-diabetic patients undergoing infrainguinal bypass surgery.

In 92 diabetic and 175 non-diabetic patients undergoing 336 femoropopliteal or femorodistal bypass procedures, 1- and 3-year cumulative life-table patency, limb salvage, and survival rates were comparatively analysed. The peroperative mortality rate was significantly higher in diabetic patients (5% compared to 1.4%, p < 0.

Renal biopsy in children: indications, technique and efficacy in 119 consecutive cases.

Consecutive renal biopsies were performed on native kidneys in 109 children and adolescents, aged 0.1-19.8 (mean 9.

The effect of postocclusion reactive hyperaemia, papaverine and nifedipine on duplex derived haemodynamic parameters of infrainguinal bypass grafts.

Objectives: The aim of the present study was to analyse the effects of various vasodilating stimuli on postoperative infrainguinal graft haemodynamics.

Design: Duplex derived haemodynamic parameters of infrainguinal bypass grafts were measured at rest and after postocclusion reactive hyperaemia, intraarterial papaverine (40 mgm) injection and peroral nifedipine (10 mg) administration.

Setting: Department of Surgery, University Hospital.

Duplex ultrasound scanning for diagnosis of aortoiliac and femoropopliteal arterial disease.

Forty patients with symptomatic aortoiliac and/or femoropopliteal occlusive arterial disease subjected to angiography were studied with duplex ultrasonography. The duplex scanning of the aortic, iliac, femoral and popliteal segments had a sensitivity of 93% in detecting significant stenoses and a specificity of 91%. The positive and negative predictive values were 75% and 98%, respectively.

Bypass grafting to the popliteal artery in limbs with occluded crural arteries.

Intraoperative completion angiograms of 47 femoropopliteal bypasses in limbs with occluded crural arteries were reviewed to identify the angiographic determinants of early outcome. Of 28 limbs in which the foot vessels were available for analysis, only 2 (7%) had an intact pedal circulation, and 18 limbs demonstrated no crural arteries suitable for distal reconstruction. The overall cumulative patency rate was 51% with a 76% limb salvage rate at 12 months.

A simple infusion method for measurement of intraoperative peripheral vascular runoff resistance.

A simple infusion system to assess the status of distal runoff was investigated on both hindlimbs of five mongrel dogs. Infusion catheters were placed in the superficial femoral arteries and the origin of the lower leg arteries was exposed for anatomic manipulation of the distal runoff. Saline solution was infused through the superficial femoral arteries at 64, 129, and 193 cm levels to calculate volume flow and index of resistance to flow.

Natural history of patients with abdominal aortic aneurysm.

Factors determining the outcome for patients with abdominal aortic aneurysm (AAA) were analysed in a retrospective population-based study of 187 consecutively diagnosed AAAs at one hospital during a 9-year period. All aneurysms were diagnosed by ultrasound, and those cases that were not primarily operated upon, were followed by repeat ultrasound examinations. An expansion rate of more than 0.

Abdominal aortic aneurysm with perianeurysmal fibrosis: experience from 11 Swedish vascular centers.

Case records of 2026 patients operated on because of abdominal aortic aneurysms from 11 Swedish Vascular Centers were reviewed and revealed 98 cases (4.8%) of inflammatory abdominal aortic aneurysm. Also included in this case-control study was an analysis of a randomized group of 82 patients from the same centers who had noninflammatory abdominal aortic aneurysms.

Angiographic criteria for prediction of early graft failure of secondary infrainguinal bypass surgery.

Complete intraoperative postreconstruction angiograms were obtained during 93 reoperations after failed femoropopliteal and femorodistal bypass grafts to evaluate the predictive value of a new method of angiographic runoff assessment. Good runoff was defined as patency of two or three lower leg arteries to the foot, or one patent vessel continuous with an intact anterior or posterior foot arch in femoropopliteal and proximal femorodistal bypasses, and integrity of both arches in low femorodistal bypasses. All other outflow patterns were considered poor.

A new method of angiographic runoff evaluation in femorodistal reconstructions. Significant correlation with early graft patency.

In 62 patients undergoing femorodistal bypass surgery, the foot vessel runoff was analyzed with a new grading system based on intraoperative postreconstruction serial angiography. The patients were divided into two groups according to the level of the distal anastomosis (proximal or low). Good runoff was defined as integrity of the anterior and/or posterior foot arch in proximal femorodistal grafts and integrity of both arches in low bypasses.