Could hyperoxic ventilation impair oxygen delivery in septic patients?

Objective: In critically ill patients, a decrease in whole body oxygen consumption under hyperoxia has been reported and this could be related to hyperoxia-induced arterial changes. We investigated changes in brachial artery circulation and tone during short-term hyperoxic ventilation in septic patients.

Design And Setting: Prospective clinical study in the intensive care unit of a university hospital.

[Crohn disease and abdominal tuberculosis: complications related to a diagnostic error].

Introduction: We report the case of a patient with abdominal tuberculosis initially treated as Crohn disease.

Case: A 50-year-old man, diagnosed with Crohn disease, was admitted to the intensive care unit for acute respiratory failure. After a new diagnosis of pulmonary and ileocecal tuberculosis and appropriate treatment for it, he improved.

Comparison of prone positioning and high-frequency oscillatory ventilation in patients with acute respiratory distress syndrome.

Objective: Both prone position and high-frequency oscillatory ventilation (HFOV) have the potential to facilitate lung recruitment, and their combined use could thus be synergetic on gas exchange. Keeping the lung open could also potentially be lung protective. The aim of this study was to compare physiologic and proinflammatory effects of HFOV, prone positioning, or their combination in severe acute respiratory distress syndrome (ARDS).

Aerobic exercise 2 hours before a dive to 30 msw decreases bubble formation after decompression.

Background: A single bout of aerobic exercise 24 h before a dive significantly reduces the formation of circulating venous gas emboli (VGE) on decompression. The purpose of this investigation was to determine the effect of aerobic exercise 2 h before a dive.

Methods: There were 16 trained military divers who were compressed to 30 msw (400 kPa) for 30 min breathing air in a dry hyperbaric chamber at rest, then decompressed at a rate of 10 m x min(-1) with a 9-min stop at 3 msw.

Influence of support on intra-abdominal pressure, hepatic kinetics of indocyanine green and extravascular lung water during prone positioning in patients with ARDS: a randomized crossover study.

Introduction: Prone positioning (PP) on an air-cushioned mattress is associated with a limited increase in intra-abdominal pressure (IAP) and an absence of organ dysfunction. The respective influence of posture by itself and the type of mattress on these limited modifications during the PP procedure remains unclear. The aim of this study was to evaluate whether the type of support modifies IAP, extravascular lung water (EVLW) and the plasma disappearance rate of indocyanine green (PDRICG) during PP.

Bubble incidence after staged decompression from 50 or 60 msw: effect of adding deep stops.

Objectives: The French Navy uses the Marine Nationale 90 (MN90) decompression tables for air dives as deep as 60 msw. The resulting incidence of decompression sickness (DCS) for deep dives (45-60 msw) is one case per 3000 dives.

Methods: Three protocols with experimental ascent profiles (EAPs) were tested in the wet compartment of a hyperbaric chamber.

Early antibiotic treatment for BAL-confirmed ventilator-associated pneumonia: a role for routine endotracheal aspirate cultures.

Study Objectives: To test whether routine quantitative cultures of endotracheal aspirates obtained before the onset of ventilator-associated pneumonia (VAP) could help to predict the causative microorganisms and to select early appropriate antimicrobial therapy before obtaining BAL culture results.

Design: Prospective observational study.

Setting: French medical ICU.

Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial.

Context: A recent trial showed that placing patients with acute lung injury in the prone position did not increase survival; however, whether those results hold true for patients with hypoxemic acute respiratory failure (ARF) is unclear.

Objective: To determine whether prone positioning improves mortality in ARF patients.

Design, Setting, And Patients: Prospective, unblinded, multicenter controlled trial of 791 ARF patients in 21 general intensive care units in France using concealed randomization conducted from December 14, 1998, through December 31, 2002.

Effects of helium-oxygen mixtures on endotracheal tubes: an in vitro study.

Question: To determine flow pattern and critical Reynolds numbers in endotracheal tubes submitted to different helium-oxygen mixtures under laboratory conditions.

Materials And Methods: Flow-pressure relationships were performed for seven endotracheal tubes (rectilinear position, entry length applied) with distal end open to atmosphere (predicted internal diameters: 6-9 mm). Nine helium-oxygen mixtures were tested, with FIHe varying from zero to 0.

Prone position and positive end-expiratory pressure in acute respiratory distress syndrome.

Objective: To determine whether positive end-expiratory pressure (PEEP) and prone position present a synergistic effect on oxygenation and if the effect of PEEP is related to computed tomography scan lung characteristic.

Design: Prospective randomized study.

Setting: French medical intensive care unit.

Haemodynamic effects of hyperbaric hyperoxia in healthy volunteers: an echocardiographic and Doppler study.

In the present study, we observed the haemodynamic changes, using echocardiography and Doppler, in ten healthy volunteers during 6 h of compression in a hyperbaric chamber with a protocol designed to reproduce the conditions as near as possible to a real dive. Ambient pressure varied from 1.6 to 3 atm (1 atm=101.

Helium-oxygen reduces work of breathing in mechanically ventilated patients with chronic obstructive pulmonary disease.

Objective: To evaluate whether helium-oxygen mixture reduces inspiratory work of breathing (WOB) in sedated, paralyzed, and mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).

Design And Setting: Open, prospective, randomized, crossover study in the medical intensive care unit in a university hospital.

Patients And Participants: 23 patients admitted for acute exacerbation of COPD and mechanically ventilated.

Evaluation of left ventricular filling pressure by transthoracic Doppler echocardiography in the intensive care unit.

Objective: To determine whether Doppler transmitral and pulmonary venous flow pattern is related to left ventricular filling pressures in critically ill patients.

Design: Prospective clinical investigation.

Setting: Medical intensive care unit of a university hospital.