Performing Accurate Standard 12 Lead ECGs on patients with Burns to the Chest.

The use of the electrocardiogram (ECG) in critical care settings is a long-established cardiovascular monitoring tool. The effectiveness of the routine 12-lead ECG relies on accurate lead placement that is consistent and replicable. Improper lead placement may display erroneous ECG patterns and affect patient management decisions.

Positional effects on the distributions of ventilation and end-expiratory gas volume in the asymmetric chest-a quantitative lung computed tomographic analysis.

Background: Body positioning affects the configuration and dynamic properties of the chest wall and therefore may influence decisions made to increase or decrease ventilating pressures and tidal volume. We hypothesized that unlike global functional residual capacity (FRC), component sector gas volumes and their corresponding regional tidal expansions would vary markedly in the setting of unilateral pleural effusion (PLEF), owing to shifting distributions of aeration and collapse as posture changed.

Methods: Six deeply anesthetized swine underwent tracheostomy, thoracostomy, and experimental PLEF with 10 mL/kg of radiopaque isotonic fluid randomly instilled into either pleural space.

Value and limitations of transpulmonary pressure calculations during intra-abdominal hypertension.

Objective: To clarify the effect of progressively increasing intra-abdominal pressure on esophageal pressure, transpulmonary pressure, and functional residual capacity.

Design: Controlled application of increased intra-abdominal pressure at two positive end-expiratory pressure levels (1 and 10 cm H2O) in an anesthetized porcine model of controlled ventilation.

Setting: Large animal laboratory of a university-affiliated hospital.

Non-pulmonary factors strongly influence the stress index.

Purpose: A quantitative measure of the airway pressure-time tracing during passive inflation [stress index (SI)] has been suggested as an indicator of tidal lung recruitment and/or overinflation. If reliable, this simple index could help guide positive end-expiratory pressure (PEEP) and tidal volume selection. The compartment surrounding the lungs should impact airway pressure and could, therefore, affect SI validity.