Background: To investigate whether angiopoietin-2 (Ang2) and vascular endothelial growth factor (VEGF) are implicated in the hypoxemic resuscitation from hemorrhagic shock.
Methods: Twenty rabbits were subjected to hemorrhagic shock after blood exsanguination; resuscitation was performed by infusion of the shed blood in ten rabbits under normoxemic conditions (NormoxRes) and in 10 under hypoxemic conditions (HypoxRes); four rabbits were subjected to sham operation. Serum was drawn at serial time intervals; serum was applied for stimulation of U937 monocytes.
Results: Serum concentrations of Ang2 were higher in the NormoxRes group compared to the HypoxRes group at 90 min (p: 0.049) and at 120 min (p: 0.028). Serum concentrations of VEGF did not differ between groups. Concentrations of VEGF in the supernatants of U937 stimulated with sera of all groups were below detection limit. The wet to dry lung ratio of the HypoxRes group was significantly lower than the NormoxRes group (p<0.0001).
Conclusions: Hypoxemic resuscitation from hemorrhagic shock is a process accompanied by reduced serum levels of Ang2. These findings add significantly to our understanding of that experimental treatment strategy of resuscitation.
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http://dx.doi.org/10.1016/j.cyto.2009.05.013 | DOI Listing |
Crit Care
January 2025
Departamento de Medicina, Hospital Clínico Universidad de Chile, Unidad de Pacientes Críticos, Dr. Carlos Lorca Tobar 999, Independencia, Santiago, Chile.
Background: Double cycling with breath-stacking (DC/BS) during controlled mechanical ventilation is considered potentially injurious, reflecting a high respiratory drive. During partial ventilatory support, its occurrence might be attributable to physiological variability of breathing patterns, reflecting the response of the mode without carrying specific risks.
Methods: This secondary analysis of a crossover study evaluated DC/BS events in hypoxemic patients resuming spontaneous breathing in cross-over under neurally adjusted ventilatory assist (NAVA), proportional assist ventilation (PAV +), and pressure support ventilation (PSV).
Folia Med (Plovdiv)
December 2024
Medical University of Plovdiv, Plovdiv, Bulgaria.
Positive end-expiratory pressure (PEEP) titration is crucial for improving oxygenation and preventing ventilator-induced lung injury in acute hypoxemic respiratory failure. Electrical impedance tomography (EIT) offers real-time, bedside monitoring of lung ventilation distribution, potentially guiding individualized PEEP settings.
View Article and Find Full Text PDFCan J Anaesth
November 2024
Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
Purpose: There is significant variability in the application of positive end-expiratory pressure (PEEP) in patients undergoing invasive mechanical ventilation. There are numerous studies assessing methods of determining optimal PEEP, but many methods, patient populations, and study settings lack high-quality evidence. Guidelines make no recommendations about the use of a specific method because of equipoise and lack of high-quality evidence.
View Article and Find Full Text PDFIntensive Care Med
December 2024
Department of Medicine, Interdepartmental Division of Critical Care Medicine, Sinai Health System and University Health Network, University of Toronto, Toronto, Canada.
Purpose: The optimal physiologic parameters to monitor after a session of awake prone positioning in patients with acute respiratory failure are not well understood. This study aimed to identify which early physiologic changes after the first session of awake prone positioning are linked to the need for invasive mechanical ventilation or death in patients with acute respiratory failure.
Methods: We performed a secondary analysis of a prospective cohort study of adult patients with acute respiratory failure related to coronavirus disease 2019 (COVID-19) treated with awake prone positioning.
J Paediatr Child Health
December 2024
NeoRESQ, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
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