TY - JOUR. T1 - Global end-diastolic volume is an important contributor to increased extravascular lung water in patients with acute lung injury and acuterespiratory distress syndrome. T2 - A multicenter observational study. AU - on behalf of the PiCCO Pulmonary Edema Study Group. AU - Kaneko, Tadashi. AU - Kawamura, Yoshikatsu. AU - Maekawa, Tsuyoshi. AU - Tagami, Takashi. AU - Nakamura, Toshiaki. AU - Saito, Nobuyuki. AU - Kitazawa, Yasuhide. AU - Ishikura, Hiroyasu. AU - Sugita, Manabu. AU - Okuchi, Kazuo. AU - Rinka, Hiroshi. AU - Watanabe, Akihiro. AU - Kase, Yoichi. AU - Kushimoto, Shigeki. AU - Izumino, Hiroo. AU - Kanemura, Takashi. AU - Yoshikawa, Kazuhide. AU - Takahashi, Hiroyuki. AU - Irahara, Takayuki. AU - Sakamoto, Teruo. AU - Kuroki, Yuichi. AU - Taira, Yasuhiko. AU - Seo, Ryutarou. AU - Yamaguchi, Junko. AU - Takatori, Makoto. PY - 2014/4/1. Y1 - 2014/4/1. N2 - Background: Extravascular lung water (EVLW), as measured by the thermodilution method, reflects the extent of pulmonary ...
article{dc35f6eb-2fe8-4e13-a6ad-684fbfae520e, abstract = {Introduction: The diagnosis of acute lung injury (ALI) may be more robust if more accurate physiological markers can be identified. Extravascular lung water (EVLW) is one possible marker, and it has been shown to correlate with respiratory function and mortality in patients with sepsis. Whether EVLW confers diagnostic value in a general population with shock, as well as which index performs best, is unclear. We investigated the diagnostic accuracy of various EVLW indices in patients with shock. Methods: We studied a prospective, observational cohort of 51 patients with shock admitted to a tertiary ICU. EVLW was measured within 6 hours of ICU admission and indexed to actual body weight (EVLW/ABW), predicted body weight (EVLW/PBW) and pulmonary blood volume (EVLW/PBV). The relationship of these indices to the diagnosis and severity of lung injury and ICU mortality were studied. Positive and negative likelihood ratios, pre- and posttest odds ...
article{dc35f6eb-2fe8-4e13-a6ad-684fbfae520e, abstract = {Introduction: The diagnosis of acute lung injury (ALI) may be more robust if more accurate physiological markers can be identified. Extravascular lung water (EVLW) is one possible marker, and it has been shown to correlate with respiratory function and mortality in patients with sepsis. Whether EVLW confers diagnostic value in a general population with shock, as well as which index performs best, is unclear. We investigated the diagnostic accuracy of various EVLW indices in patients with shock. Methods: We studied a prospective, observational cohort of 51 patients with shock admitted to a tertiary ICU. EVLW was measured within 6 hours of ICU admission and indexed to actual body weight (EVLW/ABW), predicted body weight (EVLW/PBW) and pulmonary blood volume (EVLW/PBV). The relationship of these indices to the diagnosis and severity of lung injury and ICU mortality were studied. Positive and negative likelihood ratios, pre- and posttest odds ...
Primary graft dysfunction (PGD) is the most common cause of early morbidity and mortality following lung transplant and is characterized by acute lung injury and capillary leak leading to an increase in extravascular lung water index (ELWI) and impaired graft function. PGD has many features in common with acute respiratory distress syndrome (ARDS). PGD may be life-threatening and can also lead to impaired long term lung function. In ARDS, a restrictive fluid strategy has been associated with an improvement in lung function and outcomes. Accurate methods of evaluating, quantifying and guiding the hemodynamic / fluid management and limiting the extent of ELWI that accumulates in the setting of PGD are lacking. Using transpulmonary thermodilution to estimate ELWI and the pulmonary permeability index (PPI) represents a novel approach to fluid management, which has been used in patients with ARDS, but to date not in the transplant setting. To determine if these measurements may better guide the ...
Although these findings are interesting, they deserve some comments. First, whereas indexing EVLW to PBW may reduce the number of patients with acute respiratory distress syndrome (ARDS) with normal EVLW, in this population, the EVLW/ABW index performed best [2]. Furthermore, the absence of a link between EVLW and PaO2/FiO2 (calculated r2 of 0.14 to 0.23) could explain that these indices identified only 33% of ALI and 38% of ARDS cases. Second, the EVLW/PBV terminology appears very unusual. The transpulmonary thermodilution technique determines cardiac output, intrathoracic thermal volume (ITTV), pulmonary thermal volume (PTV) and global end-diastolic volume (Global end-diastolic volume (GEDV) = ITTV - PTV). The estimated blood volume of the chest (Intrathoracic blood volume (ITBV) = GEDV + PBV) permits the calculation of PBV (ITBV = 1.25 × GEDV - 28.4 ml) [3]. Importantly, the PiCCO monitor automatically provides, at each calibration, an estimation of the pulmonary vascular permeability index ...
This investigation is a prospective randomized control study. Informed consents will be obtained from all patients or their surrogates prior to the procedure of alveolar recruitment maneuver and PiCCO monitoring system.. Patients and methods:. From September 2010 to September 2012, consecutive patients with ALI/ARDS undergo alveolar recruitment maneuver will be enrolled at Chang Gung Memorial Hospital, a university-affiliated hospital in Taiwan. EVLW will be measured by PiCCO monitoring system, alveolar recruitment maneuver will be setting by protocol under supervision of chest physicians and respiratory therapists. Serum cytokine such as endothelin-1, TNF-, IL-6, Tie-1, Tie-2, angiopoietin-1, angiopoietin-2,VEGF and thrombomodulin will be measured. ...
A retrospective chart review of 86 adult patients with ALI found that patients with ALI who also received high dose nebulized salbutamol (2.5-6.4 mg/day) had significantly more days alive and free of ALI (n = 22, 12.2 [4.4] days) compared with the group receiving ≤ 2.4 mg/day (n = 64, 7.6 [1.9] days). There were no differences in non-pulmonary organ failure or hospital mortality rates (48% vs 50%) [26]. After adjustment for differences in case mix between the groups, high dose salbutamol remained independently associated with the number of days alive and free of ALI in a multivariate model.. The β-agonist Lung Injury Trial (BALTI-1) [27] was a phase II prospective randomized, double blind, placebo-controlled and the first study in humans to evaluate the effect of β-agonists on lung water. This single center study randomized 40 adult patients with ARDS to an intra-venous infusion of salbutamol 15 μg/kg/hr for 7 days and serially recorded the effect on extravascular lung water (EVLW). The ...
OBJECTIVES:: Measurements of extravascular lung water (EVLW) correlate to the degree of pulmonary edema and have substantial prognostic information in critically ill patients. Prior studies using single indicator thermodilution have reported that 21% to 35% of patients with clinical acute respiratory distress syndrome (ARDS) have normal EVLW (,10 mL/kg). Given that lung size is independent of actual body weight, we sought to determine whether indexing EVLW to predicted or adjusted body weight affects the frequency of increased EVLW in patients with ARDS. DESIGN:: Prospective, observational cohort study. SETTING:: Medical and surgical intensive care units at two academic hospitals. PATIENTS:: Thirty patients within 72 hrs of meeting American-European Consensus Conference definition of ARDS and 14 severe sepsis patients without ARDS. INTERVENTIONS:: None. MEASUREMENT AND MAIN RESULTS:: EVLW was measured for 7 days by PiCCO transpulmonary thermodilution; 225 measurements of EVLW indexed to actual ...
We have read with interest the study carried out by Mallamaci et al. (1) in iJACC. The authors evaluate pulmonary vascular congestion in a group of patients in chronic dialysis through a score derived from the number of ultrasound lung comets in the anterior chest regions (2-5).. No doubt exists that a "wet lung" will present a proportionally larger number of comets, reflecting the increase in its extravascular lung water. Cardiogenic pulmonary edema typically manifests with ultrasound lung comets that are initially more evident at lung bases and then extend to the middle and superior fields in relation to the increase in capillary venous pressure.. However, the hypothesis proposed by the authors (1), that lung comets originate from the subpleural interlobular edematous septa, is less convincing. First, the 7-mm distance observed between the comets does not correspond to anatomic observations, which show a variable distance from 10 to 30 mm between the interlobular septa (6,7). Second, we have ...
The VolumeView set from Edwards Lifesciences in combination with EV1000 clinical platform enables the display of valuable volumetric parameters in a meaningful way.
Remote sensing has more advantages than the traditional methods of land surface water (LSW) mapping because it is a low-cost, reliable information source that is capable of making high-frequency and repeatable observations. The normalized difference water indexes (NDWIs), calculated from various band combinations (green, near-infrared (NIR), or shortwave-infrared (SWIR)), have been successfully applied to LSW mapping. In fact, new NDWIs will become available when Advanced Land Imager (ALI) data are used as the ALI sensor provides one green band (Band 4), two NIR bands (Bands 6 and 7), and three SWIR bands (Bands 8, 9, and 10). Thus, selecting the optimal band or combination of bands is critical when ALI data are employed to map LSW using NDWI. The purpose of this paper is to find the best performing NDWI model of the ALI data in LSW map. In this study, eleven NDWI models based on ALI, Thematic Mapper (TM), and Enhanced Thematic Mapper Plus (ETM+) data were compared to assess the performance of ALI data
Promising data have recently been obtained by lung ultrasound (LUS), which allows the detection of pulmonary fibrosis by the evaluation of B-lines (previously called ultrasound lung comets). B-lines are the sonographic sign of pulmonary interstitial involvement, including increased thickness of the pulmonary septa. Traditionally, B-lines have been employed in patients with heart failure to detect the location and quantification of extravascular lung water, but many data suggest their use also in assessing interstitial lung disease. Assessment of B-lines by LUS would represent an attractive biomarker for the frequent evaluation of pulmonary involvement in patients with rheumatic disease, since it is non-ionising, inexpensive and easy to perform and interpret.. ...
In a double-blind randomised placebo-controlled trial, we showed that sustained treatment with intravenous salbutamol considerably reduced extravascular lung water in humans with ALI/ARDS.19 In contrast with our initial hypothesis and supporting data from animal studies,27 the response was not evident until 48 h after the initiation of treatment. Our study sought to identify whether salbutamol was having an effect on pulmonary neutrophil accumulation and alveolar inflammation. Our study confirms previous observations that there is increased neutrophil accumulation and inflammation in the alveolar space in people with ALI/ARDS. The novel finding of a positive association between the intensity of neutrophilic infiltration and an in vivo measurement of alveolar-capillary permeability adds additional support to the hypothesis that the neutrophil is a key inflammatory mediator in ARDS. Contrary to in vitro, animal and healthy volunteer studies, we found no evidence that intravenous salbutamol ...
Summary: ScientiaCME has the following Critical Care - Hemodynamics courses available currently:Advanced Hemodynamic Monitoring (0.5 CME Credits) Are We Applying Goal Directed Therapy Concepts During High-Risk Surgery? (0.75 CME Credits) Basics of Blood Management (0.5 CME Credits) Cardiac Output Monitoring vs. TEE/TTE (0.5 CME Credits) Expanded Applications For Hemodynamic Monitoring (1 CME Credit) Extravascular Lung Water: Clinical Implications (0.5 hr CME) Fluid First: Using PLR and SVV to Optimize Volume (0.75 CME Credits) Hemodynamic Optimization (0.5 hr CME) National Implementation of Enhanced Recovery in UK and next steps (0.75 hr CME) Perioperative Fluid Optimization with Goal Directed Therapy (0.75 hr CME) Perioperative Hemodynamic Optimization Using Goal Directed Therapy (1 [...] ...
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TY - JOUR. T1 - Transpulmonary thermodilution in neonates undergoing arterial switch surgery. AU - Székely, Andrea. AU - Breuer, Tamás. AU - Sápi, Erzsébet. AU - Székely, Edgár. AU - Szatmári, András. AU - Tóth, Miklós. AU - Hauser, Balázs. AU - Gál, János. PY - 2011/2/1. Y1 - 2011/2/1. N2 - Measurement of the global end-diastolic volume index (GEDI) by transpulmonary thermodilution (TPTD) has become a useful technique for measuring preload in adults. This study aimed to investigate the hemodynamic changes in neonates during the postoperative period after arterial switch surgery. Over a 13-month period, the postoperative data of 12 neonates with transposition of the great arteries were retrospectively investigated. Arterial and central venous blood pressures were monitored, Cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI), GEDI, and extravascular lung water index (ELWI) were measured by thermodilution. The CI was significantly correlated with ...
The study also shows that CO determined by transpulmonary thermodilution compared favorably with pulmonary artery thermodilution technique during the four stages of the experiment (fig. 2). These findings therefore confirm the view that transpulmonary thermodilution technique provides a reliable alternative to the pulmonary artery thermodilution technique to measure CO. Previous investigators have reported similar findings in other clinical conditions such as subarachnoid hemorrhage, sepsis, and major burns and in patients undergoing heart transplantation.3,23,24 Our findings in a large animal model of hemorrhagic shock add to the current body of evidence in this area. Estimates of EVLW based on the single thermal dilution technique have been shown to be significantly different from the corresponding estimates based on dye-thermal dilution technique in a previous clinical study that involved a small group of patients with septic shock.25 However, this early study used an older technology based ...
A differential diagnosis of the pulmonary oedema is important because the therapeutic approach is quite different. In cardiogenic pulmonary oedema, a negative fluid balance is sought, while in cases of permeability pulmonary oedema treating the cause of inflammation has priority. The Pulmonary Vascular Permeability Index (PVPI) enables this differential diagnosis. This parameter is calculated from the relation between Extravascular Lung Water (EVLW) and Pulmonary Blood Volume (PBV). A PVPI value in the range of 1 to 3 points to a cardiogenic pulmonary oedema, while a PVPI value greater than 3 suggests a permeability pulmonary oedema.. ...
Abstract: Acute respiratory distress syndrome (ARDS) is a fatal complication of severe sepsis. Due to its higher molecular weight, the use of colloids in fluid resuscitation may be associated with fewer cases of ARDS compared to crystalloids. Extravascular lung water (EVLW) elevation and levels of interleukin-8 (IL-8) and vascular cell adhesion molecule-1 (VCAM-1) have been studied as indicators playing a role in the pathogenesis of ARDS. The aim of the study was to determine the effects of colloid or crystalloid on the incidence of ARDS, elevation of EVLW, and levels of IL-8 and VCAM-1, in swine models with severe sepsis. ...
Nephrology was consulted for acute kidney injury and hypervolemia in a chronically ill nursing home resident. You decide to perform lung POCUS to assess extravascular lung water. Multiple B-lines per rib interspace are noted bilaterally consistent with pulmonary edema. Chest X-ray shown for comparison. Right upperLeft upperChest radiograph But would you stop there? No. Focused…
In critically ill patients, many decisions depend on accurate assessment of the hemodynamic status. We evaluated the accuracy of physicians conventional hemodynamic assessment and the impact that additional advanced monitoring had on therapeutic decisions. Physicians from seven European countries filled in a questionnaire in patients in whom advanced hemodynamic monitoring using transpulmonary thermodilution (PiCCO system; Pulsion Medical Systems SE, Feldkirchen, Germany) was going to be initialized as part of routine care. The collected information included the currently proposed therapeutic intervention(s) and a prediction of the expected transpulmonary thermodilution-derived variables. After transpulmonary thermodilution measurements, physicians recorded any changes that were eventually made in the original therapeutic plan. A total of 315 questionnaires pertaining to 206 patients were completed. The mean difference (±standard deviation; 95 % limits of agreement) between estimated and ...
Since the inception of thermodilution methods to measure EVLW, it has been assumed that lung water will be underestimated in regions with decreased pulmonary vascular perfusion. The thermodilution method for measuring EVLW relies on heat exchange across the alveolar epithelial and endothelial barriers. The cold saline thermal indicator must have access to all lung tissue because the ITTV is determined by measuring the quantity of heat transferred between the cooled blood and the surrounding tissues during transit through the intrathoracic vessels (48). If the thermal indicator does not have access to all lung tissue because of decreased perfusion, then EVLW will be consistently underestimated because the thermal indicator cannot detect lung water in these regions. Large pulmonary vessel obstruction (as in acute pulmonary embolism) or pulmonary vascular microembolism (as in cases of ALI) can result in decreased pulmonary perfusion. A third cause of decreased perfusion is hypoxic vasoconstriction ...
Patients who have NYHA class III CHF and whose water balance is apparently in equilibrium may also have thoracic x-ray signs of congestion and accumulation of fluid. This pulmonary over-hydration significantly contributes to limit patients functional capacity (23,25,31). The possibility of improving patients functional class through normalization of abnormal lung water content has been proposed from the beginning of 90 (23), and several studies have shown that UF is safe and allows the improvement of clinical condition, exercise capacity, ventilatory and neurohumoral pattern, also in patients with moderate CHF (32). In a controlled study (23), clinical and functional improvement in patients with moderate CHF lasted up to 6 months after UF. Only in UF-treated patients, pulmonary function tests improved and a chest x-ray score of lung water diminished. Exercise tolerance and functional capacity, as measured by expired gas analysis during exercise, also improved. Norepinephrine at rest was ...
Less invasive advanced haemodynamic monitoring combining fiberoptic oximetry, transpulmonary thermodilution and arterial pulse contour analysis.
Objective: To investigate the risk factors of ultrasound lung comets and its impact on the survivals of patients undergoing hemodialysis. Methods: One hundred and forty-two patients on hemodialysis (Male 76, female 66) were divided into three groups according to the score of lung comets (mild: ≤14 comets; moderate: 15 to 30 comets; severe: ,30 comets). Seventy-two healthy subjects examined by lung ultrasound serve as a control. Pulmonary artery systolic pressure and left ventricular ejection fraction (LVEF) were assessed by Doppler ultrasonography ...
Notes: W -- Individual state volumes are withheld to avoid disclosure of operator-level reserves data, due to statistical precision requirements, or due to other data quality reasons. The individual state volumes are included in the U.S. Total volume. See Definitions, Sources, and Notes link above for more information on this table ...
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Диагностика. Cокращения, используемые при диагностике (OBD). Диагностика OBD-II (ОБД 2). Перечень сокращений, используемых в OBD-II (ОБД 2). Таблица сокращений OBD. AFC.
TY - JOUR. T1 - Role of the bronchial circulation in ischemia-reperfusion lung injury. AU - Pearse, D. B.. AU - Wagner, E. M.. PY - 1994/1/1. Y1 - 1994/1/1. N2 - Bronchial arterial (BA) perfusion could modify pulmonary arterial (PA) ischemia-reperfusion (IR) injury by promoting clearance of peribronchial edema or limiting edema formation through maintenance of pulmonary vessel integrity via bronchopulmonary anastomotic or pulmonary vasa vasorum flow. The purpose of this study was to determine the effect of BA perfusion on IR injury in isolated sheep lungs. In 12 lungs (BA++) the BA was perfused throughout 30 min of PA ischemia and 180 min of reperfusion. In 12 lungs (BA- +) BA perfusion was begun with PA reperfusion, and in 15 lungs (BA--) the BA was never perfused. After 180 min, extravascular lung water was less (P , 0.05) in BA++ and BA-+ lungs [4.70 ± 0.16 and 4.57 ± 0.18 g/g blood-free dry lung (bfdl)] than in BA-- lungs (5.23 ± 0.19 g/g bfdl). The reflection coefficient for albumin was ...
A improved method named vegetation normalized difference water index (VNDWI) has been proposed in this paper based on NEW of Xiao Yun-fang(2010), which uses Band 1 and Band 7 and the normalized difference vegetation index (NDVI) in TM5 imagery to construct the VNDWI. This method has been tested in the Yangtze River Basin, and compares the results with other methods is the best. Due to the reflection characteristics differences between water and cloud, NEW method cannot distinguish the differences effectively. However, joins the NDVI parameter, VNDWI can enhance the difference between water and cloud, so it can remove clouds and its shadow noise from water body information without using complicated procedures, which is particular difficult work should be done in pretreatment.
Stimulation of Na+/K+-ATPase translocation to the cell surface increases active Na+ transport, which is the driving force of alveolar fluid reabsorption, a process necessary to keep the lungs free of edema and to allow normal gas exchange. Here, we provide evidence that insulin increases alveolar fluid reabsorption and Na+/K+-ATPase activity by increasing its translocation to the plasma membrane in alveolar epithelial cells. Insulin-induced Akt activation is necessary and sufficient to promote Na+/K+-ATPase translocation to the plasma membrane. Phosphorylation of AS160 by Akt is also required in this process, whereas inactivation of the Rab GTPase-activating protein domain of AS160 promotes partial Na+/K+-ATPase translocation in the absence of insulin. We found that Rab10 functions as a downstream target of AS160 in insulin-induced Na+/K+-ATPase translocation. Collectively, these results suggest that Akt plays a major role in Na+/K+-ATPase intracellular translocation and thus in alveolar fluid ...
Daniel Wehrhahn, Eppendorf, presents the new 5ml Eppendorf tube as the missing link for scientists working with liquid volumes between 2ml and 5ml. Watch this video interview to learn about the advantages of this new tube and the accessories that go with it. Interview filmed by SelectScience at Biotechnica 2013.
OBJECTIVE: To investigate the accuracy of measurement of intrathoracic blood volume index by single thermodilution (ITBVI*) and its sensitivity to detect changes in preload after cardiac surgery compared with conventional transpulmonary arterial dye dilution ITBVI and with conventional monitoring (central venous pressure [CVP] and left ventricular end-diastolic area index [EDAI] by transesophageal echocardiography).. DESIGN: Prospective clinical study.. SETTING: University hospital.. PARTICIPANTS: Nineteen patients immediately after cardiac surgery.. INTERVENTIONS: Volume loading was administered with 20 mL of oxypoligelatine (Haemaccel [Behringwerke Aktiengesellschaft Corp, Marburg, Germany]) 3.5% times body mass index over 10 minutes.. MEASUREMENTS AND MAIN RESULTS: Intrathoracic blood volume index was measured by dye dilution (ITBVI) and thermodilution (ITBVI*) immediately before and after volume loading. Measurements of ITBVI and ITBVI* correlated closely (r = 0.94; p , 0.0001). With volume ...
Impedance phlebography, or impedance plethysmography (IPG), is a non-invasive medical test that measures small changes in electrical resistance of the chest, calf or other regions of the body. These measurements reflect blood volume changes, and can indirectly indicate the presence or absence of venous thrombosis. This procedure provides an alternative to venography, which is invasive and requires a great deal of skill to execute adequately and interpret accurately. For the chest, the technique was developed by NASA to measure the split second impedance changes within the chest, as the heart beats, to calculate both cardiac output and lung water content. This technique has progressed clinically (often now called BioZ, i.e. biologic impedance, as promoted by the leading manufacturer in the US) and allows low cost, non-invasive estimations of cardiac output and total peripheral resistance, using only 4 skin electrodes, oscillometric blood pressure measurement and lung water volumes with minimal ...
Introduction: Heart failure (HF) is often associated with hospitalizations due to pulmonary congestion resulting in cardiogenic lung edema (LE). Implant-based monitoring of intrathoracic impedance as a surrogate measure of thoracic fluid status provides the chance to detect early stages of cardiac decompensation. Previously pulmonary fluid congestion has been related to clinical or preload parameters. In this study we tested for the first time the correlation between changes in intrathoracic impedance (Z) and directly measured intrathoracic fluids during LE induction as well as LE recovery.. Methods: 20 anesthetized sheep were studied, 3 served as controls, in 17 acute pulmonary fluid overload was induced by hypervolemia in combination with gradually increasing peripheral arterial resistance, in 5 sheep restitution of pulmonary fluid overload was attempted. Hemodynamics were continuously monitored including LVEDP. A transpulmonary thermodilution system was used to determine intrathoracic blood ...
Other names: pulmonary congestion, congestion of blood in the lungs Pulmonary congestion is not a classic symptom of subjective, but rather a sign of a disease on chest radiograph, which alerts the clinician to either lung disease or heart. However, it may manifest dyspnea and bloody sputum secretion. Technically this phenomenon called pulmonary congestion (stasis of blood in the lungs). It may mean that the heart can not handle pump blood into the large circulation and it then accumulates in the small circulation - in pulmonary vessels. These radiographic appears to be widespread, highlighted. When judgment is advanced to pulmonary edema (pulmonary edema when the fluid passes from the blood vessels into the lung tissue). Such heart failure are often elderly people from various causes (degenerative valvular defects, heart attack, high blood pressure, …) or even small children from birth if they have some developmental heart defects often more serious nature. At other times, however, slight pulmonary
Article Comply with Highly Regulated Oil in Water Measurements Using Portable Infrared Analyzers. The Petroleum Industry – both offshore and onshore -- has regulations that limit the amount of oil in discharged water. Fixed filter infrared (IR)...
Complications related to less-invasive haemodynamic monitoring‡. Belda, F. J.; Aguilar, G.; Teboul, J. L.; Pestaña, D.; Redondo, F. J.; Malbrain, M.; Luis, J. C.; Ramasco, F.; Umgelter, A.; Wendon, J.; Kirov, M.; Fernández-Mondéjar, E. // BJA: The British Journal of Anaesthesia;Apr2011, Vol. 106 Issue 4, p482 Background The aim of this study was to evaluate the type and incidence of complications during insertion, maintenance, and withdrawal of central arterial catheters used for transpulmonary thermodilution haemodynamic monitoring (PiCCOâ„¢). Methods We conducted a prospective, observational,... ...
may refer to from time to time as "proceeds", "deferred purchase price" and/or "carry capital", regardless of the legal form) as a result of various conditions not being met; product supply and demand; market competition; risks inherent in the companys and its subsidiaries marketing operations, including credit risks; imprecision of reserves estimates and estimates of recoverable quantities of natural gas and liquids from resource plays and other sources not currently classified as proved, probable or possible reserves or economic contingent resources, including future net revenue estimates; marketing margins; potential disruption or unexpected technical difficulties in developing new facilities; unexpected cost increases or technical difficulties in constructing or modifying processing facilities; risks associated with technology; the companys ability to acquire or find additional reserves; hedging activities resulting in realized and unrealized losses; business interruption and casualty ...
TABLE-US-00005 TABLE 5 Hemodynamic, gas exchange, and acid-base and metabolic parameters Before aortic occlusion Before drug After 2 h drug After aortic occlusion infusion infusion 1 h 2 h 4 h 8 h MAP, mmHg Control 94 97 93 95 90 89 (85-111) (89-108) (82-99) (89-105) (84-96) (83-105) Sulfide 97 99 95 92 91 94 (92-103) (90-100) (86-97) (89-96) (86-103) (78-96) Central venous Control 11 10 12 12 12 12 pressure, (mmHg) (8-14) (8-15) (6-13) (10-14) (11-15) (10-14) Sulfide 10 10 11 10 10 12 (8-14) (8-11) (9-13) (8-12) (9-13) (9-14) Global end-diastolic Control 733 645 715 690 660 692 Volume, mL .sup. (650-1,073) .sup. (573-1,186) (653-1,304) (631-1,111) (604-1,256) (642-1,173) Sulfide 743 731 870 786 747 691 (568-791) (640-991) .sup. (760-1,007)* (653-947) (558-915) (503-1,089) Pao2, mmHg Control 152 154 127 128 132 144 (145-156) (150-159) (119-135)* (116-131)* (121-145)* (135-150)* Sulfide 150 154 114 134 140 92 (148-158) (152-158) (109-126)* (124-139)* (125-143)* .sup. (66-107)*.sup.† Paco2, mmHg ...
Cerrar Maskara S Sen N et al. Correlation between lung injury score and serum albumin levels in patietns at risk for developing acute lung injury. Nutrition. 2000; 16: 91-94 ...
This study investigated the effect of glass shape on the pouring accuracy of liquid volume. Participants (n = 96) were asked to pour water up to the midpoint of four pint ...
There is no one single test for confirming that breathlessness is caused by pulmonary edema; indeed, in many cases, the cause of shortness of breath is probably multifactorial. Low oxygen saturation and disturbed arterial blood gas readings support the proposed diagnosis by suggesting a pulmonary shunt. Chest X-ray will show fluid in the alveolar walls, Kerley B lines, increased vascular shadowing in a classical batwing peri-hilum pattern, upper lobe diversion (increased blood flow to the superior parts of the lung), and possibly pleural effusions. In contrast, patchy alveolar infiltrates are more typically associated with noncardiogenic edema[2] Lung ultrasound, employed by a healthcare provider at the point of care, is also a useful tool to diagnose pulmonary edema; not only is it accurate, but it may quantify the degree of lung water, track changes over time, and differentiate between cardiogenic and non-cardiogenic edema.[18] Especially in the case of cardiogenic pulmonary edema, urgent ...
Signs of Pulmonary edema including medical signs and symptoms of Pulmonary edema, symptoms, misdiagnosis, tests, common medical issues, duration, and the correct diagnosis for Pulmonary edema signs or Pulmonary edema symptoms.
Background In critically sick sufferers intravascular quantity pulmonary and position edema have to be quantified at the earliest opportunity. and assessed CVP. Supplementary endpoint: interobserver relationship and contract between 1092539-44-0 supplier R1 and R2. Outcomes Precision of CT-estimation of GEDVI (< 680, 680-800, > 800 mL/m2) was 33%(R1)/27%(R2). For R1 and R2 awareness for medical diagnosis of low GEDVI (< 680 mL/m2) was 0% (specificity 100%). Awareness for prediction of raised GEDVI (> 800 mL/m2) was 86%(R1)/57%(R2) using a specificity of 57%(R1)/39%(R2) (positive predictive worth 38%(R1)/22%(R2); harmful predictive worth 93%(R1)/75%(R2)). Approximated CT-GEDVI and TPTD-GEDVI had been significantly different displaying. ...
Pulmonary edema is a disorder wherein fluid accumulates in the lungs leading to lack of oxygen in the body. The usual cause of pulmonary edema is c...
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Hemodynamic and Autonomic Reactivity to Mental and Physical Stress in Lean, Overweight and Obese Subjects. Candidate Selection, Determinant Factor for a Good Result in Cardiac Retransplantation: our Experience. Outcome and Hemodynamic Alternation in Uterine Artery Following Hysteroscopic Roller-Ball Endometrial Ablation. Nutritional Aspects in Heart Failure. The Echocardiographic Tei-index Compared to Transpulmonary Thermodilution Measurement With Different Hemodynamic Biomodels. Articles related to hemodynamic are open access to read here.
Post-liver transplantation acute lung injury (ALI) severely affects patients survival, whereas the mechanism is unclear and effective therapy is lacking. The authors postulated that reperfusion-induced increased oxidative stress plays a critical role in mediating post-liver transplantation ALI and that induction of heme oxgenase-1 (HO-1), an enzyme with anti-oxidative stress properties, can confer effective protection of lung against ALI. Male Sprague-Dawley rats underwent autologous orthotopic liver transplantation (OALT) in the absence or presence of treatments with the selective HO-1 inducer (Hemin) or HO-1 inhibitor (ZnPP). Lung tissues were collected at 8 h after OALT, pathological scores and lung water content were evaluated; survival rate of rats was analyzed; protein expression of HO-1 was determined by western blotting, and nuclear translocation of Nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor(NF)-κB p65 were detected by Immunofluorescence staining. The inflammatory
There is no single test for confirming that breathlessness is caused by pulmonary edema - there are many causes of shortness of breath. Low oxygen saturation and disturbed arterial blood gas readings support the proposed diagnosis by suggesting a pulmonary shunt. A chest X-ray will show fluid in the alveolar walls, Kerley B lines, increased vascular shadowing in a classical batwing peri-hilum pattern, upper lobe diversion (increased blood flow to the superior parts of the lung), and possibly pleural effusions. In contrast, patchy alveolar infiltrates are more typically associated with noncardiogenic edema[2] Lung ultrasound, employed by a healthcare provider at the point of care, is also a useful tool to diagnose pulmonary edema; not only is it accurate, but it may quantify the degree of lung water, track changes over time, and differentiate between cardiogenic and non-cardiogenic edema.[20] Especially in the case of cardiogenic pulmonary edema, urgent echocardiography may strengthen the ...