... substantial
contribution in analysing and interpreting the patient’s
data during the ICU admission and has been involved in
drafting the manuscript for the part concerning the ICU
admission. He gave final approval ... journal.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
CB was the major contributor in collecting the patient’s
data and writing the manuscript. ... gave final approval
of the version to be published. VL made a substantial
contribution in the data-analysis and interpretation, and
has been involved in drafting the manuscript. She gave
final...
... a benefit
to prone positioning.
Commentary
Pro/con clinical debate: The use of pronepositioningin the
management of patients with acuterespiratory distress
syndrome
John J Marini* and Gordon ... complications, such as ocular injury,
jugular vein compression, and skin ulceration at points of
increased pressure (for instance, the nose, chin, or knees).
Maintaining a supine position may also be ... withholding effective life-saving therapy from a
patient with ARDS by deciding not to put the patient in the
prone position. Clinicians who choose ventilation in the
prone position are applying experimental...
... concentration in pulmonary
epithelial lining fluid is a useful prognostic indicator in patients with
acute respiratorydistress syndrome. Respiratory Research 2011 12:32.
Kondo et al. Respiratory ... intense inflammatory and profibrotic reactions in the early phase
of acuterespiratorydistress syndrome. Crit Care Med 1999, 27:304-312.
2. Ware LB, Matthay MA: Medical progress: the acuterespiratory ... Nakamura M, Fang X, Martin TR, Matthay MA,
Hashimoto S: Elevation of KL-6, a lung epithelial cell marker, in plasma
and epithelial lining fluid inacuterespiratorydistress syndrome. Am J
Physiol...
... written,
informed consent was obtained. After intubation with a
cuffed tube, all patients received into the trachea 20 ml of
normal saline containing 7.5 mg of
13
C-dipalmitoyl-
phosphatidylcholine ... number not for citation purposes)
Respiratory Research
Open Access
Research
Surfactant disaturated-phosphatidylcholine kinetics inacute
respiratory distresssyndrome by stable isotopes and a ... therapeutic options. Intensive
Care Med 2001, 27:1699-1717.
5. Haitsma JJ, Papadakos PJ, Lachmann B: Surfactant therapy for
acute lung injury /acute respiratorydistress syndrome. Curr
Opin Crit Care...
... implicated in the
course of inflammatory lung diseases such as the Acute
RespiratoryDistressSyndrome (ARDS). Indeed, in clinical
studies focusing on ARDS [3-6] and, more recently, on
severe pneumonia ... volumes as compared
with traditional tidal volumes for acute lung injury and the
acute respiratorydistress syndrome. The Acute Respiratory
DistressSyndrome Network. N Engl J Med 2000, 342:1301-1308.
15. ... regimen, may indeed promote better outcome
in ARDS. In this line of reasoning, multiple surfactant dos-
ing with persistent improvement in gas exchange may
ultimately improve outcome in ARDS.
Conclusion
We...
... resistance index (∆PVRI) induced by
increasing inspiratory intratracheal concentrations of inhaled NO (Insp
IT NO) in the presence (n = 8, ●) or absence (n = 8, ❍) of septic shock
in 16 patients ... oxide in
patients with adult respiratorydistress syndrome. Anesthesiol-
ogy 1994, 80:761-770.
7. Young JD, Brampton WJ, Knighton JD, Finfer SR: Inhaled nitric
oxide inacuterespiratory failure in ... decrease in MPAP
and an increase in PaO
2
/FiO
2
in the range of 0.15 to 150
ppm inhaled NO.
Toxic effects of increasing concentrations of inhaled NO
As shown in Table 3, methemoglobin and NO
2
...
... cGMP increased significantly during NO
inhalation. EVLWI did not change either during ANP infu-
sion or during NO inhalation. In patients who responded to
NO inhalation with an increase in PaO
2
/F
i
O
2
> ... only a modest increase in the arterial
concentration during the infusion of ANP. Since ANP was
infused on the venous side of the circulation, these find-
ings suggest that most of the infused ANP ... research
Primary research
Atrial natriuretic peptide infusion and nitric oxide inhalation in
patients with acuterespiratorydistress syndrome
Alexander JGH Bindels*
Đ
, Johannes G van der Hoeven*
ả
,...
... adequate
mechanical ventilation inacute lung injury and acuterespiratorydistresssyndrome (ARDS). In the present
study we tested the effect on gastric intramucosal pH of incremental increases in PEEP level ... http://ccforum.com/content/7/3/R17
Research
Gastric intramucosal pH is stable during titration of positive
end-expiratory pressure to improve oxygenation in acute
respiratorydistress syndrome
Ibrahim Ozkan Akinci
1
, Nahit ầakar
2
, ... of acute lung injury
(ALI) and acuterespiratorydistresssyndrome (ARDS). PEEP
improves oxygenation by redistributing the alveolar fluid and
restores functional residual capacity by keeping...
... and their
interactions [1]. The common increase in the elastance
(decrease in compliance) of the whole respiratory system in
acute lung injury (ALI) and inacuterespiratory distress
syndrome ... importance of chest wall elastance in characterizing acute lung injury /acute respiratory distress
syndrome patients and in setting mechanical ventilation is increasingly recognized. Nearly 30% of
patients ... the intra-abdominal pressure
is altered. We in fact found that chest wall elastance
increases linearly with the intra-abdominal pressure
according to the following equation: E
cw
= 0.47 ì intra-
abdominal...
... in the acuterespiratory distress
syndrome. N Engl J Med 1998, 338:347-354.
3. Gutierrez G, Palizas F, Doglio G, Wainsztein N, Gallesio A, Pacin
J, Dubin A, Schiavi E, Jorge M, Pusajo J, Klein ... NS
APACHE, Acute Physiology and Chronic Health Evaluation; Crs, Respiratory system compliance; Dbt, dobutamine; Dp, dopamine; LIP, lower
inflection point; NE, norepinephrine (noradrenaline); NL, ... applied in four consecutive 30 min
periods, respectively. Respiratory rate was modified to main-
tain end tidal CO
2
within ± 10 mmHg of basal. All patients
were receiving a constant infusion...
... [11,12], adequate replacement of
intravascular fluid volumes is required to maintain cardiac
Commentary
Positive end-expiratory pressure inacuterespiratory distress
syndrome – an old yet mysterious ... end-expiratory pressure (PEEP)
into the practice of mechanical ventilation in patients with
acute respiratorydistresssyndrome (ARDS) [1] was among
the most important milestones in critical care therapy.
However, ... ventilation for
patients with acute lung injury or ARDS [7] increasingly
recommend fairly high levels of PEEP. In view of this, any
data that may improve our understanding of the benefits and
dangers...
... was present only in one patient
(no. 13). Clinical data are given in Table 1. Twenty healthy non-
smoking students independent of the investigating institutions
were enrolled and interviewed to ... ventilation by a moderate
increase in PEEP. Accordingly, increasing PEEP from 0 to 15
cmH
2
O has been shown in a study of pulmonary mechanics to
increase pulmonary compliance in some patients, which ... CT scanned in maintained apnoea. The rebreathing proce-
dure was performed in duplicate before and after a single CT
exposure.
Before the supine measurements, the nose-clipped, supine
and relaxed...
... mortality in the acuterespiratorydistress syn-
drome. N Engl J Med 1998, 338:347–354.
Figure 1
Thoracic tomography of two different models of acute lung injury /acute respiratorydistresssyndrome ... be kept in the mind of the critical care physicians
when treating a patient with ARDS in the intensive care unit.
Competing interests
The author(s) declare that they have no competing interests.
References
1. ... ventilation [1]. (b) CT scan of acuterespiratorydistresssyndrome patients before
and after a recruitment maneuver with 60 cmH
2
O maximal inspiratory pressure maintaining PEEP values of 20 and 25...