Chin Crit Care Med, July 2004, Vol.16, No.7
385-386
Strategy of mechanical ventilation in acute respiratory distress syndrome：From heterogeneous to homogeneous
LIU Da-wei
Chinese Academy of Medical Sciences, Beijing 100730, China
387-389
Diagnosis and reatment of thoracic hydrops in ICU patients
YU Sen-yang
, http://www.100md.com
Respiratory Department, General Hospital of PLA, Beijing 100853, china
390-393
Brief introduction: guidelines for the management of severe sepsis and septic shock (2004)
QIU Hai-bo, LIU Da-wei
ICU, Zhongda Hospital, South-east University, Nanjing 210009, Jiangsu, China
394-398
Role of bcl-2 and bax expression in apoptosis of hypoxic pulmonary artery smooth muscle cells of rats induced by Na+/H+ exchanger isoform-1 inhibition in vitro
, http://www.100md.com
LU Jun-yu， YAO Wei， QIAN Gui-sheng, YANG Xiao-jing, CHEN Wei-zhong, LI Shu-ping. Institute of Respiratory Disease， Xinqiao Hospital， Third Military Medical University， Chongqing 400037， China
OBJECTIVE: To investigate the role of bcl-2 and bax expression in apoptosis of hypoxic pulmonary artery smooth muscle cells (PASMCs) of rats induced by Na+/H+ exchanger isoform-1 (NHE-1) inhibition in vitro. METHODS: Cultured rat PASMCs transfected with NHE-1 ribozyme gene (PRZ cell), cultured rat PASMCs transfected only with pLXSN vector (PX cell) and non-transfected rat PASMCs (PA cell) were obtained in our previous studies. The cells were cultured under low oxygen tension (<1% O2) for 0, 2, 6, 12, 24 and 48 hours respectively. Then cell apoptosis was examined with terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). Intracellular Ca2+([Ca2+]i) of cells was measured using fluorescence dye Fura-2/AM. The changes in mRNA expression of bcl-2 and bax in cells were assessed by semi quantitative reverse transcription-polymerase chain reaction (sqRT-PCR). The expression of Bcl-2 protein and Bax protein of cells was detected immunohistochemically. RESULTS: In contrast to normal PASMCs and cells transfected with pLXSN, the apoptosis rates in recombinant vectors transfected cells increased significantly and continuously. [Ca2+]i values were also increased in these cells, but the increase extent was remarkably lower than in the normal PASMCs (all P<0.01). The expression of bax mRNA and protein of cells transfected with recombinant vectors was increased significantly compared with cells of other two groups. Meanwhile, the expression of bcl-2 mRNA and protein of these cells were decreased significantly. CONCLUSION: The NHE-1 specific hammerhead ribozymes induce apoptosis of PASMCs under low oxygen tension by inhibiting the increase in intracellular Ca2+ concentration, increasing bax expression and decreasing bcl-2 expression.
, http://www.100md.com
399-402
Effects of positive end-expiratory pressure on lung recruited volume and oxygenation in patients with acute respiratory distress syndrome
QIU Hai-bo, XU Hong-yang, YANG Yi, ZHOU Shao-xia, CHEN Yong-ming, SUN Hui-ming. Department of Critical Care Medicine, Zhongda Hospital and School of Clinical Medicine, Southeast University, Nanjing 210009, Jiangsu, China
OBJECTIVE: To access alveolar recruitment with positive end-expiratory pressure (PEEP) and to correlate the recruited volume with arterial oxygenation in acute respiratory distress syndrome (ARDS). METHODS: Eleven ventilated patients satisfying criteria of ARDS were included in the study group. Recruited volume of three different PEEP levels [5 cm H2O, 10 cm H2O, 15 cm H2O (1cm H2O =0.098 kPa)]were measured by pressure-volume curve method. Effects of different PEEP levels on lung mechanics and gas exchange were compared. RESULTS: Lung recruited volume elevated when PEEP increased from 5 cm H2O to 15 cm H2O[(40.2±15.3)ml vs. (123.8±43.1)ml vs. (178.9±43.5)ml, all P<0.05]. Arterial oxygenation index increased with PEEP and a positive correlation was found between recruited volume and changes in arterial oxygenation index (r=0.483, P<0.01). There was no significant difference during the static compliance at different PEEP levels at a fixed tidal volume (P>0.05). Recruited volume at PEEP 15 cm H2O in the patient group with lower inflection point (LIP) was larger than the group without LIP. CONCLUSION: Recruited volume increases with PEEP, and the PEEP-induced increase in arterial oxygenation is significantly correlated to recruited volume.
, http://www.100md.com
403-408
Relative functional changes in neutrophils in early period of acute lung injury in rabbit
WANG Shuo, NIE Xiu-hong, GUO De-yu, XIAO Han, REN Kui.
Respiratory Department, Xuanwu Hospital, Capital University of Medical Science, Beijing 100053, China
OBJECTIVE: To explore the relationship of interleukin-8 (IL-8), adherence function of neutrophil (PMN) and acute lung injury (ALI). METHODS: Eighteen male New Zealand rabbits were divided into two groups randomly: the control group (n=8) and the ALI group (n=10). The model of ALI was replicated by using intravenous lipopolysaccaride (LPS) in the rabbits of group ALI. Blood pressure, heart rate, blood gas analysis, hemogram, CD11b expression intensity on the surface of PMN, concentration of serum IL-8 and malondialdehyde (MDA) were measured at each time point. Specimens for pathology were obtained at the end of experiment. RESULTS: In group ALI, blood pressure, heart rate and pH declined obviously. PMN count was lowered obviously at 3 hours and increased at 6 hours to some extent. CD11b expression intensity on the surface of PMN, the concentration of serum IL-8 and MDA were increased progressively (all P<0.05). The main changes in the microscopic examination were inflammatory granulocyte infiltration, disseminated thickening of alveolar septa and focal hemorrhages. There were significant correlations between CD11b and IL-8 (r2=0.813， Y=26.729X), and between CD11b and the grades of pathological changes at 6 hours after intravenous LPS (r2=0.771， Y=0.011 02X+5.292). CONCLUSION: LPS could induce the release of large amount of IL-8, and it activates the expression of CD11b on the surface of PMN, which shows high degree of correlation with IL-8 and the degree of pathological changes in the lung. Therefore, both of them could serve as sensitive indexes for the diagnosis of ALI.
, 百拇医药
408
Establishment of outhospital first-aid process in the basement hospital
REN Xiang-mei, LI Xue-xian, GENG Shou-zhen, MU Xue-rong, YU Yong-mei
Yiyuan Traditional Chinese Medical Hospital, Zibo 256100, Shandong, China
409-412
Protective effect of specific antibody in serum of convalescent patient with SARS
, 百拇医药
LI Yong， XU Jun， MO Hong-ying， LAI Ke-fang， TAN Ya-xia， PI Xiang-ying, REN Xiao-lan， ZENG Guang-qiao， LIU Miao-fang， ZHONG Nan-shan. Guangzhou Institute of Respiratory Disease， Guangzhou 510120， Guangdong, China
OBJECTIVE: To investigate inhibitory effect of serum severe acute respiratory syndrome (SARS) -specific antibodies from convalescent patients after half an year of onset on SARS-CoⅤ-mediated cytopathic response.METHODS: SARS-CoⅤ immunoglobulin G (IgG) antibody was determinated by enzyme linked immunoadsorbent assay (ELISA).Twelve serum samples from convalescent patients， diluted by 1∶8 with maintenance medium, were mixed with the three dilution supernatants of SARS-CoⅤ. SARS-CoⅤ were isolated, cultured and identified by the Guangzhou Institute of Respiratory Disease, and cultured with Vero E6 cell suspension.The extent of cytopathic response was observed.RESULTS: The absorbance (A) value of SARS-CoⅤ IgG antibody ranged from 0.81 to 2.06 in patients after half an year of SARS onset，and form 0.79 to 2.01 in patients before half an year of SARS onset. The extent of cytopathic respone was decreased by more than 25% in all 12 convalescent patients， as compared with control serum. CONCLUSION:: The A value of SARS-CoⅤ IgG antibody in serum of convalescent patients tended to elevate in half an year after SARS onset. SARS-CoⅤ IgG antibody could inhibit SARS-CoⅤ-mediated cytopathic response，indicating it might be one of protective antibodies.
, 百拇医药
413-416
A comparison study on quantitative methods for the recruited volume in sheep with acute respiratory distress syndrome
XU Hong-yang, QIU Hai-bo, YANG Yi, ZHOU Shao-xia, SUN Hui-ming, CHEN Yong-ming.
Department of Critical Care Medicine, Zhongda Hospital and School of Clinical Medicine, Southeast University,Nanjing 210009, Jiangsu, China
OBJECTIVE: To compare equal pressure method with pressure-volume curve method to quantify the recruited volume. METHODS: Acute respiratory distress syndrome sheep model was induced by intravenous infusion 3 μg/kg lipopolysaccharide (LPS). Recruited volume of three different levels of positive end-expiratory pressure (PEEP=5, 10, 15 cm H2O) were measured both by pressure-volume curve method and by equal pressure method. RESULTS: The time needed to measure recruited volume by pressure-volume curve method was 5-6 minutes, which was longer than that of equal pressure method. Recruited volume measured by the two methods increased with PEEP. No significant difference was found between the recruited volume measured by equal pressure method and by equal pressure method at PEEP of 5 cm H2O, they were (25.79±20.48)ml vs. (63.26±54.57)ml (P>0.05), while recruited volume at PEEP of 10 cm H 2O and 15 cm H2O measured by equal pressure method were lower than those measured by the pressure-volume curve method, they were (48.64±30.51)ml vs. (148.14±85.42)ml and (71.50±58.09)ml vs. (322.86±148.42)ml (all P<0.05) respectively. CONCLUSION: Though equal pressure method is simple, it could not take the place of pressure-volume curve method to quantify recruited volume.
, 百拇医药
416
Factors related to airway stenosis of distal endotracheal tube and intubation dilatation
XU Si-cheng, HUANG Yi-fen.
MICU, Department of Pulmonology, First Clinical Hospital, Xinjiang Medical University, Urumqi 830000, China
417-420
Influence of salbutamol inhalation during volume target pressure control ventilation on ventilation parameters in patients with respiratory failure
, 百拇医药
CHEN Yu-qing, ZHAO Bing-qing, ZHOU Xin.
Department of Respiratory, Shanghai First People's Hospital, Jiaotong University, Shanghai 200080, China
OBJECTIVE: To compare the effects of volume target pressure control ventilation (VTPC) and volume control ventilation (VCV) on respiratory mechanics in patients with respiratory failure, and to investigate the effects of ventilated parameters after salbutamol inhalation. METHODS: Ten patients with mean age (68±5) years were intubated and mechanically ventilated for acute respiratory failure of diverse causes. After 30 minutes with VCV [tidal volume (VT) 8-10 ml/kg], measurements of respiratory mechanics were begun, and then the patients were ventilated with VTPC for 30 minutes. VCV and VTPC were repeated after salbutamol 600 μg inhalation. RESULTS: The static compliance (Cst) was (38.4±2.7)ml/cm H2O (1 cm H2O=0.098 kPa) and airway resistance (Raw) was (20.1±2.0)cm H2O·L-1·s-1 in 10 patients. With the same tidal volume, peak inspiratory pressure (PIP) and mean inspiratory flow [VT/inflation time (Tinflate)]during VTPC were lower, but peak inspiratory flow (PIF) was signify cantly higher than that during VCV (all P<0.05). The same plateau pressure (Pplat) was observed during VCV as during VTPC, they were (22.1±0.9)cm H2O vs. (23.0±1.2)cm H2O. After salbutamol inhalation, PIP and Raw were significantly decreased in all patients (both P<0.05), but no changes were found in Cst and Pplat. PIF and peak expiratory flow (PEF) were increased much more during two modes than before inhalation (both P<0.05), but Tinflate was decreased (P<0.05). CONCLUSION: VTPC is a new mechanical ventilation mode in which closed-loop control theory is used. The airway pressure during VTPC is associated with Cst and not influenced by Raw.
, 百拇医药
420
Intensive hemodialysis for emergency therapy of paraquat poisoning
LIU Bing, HAN Yu-ping, GAO Hua.
Hebei People’s Hospital, Shijiazhuang 050051, Hebei, China
421-423
Adjustment methods of proportional pressure support on weaning during acute aggravation in chronic respiratory failure patients with chronic obstructive pulmonary disease
, http://www.100md.com
WANG Shi-yong， ZHAN Chun, ZHANG Na-xin, QIN Ying-zhi， XU Lei.
Intensive Care Unit, Tianjin Third Center Hospital, Tianjin 300170，China
OBJECTIVE: To study the effects of two adjustment methods of proportional pressure support (PPS) on patients with acute aggravation in chronic respiratory failure of chronic obstructive pulmonary disease. METHODS: Seventy-five patients were randomized to two groups, 30 in proportional adjustment group and 45 in target adjustment group, respectively. Suitable flow assist (FA) and volume assist (VA) were adjusted with proportional adjustment and target adjustment methods respectively according to the ventilation parameters until the weaning of ventilation. RESULTS: There were no significant differences in resistance, elastic, FA as well as VA on weaning point, duration of mechanical ventilation, and successful weaning rate between the two groups (all P>0.05). CONCLUSION: The same aim and successful weaning rate could be gained in the target adjustment group compared with the proportional adjustment group. More clinical experience and more intensive care would be needed in the target adjustment group.
, 百拇医药
424-427
Treatment of acute respiratory distress syndrome using pressure and volume controlled ventilation with lung protective strategy
GE Ying, WAN Yong, WANG Da-qing, SU Xiao-lin, LI Jun-ying, CHEN Jing.
ICU, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China
OBJECTIVE: To investigate the significance and effect of pressure controlled ventilation (PCV) as well as volume controlled ventilation (VCV) by lung protective strategy on respiratory mechanics, blood gas analysis and hemodynamics in patients with acute respiratory distress syndrome (ARDS). METHODS: Fifty patients with ARDS were randomly divided into PCV and VCV groups with permissive hypercapnia and open lung strategy. Changes in respiratory mechanics, blood gas analysis and hemodynamics were compared between two groups. RESULTS: Peak inspiration pressure (PIP) in PCV group was significantly lower than that in VCV group, while mean pressure of airway (MPaw) was significantly higher than that in VCV after 24 hours mechanical ventilation. After 24 hours mechanical ventilation, there were higher central venous pressure (CVP) and slower heart rate (HR) in two groups, CVP was significantly higher in VCV compared with PCV, and PCV group had slower HR than VCV group, the two groups had no differences in mean blood pressure (MBP) at various intervals. All patients showed no ventilator-induced lung injury. Arterial blood oxygenations were obviously improved in two groups after 24 hours mechanical ventilation, PCV group had better partial pressure of oxygen in artery (PaO2) than VCV group. CONCLUSION: Both PCV and VCV can improve arterial blood oxygenations, prevent ventilator-induced lung injury, and have less disturbance in hemodynamic parameters. PCV with lung protective ventilatory strategy should be early use for patients with ARDS.
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427
Successful resuscitation in a patient with heroin-induced cardiac pulmonary arrest for 25 minutes by external defibrillation for 16 times
XIN Yong-tuan
Medical Emerency Centre of Xiamen, Xiamen 361004,Fujian, China
428-429
A retrospective study on 87 cases with severe acute respiratory syndrome
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MO Jian-kun, LIANG Shu-li, WANG Zhong-xin, WU Zheng-guang, LI Yong-xin, ZHANG Zhi.
Department of Clinical Laboratory Medicine, Guangdong Second People’s Hospital, Guangzhou 510310, Guangdong, China
430-431
Correlations of circulating lipoproteins to cytokines and their effects on prognosisis in patients with SIRS
LI Qian, SUN Ren-hua, YANG Xiang-hong, XU Yun-xiang.
, 百拇医药
ICU, Zhejiang People’s Hospital, Hangzhou 310014, Zhejiang, China
431
The nursing care experience in patients with multiple organ failure
XIA Xin-hua
Tianjin Tianhe Hospital, Tianjin 300050, China
432-433
Dynamic changes and significance of serum TNF-α, IL-8 levels in patients with acute respiratory distress syndrome after severe trauma
, 百拇医药
LANG Zhong-bing, WEN Liang, CHU Jun.
Department of Emergency, South-west Hospital, The Third Military Medical University, Chongqing 400038,china
433
The influence of body position on anesthesia duration following spinal anesthesia
XIE Li-mei, WANG Zhen-feng
The Third People’s Hospital of Qiannan Autonomous Prefecture, Qiannan 558000, Guizhou, China
, http://www.100md.com
434-435
Antegrade-Retregrade-Warm cardioplegia of myocardial protection in the serious heart valve disease
MU Rong, ZHOU Li-yuan
Department of Anesthesiology, Tianjin Tianhe Hospital, Tianjin 300050, China
436-437
Treatment for ARDS and hemerrhagic-traumatic shock in severe thoracic trauma
, 百拇医药 CHEN Xiao-xiong
Department of Emergency, Tongren Hospital, Calital University of Medical Science, Beijing 100730, China
438
Resistance of 300 strains of gram-negotive bacteria isolated from ventilator-associated pneumonia (VAP) in emergency intensive care unite (EICU)
ZHOU Ju-fen, JIANG Xu-hong
Hangzhou The First Hospital, Hangzhou 310006, Zhejiang, China
, 百拇医药
439-440
Common ventilator alarms and mechanical disfunction during mechanical ventilation (a report of 890 times)
XIA Wen-jun, JIANG Xue-ge, YU Sen-yang
General Hospital of PLA, Beijing 100853, China
440
Nonninvasive bi-level positive airway pressure ventilation in the treatment of 24 cases with acute pulmonary edema
, 百拇医药
HAN Yu-ping, LIU Bing, WANG Li-jun
Hebei People’s Hospital, Shijiazhuang 050051, Hebei, China
441-443
Noninvasive positive pressure ventilation in stable patients with chronic obstruction pulmonary disease
JIANG Hui, YU Sen-yang
Respiratory Department, General Hospital of PLA, Beijing 100853, china
, http://www.100md.com
443
Ozagrl sodium and LMWH in tesating delayed edencephdopathy resulting from acute carbon monoxide poisoning
SUN Ming-liang, WANG Rong-xi, SU Chun-hua
Emergency Department of the People’s Hospital, Dezhou 253014, Shandong, China
444-446
Cell adhesion molecules and acute lung injury
JI Xian-fei, HUANG Liang
, http://www.100md.com
Department of Emergency, First Affiliated Hospital, Jiangxi Medical College, Nanchang 330006, Jiangxi, China
447-448
Trif:A new member of Toll-like receptor-associated signal transduction
WANG Tian-yi, WANG Jun-min, YAO Xi-xian
The Bethune International Peace Hospital, Shijiazhuang 050082, Hebei, China, 百拇医药
Strategy of mechanical ventilation in acute respiratory distress syndrome：From heterogeneous to homogeneous
LIU Da-wei
Chinese Academy of Medical Sciences, Beijing 100730, China
387-389
Diagnosis and reatment of thoracic hydrops in ICU patients
YU Sen-yang
, http://www.100md.com
Respiratory Department, General Hospital of PLA, Beijing 100853, china
390-393
Brief introduction: guidelines for the management of severe sepsis and septic shock (2004)
QIU Hai-bo, LIU Da-wei
ICU, Zhongda Hospital, South-east University, Nanjing 210009, Jiangsu, China
394-398
Role of bcl-2 and bax expression in apoptosis of hypoxic pulmonary artery smooth muscle cells of rats induced by Na+/H+ exchanger isoform-1 inhibition in vitro
, http://www.100md.com
LU Jun-yu， YAO Wei， QIAN Gui-sheng, YANG Xiao-jing, CHEN Wei-zhong, LI Shu-ping. Institute of Respiratory Disease， Xinqiao Hospital， Third Military Medical University， Chongqing 400037， China
OBJECTIVE: To investigate the role of bcl-2 and bax expression in apoptosis of hypoxic pulmonary artery smooth muscle cells (PASMCs) of rats induced by Na+/H+ exchanger isoform-1 (NHE-1) inhibition in vitro. METHODS: Cultured rat PASMCs transfected with NHE-1 ribozyme gene (PRZ cell), cultured rat PASMCs transfected only with pLXSN vector (PX cell) and non-transfected rat PASMCs (PA cell) were obtained in our previous studies. The cells were cultured under low oxygen tension (<1% O2) for 0, 2, 6, 12, 24 and 48 hours respectively. Then cell apoptosis was examined with terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). Intracellular Ca2+([Ca2+]i) of cells was measured using fluorescence dye Fura-2/AM. The changes in mRNA expression of bcl-2 and bax in cells were assessed by semi quantitative reverse transcription-polymerase chain reaction (sqRT-PCR). The expression of Bcl-2 protein and Bax protein of cells was detected immunohistochemically. RESULTS: In contrast to normal PASMCs and cells transfected with pLXSN, the apoptosis rates in recombinant vectors transfected cells increased significantly and continuously. [Ca2+]i values were also increased in these cells, but the increase extent was remarkably lower than in the normal PASMCs (all P<0.01). The expression of bax mRNA and protein of cells transfected with recombinant vectors was increased significantly compared with cells of other two groups. Meanwhile, the expression of bcl-2 mRNA and protein of these cells were decreased significantly. CONCLUSION: The NHE-1 specific hammerhead ribozymes induce apoptosis of PASMCs under low oxygen tension by inhibiting the increase in intracellular Ca2+ concentration, increasing bax expression and decreasing bcl-2 expression.
, http://www.100md.com
399-402
Effects of positive end-expiratory pressure on lung recruited volume and oxygenation in patients with acute respiratory distress syndrome
QIU Hai-bo, XU Hong-yang, YANG Yi, ZHOU Shao-xia, CHEN Yong-ming, SUN Hui-ming. Department of Critical Care Medicine, Zhongda Hospital and School of Clinical Medicine, Southeast University, Nanjing 210009, Jiangsu, China
OBJECTIVE: To access alveolar recruitment with positive end-expiratory pressure (PEEP) and to correlate the recruited volume with arterial oxygenation in acute respiratory distress syndrome (ARDS). METHODS: Eleven ventilated patients satisfying criteria of ARDS were included in the study group. Recruited volume of three different PEEP levels [5 cm H2O, 10 cm H2O, 15 cm H2O (1cm H2O =0.098 kPa)]were measured by pressure-volume curve method. Effects of different PEEP levels on lung mechanics and gas exchange were compared. RESULTS: Lung recruited volume elevated when PEEP increased from 5 cm H2O to 15 cm H2O[(40.2±15.3)ml vs. (123.8±43.1)ml vs. (178.9±43.5)ml, all P<0.05]. Arterial oxygenation index increased with PEEP and a positive correlation was found between recruited volume and changes in arterial oxygenation index (r=0.483, P<0.01). There was no significant difference during the static compliance at different PEEP levels at a fixed tidal volume (P>0.05). Recruited volume at PEEP 15 cm H2O in the patient group with lower inflection point (LIP) was larger than the group without LIP. CONCLUSION: Recruited volume increases with PEEP, and the PEEP-induced increase in arterial oxygenation is significantly correlated to recruited volume.
, http://www.100md.com
403-408
Relative functional changes in neutrophils in early period of acute lung injury in rabbit
WANG Shuo, NIE Xiu-hong, GUO De-yu, XIAO Han, REN Kui.
Respiratory Department, Xuanwu Hospital, Capital University of Medical Science, Beijing 100053, China
OBJECTIVE: To explore the relationship of interleukin-8 (IL-8), adherence function of neutrophil (PMN) and acute lung injury (ALI). METHODS: Eighteen male New Zealand rabbits were divided into two groups randomly: the control group (n=8) and the ALI group (n=10). The model of ALI was replicated by using intravenous lipopolysaccaride (LPS) in the rabbits of group ALI. Blood pressure, heart rate, blood gas analysis, hemogram, CD11b expression intensity on the surface of PMN, concentration of serum IL-8 and malondialdehyde (MDA) were measured at each time point. Specimens for pathology were obtained at the end of experiment. RESULTS: In group ALI, blood pressure, heart rate and pH declined obviously. PMN count was lowered obviously at 3 hours and increased at 6 hours to some extent. CD11b expression intensity on the surface of PMN, the concentration of serum IL-8 and MDA were increased progressively (all P<0.05). The main changes in the microscopic examination were inflammatory granulocyte infiltration, disseminated thickening of alveolar septa and focal hemorrhages. There were significant correlations between CD11b and IL-8 (r2=0.813， Y=26.729X), and between CD11b and the grades of pathological changes at 6 hours after intravenous LPS (r2=0.771， Y=0.011 02X+5.292). CONCLUSION: LPS could induce the release of large amount of IL-8, and it activates the expression of CD11b on the surface of PMN, which shows high degree of correlation with IL-8 and the degree of pathological changes in the lung. Therefore, both of them could serve as sensitive indexes for the diagnosis of ALI.
, 百拇医药
408
Establishment of outhospital first-aid process in the basement hospital
REN Xiang-mei, LI Xue-xian, GENG Shou-zhen, MU Xue-rong, YU Yong-mei
Yiyuan Traditional Chinese Medical Hospital, Zibo 256100, Shandong, China
409-412
Protective effect of specific antibody in serum of convalescent patient with SARS
, 百拇医药
LI Yong， XU Jun， MO Hong-ying， LAI Ke-fang， TAN Ya-xia， PI Xiang-ying, REN Xiao-lan， ZENG Guang-qiao， LIU Miao-fang， ZHONG Nan-shan. Guangzhou Institute of Respiratory Disease， Guangzhou 510120， Guangdong, China
OBJECTIVE: To investigate inhibitory effect of serum severe acute respiratory syndrome (SARS) -specific antibodies from convalescent patients after half an year of onset on SARS-CoⅤ-mediated cytopathic response.METHODS: SARS-CoⅤ immunoglobulin G (IgG) antibody was determinated by enzyme linked immunoadsorbent assay (ELISA).Twelve serum samples from convalescent patients， diluted by 1∶8 with maintenance medium, were mixed with the three dilution supernatants of SARS-CoⅤ. SARS-CoⅤ were isolated, cultured and identified by the Guangzhou Institute of Respiratory Disease, and cultured with Vero E6 cell suspension.The extent of cytopathic response was observed.RESULTS: The absorbance (A) value of SARS-CoⅤ IgG antibody ranged from 0.81 to 2.06 in patients after half an year of SARS onset，and form 0.79 to 2.01 in patients before half an year of SARS onset. The extent of cytopathic respone was decreased by more than 25% in all 12 convalescent patients， as compared with control serum. CONCLUSION:: The A value of SARS-CoⅤ IgG antibody in serum of convalescent patients tended to elevate in half an year after SARS onset. SARS-CoⅤ IgG antibody could inhibit SARS-CoⅤ-mediated cytopathic response，indicating it might be one of protective antibodies.
, 百拇医药
413-416
A comparison study on quantitative methods for the recruited volume in sheep with acute respiratory distress syndrome
XU Hong-yang, QIU Hai-bo, YANG Yi, ZHOU Shao-xia, SUN Hui-ming, CHEN Yong-ming.
Department of Critical Care Medicine, Zhongda Hospital and School of Clinical Medicine, Southeast University,Nanjing 210009, Jiangsu, China
OBJECTIVE: To compare equal pressure method with pressure-volume curve method to quantify the recruited volume. METHODS: Acute respiratory distress syndrome sheep model was induced by intravenous infusion 3 μg/kg lipopolysaccharide (LPS). Recruited volume of three different levels of positive end-expiratory pressure (PEEP=5, 10, 15 cm H2O) were measured both by pressure-volume curve method and by equal pressure method. RESULTS: The time needed to measure recruited volume by pressure-volume curve method was 5-6 minutes, which was longer than that of equal pressure method. Recruited volume measured by the two methods increased with PEEP. No significant difference was found between the recruited volume measured by equal pressure method and by equal pressure method at PEEP of 5 cm H2O, they were (25.79±20.48)ml vs. (63.26±54.57)ml (P>0.05), while recruited volume at PEEP of 10 cm H 2O and 15 cm H2O measured by equal pressure method were lower than those measured by the pressure-volume curve method, they were (48.64±30.51)ml vs. (148.14±85.42)ml and (71.50±58.09)ml vs. (322.86±148.42)ml (all P<0.05) respectively. CONCLUSION: Though equal pressure method is simple, it could not take the place of pressure-volume curve method to quantify recruited volume.
, 百拇医药
416
Factors related to airway stenosis of distal endotracheal tube and intubation dilatation
XU Si-cheng, HUANG Yi-fen.
MICU, Department of Pulmonology, First Clinical Hospital, Xinjiang Medical University, Urumqi 830000, China
417-420
Influence of salbutamol inhalation during volume target pressure control ventilation on ventilation parameters in patients with respiratory failure
, 百拇医药
CHEN Yu-qing, ZHAO Bing-qing, ZHOU Xin.
Department of Respiratory, Shanghai First People's Hospital, Jiaotong University, Shanghai 200080, China
OBJECTIVE: To compare the effects of volume target pressure control ventilation (VTPC) and volume control ventilation (VCV) on respiratory mechanics in patients with respiratory failure, and to investigate the effects of ventilated parameters after salbutamol inhalation. METHODS: Ten patients with mean age (68±5) years were intubated and mechanically ventilated for acute respiratory failure of diverse causes. After 30 minutes with VCV [tidal volume (VT) 8-10 ml/kg], measurements of respiratory mechanics were begun, and then the patients were ventilated with VTPC for 30 minutes. VCV and VTPC were repeated after salbutamol 600 μg inhalation. RESULTS: The static compliance (Cst) was (38.4±2.7)ml/cm H2O (1 cm H2O=0.098 kPa) and airway resistance (Raw) was (20.1±2.0)cm H2O·L-1·s-1 in 10 patients. With the same tidal volume, peak inspiratory pressure (PIP) and mean inspiratory flow [VT/inflation time (Tinflate)]during VTPC were lower, but peak inspiratory flow (PIF) was signify cantly higher than that during VCV (all P<0.05). The same plateau pressure (Pplat) was observed during VCV as during VTPC, they were (22.1±0.9)cm H2O vs. (23.0±1.2)cm H2O. After salbutamol inhalation, PIP and Raw were significantly decreased in all patients (both P<0.05), but no changes were found in Cst and Pplat. PIF and peak expiratory flow (PEF) were increased much more during two modes than before inhalation (both P<0.05), but Tinflate was decreased (P<0.05). CONCLUSION: VTPC is a new mechanical ventilation mode in which closed-loop control theory is used. The airway pressure during VTPC is associated with Cst and not influenced by Raw.
, 百拇医药
420
Intensive hemodialysis for emergency therapy of paraquat poisoning
LIU Bing, HAN Yu-ping, GAO Hua.
Hebei People’s Hospital, Shijiazhuang 050051, Hebei, China
421-423
Adjustment methods of proportional pressure support on weaning during acute aggravation in chronic respiratory failure patients with chronic obstructive pulmonary disease
, http://www.100md.com
WANG Shi-yong， ZHAN Chun, ZHANG Na-xin, QIN Ying-zhi， XU Lei.
Intensive Care Unit, Tianjin Third Center Hospital, Tianjin 300170，China
OBJECTIVE: To study the effects of two adjustment methods of proportional pressure support (PPS) on patients with acute aggravation in chronic respiratory failure of chronic obstructive pulmonary disease. METHODS: Seventy-five patients were randomized to two groups, 30 in proportional adjustment group and 45 in target adjustment group, respectively. Suitable flow assist (FA) and volume assist (VA) were adjusted with proportional adjustment and target adjustment methods respectively according to the ventilation parameters until the weaning of ventilation. RESULTS: There were no significant differences in resistance, elastic, FA as well as VA on weaning point, duration of mechanical ventilation, and successful weaning rate between the two groups (all P>0.05). CONCLUSION: The same aim and successful weaning rate could be gained in the target adjustment group compared with the proportional adjustment group. More clinical experience and more intensive care would be needed in the target adjustment group.
, 百拇医药
424-427
Treatment of acute respiratory distress syndrome using pressure and volume controlled ventilation with lung protective strategy
GE Ying, WAN Yong, WANG Da-qing, SU Xiao-lin, LI Jun-ying, CHEN Jing.
ICU, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China
OBJECTIVE: To investigate the significance and effect of pressure controlled ventilation (PCV) as well as volume controlled ventilation (VCV) by lung protective strategy on respiratory mechanics, blood gas analysis and hemodynamics in patients with acute respiratory distress syndrome (ARDS). METHODS: Fifty patients with ARDS were randomly divided into PCV and VCV groups with permissive hypercapnia and open lung strategy. Changes in respiratory mechanics, blood gas analysis and hemodynamics were compared between two groups. RESULTS: Peak inspiration pressure (PIP) in PCV group was significantly lower than that in VCV group, while mean pressure of airway (MPaw) was significantly higher than that in VCV after 24 hours mechanical ventilation. After 24 hours mechanical ventilation, there were higher central venous pressure (CVP) and slower heart rate (HR) in two groups, CVP was significantly higher in VCV compared with PCV, and PCV group had slower HR than VCV group, the two groups had no differences in mean blood pressure (MBP) at various intervals. All patients showed no ventilator-induced lung injury. Arterial blood oxygenations were obviously improved in two groups after 24 hours mechanical ventilation, PCV group had better partial pressure of oxygen in artery (PaO2) than VCV group. CONCLUSION: Both PCV and VCV can improve arterial blood oxygenations, prevent ventilator-induced lung injury, and have less disturbance in hemodynamic parameters. PCV with lung protective ventilatory strategy should be early use for patients with ARDS.
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427
Successful resuscitation in a patient with heroin-induced cardiac pulmonary arrest for 25 minutes by external defibrillation for 16 times
XIN Yong-tuan
Medical Emerency Centre of Xiamen, Xiamen 361004,Fujian, China
428-429
A retrospective study on 87 cases with severe acute respiratory syndrome
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MO Jian-kun, LIANG Shu-li, WANG Zhong-xin, WU Zheng-guang, LI Yong-xin, ZHANG Zhi.
Department of Clinical Laboratory Medicine, Guangdong Second People’s Hospital, Guangzhou 510310, Guangdong, China
430-431
Correlations of circulating lipoproteins to cytokines and their effects on prognosisis in patients with SIRS
LI Qian, SUN Ren-hua, YANG Xiang-hong, XU Yun-xiang.
, 百拇医药
ICU, Zhejiang People’s Hospital, Hangzhou 310014, Zhejiang, China
431
The nursing care experience in patients with multiple organ failure
XIA Xin-hua
Tianjin Tianhe Hospital, Tianjin 300050, China
432-433
Dynamic changes and significance of serum TNF-α, IL-8 levels in patients with acute respiratory distress syndrome after severe trauma
, 百拇医药
LANG Zhong-bing, WEN Liang, CHU Jun.
Department of Emergency, South-west Hospital, The Third Military Medical University, Chongqing 400038,china
433
The influence of body position on anesthesia duration following spinal anesthesia
XIE Li-mei, WANG Zhen-feng
The Third People’s Hospital of Qiannan Autonomous Prefecture, Qiannan 558000, Guizhou, China
, http://www.100md.com
434-435
Antegrade-Retregrade-Warm cardioplegia of myocardial protection in the serious heart valve disease
MU Rong, ZHOU Li-yuan
Department of Anesthesiology, Tianjin Tianhe Hospital, Tianjin 300050, China
436-437
Treatment for ARDS and hemerrhagic-traumatic shock in severe thoracic trauma
, 百拇医药 CHEN Xiao-xiong
Department of Emergency, Tongren Hospital, Calital University of Medical Science, Beijing 100730, China
438
Resistance of 300 strains of gram-negotive bacteria isolated from ventilator-associated pneumonia (VAP) in emergency intensive care unite (EICU)
ZHOU Ju-fen, JIANG Xu-hong
Hangzhou The First Hospital, Hangzhou 310006, Zhejiang, China
, 百拇医药
439-440
Common ventilator alarms and mechanical disfunction during mechanical ventilation (a report of 890 times)
XIA Wen-jun, JIANG Xue-ge, YU Sen-yang
General Hospital of PLA, Beijing 100853, China
440
Nonninvasive bi-level positive airway pressure ventilation in the treatment of 24 cases with acute pulmonary edema
, 百拇医药
HAN Yu-ping, LIU Bing, WANG Li-jun
Hebei People’s Hospital, Shijiazhuang 050051, Hebei, China
441-443
Noninvasive positive pressure ventilation in stable patients with chronic obstruction pulmonary disease
JIANG Hui, YU Sen-yang
Respiratory Department, General Hospital of PLA, Beijing 100853, china
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443
Ozagrl sodium and LMWH in tesating delayed edencephdopathy resulting from acute carbon monoxide poisoning
SUN Ming-liang, WANG Rong-xi, SU Chun-hua
Emergency Department of the People’s Hospital, Dezhou 253014, Shandong, China
444-446
Cell adhesion molecules and acute lung injury
JI Xian-fei, HUANG Liang
, http://www.100md.com
Department of Emergency, First Affiliated Hospital, Jiangxi Medical College, Nanchang 330006, Jiangxi, China
447-448
Trif:A new member of Toll-like receptor-associated signal transduction
WANG Tian-yi, WANG Jun-min, YAO Xi-xian
The Bethune International Peace Hospital, Shijiazhuang 050082, Hebei, China, 百拇医药