| 1. |
|
|
| 2. |
- Andersson, Bertil, et al.
(författare)
-
End-expiratory lung volume and ventilation distribution with different continuous positive airway pressure systems in volunteers.
- 2011
-
Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:2, s. 157-64
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Continuous positive airway pressure (CPAP) has been shown to improve oxygenation and a number of different CPAP systems are available. The aim of this study was to assess lung volume and ventilation distribution using three different CPAP techniques. Methods: A high-flow CPAP system (HF-CPAP), an ejector-driven system (E-CPAP) and CPAP using a Servo 300 ventilator (V-CPAP) were randomly applied at 0, 5 and 10 cmH2O in 14 volunteers. End-expiratory lung volume (EELV) was measured by N2 dilution at baseline; changes in EELV and tidal volume distribution were assessed by electric impedance tomography. Results: Higher end-expiratory and mean airway pressures were found using the E-CPAP vs. the HF-CPAP and the V-CPAP system (P<0.01). EELV increased markedly from baseline, 0 cmH2O, with increased CPAP levels: 1110±380, 1620±520 and 1130±350 ml for HF-, E- and V-CPAP, respectively, at 10 cmH2O. A larger fraction of the increase in EELV occurred for all systems in ventral compared with dorsal regions (P<0.01). In contrast, tidal ventilation was increasingly directed toward dorsal regions with increasing CPAP levels (P<0.01). The increase in EELV as well as the tidal volume redistribution were more pronounced with the E-CPAP system as compared with both the HF-CPAP and the V-CPAP systems (P<0.05) at 10 cmH2O. Conclusion: EELV increased more in ventral regions with increasing CPAP levels, independent of systems, leading to a redistribution of tidal ventilation toward dorsal regions. Different CPAP systems resulted in different airway pressure profiles, which may result in different lung volume expansion and tidal volume distribution.
|
|
| 3. |
- Grivans, Christina, 1963, et al.
(författare)
-
Positive end-expiratory pressure-induced changes in end-expiratory lung volume measured by spirometry and electric impedance tomography.
- 2011
-
Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:9, s. 1068-77
-
Tidskriftsartikel (refereegranskat)abstract
- A bedside tool for monitoring changes in end-expiratory lung volume (ΔEELV) would be helpful to set optimal positive end-expiratory pressure (PEEP) in acute lung injury/acute respiratory distress syndrome patients. The hypothesis of this study was that the cumulative difference of the inspiratory and expiratory tidal volumes of the first 10 breaths after a PEEP change accurately reflects the change in lung volume following a PEEP alteration.
|
|
| 4. |
- Lowhagen, Karin, 1973, et al.
(författare)
-
A new non-radiological method to assess potential lung recruitability: a pilot study in ALI patients.
- 2011
-
Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:2, s. 165-74
-
Tidskriftsartikel (refereegranskat)abstract
- Potentially recruitable lung has been assessed previously in patients with acute lung injury (ALI) by computed tomography. A large variability in lung recruitability was observed between patients. In this study, we assess whether a new non-radiological bedside technique could determine potentially recruitable lung volume (PRLV) in ALI patients.
|
|
| 5. |
- Lowhagen, Karin, 1973, et al.
(författare)
-
Prolonged moderate pressure recruitment manoeuvre results in lower optimal positive end-expiratory pressure and plateau pressure.
- 2011
-
Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:2, s. 175-84
-
Tidskriftsartikel (refereegranskat)abstract
- In acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), recruitment manoeuvres (RMs) are used frequently. In pigs with induced ALI, superior effects have been found using a slow moderate-pressure recruitment manoeuvre (SLRM) compared with a vital capacity recruitment manoeuvre (VICM). We hypothesized that the positive recruitment effects of SLRM could also be achieved in ALI/ARDS patients. Our primary research question was whether the same compliance could be obtained using lower RM pressure and subsequent positive end-expiratory pressure (PEEP). Secondly, optimal PEEP levels following the RMs were compared, and the use of volume-dependent compliance (VDC) to identify successful lung recruitment and optimal PEEP was evaluated.
|
|
| 6. |
|
|
| 7. |
- Lundin, Stefan, 1953, et al.
(författare)
-
Electrical impedance tomography: potentials and pitfalls.
- 2012
-
Ingår i: Current opinion in critical care. - 1531-7072. ; 18:1, s. 35-41
-
Tidskriftsartikel (refereegranskat)abstract
- Electrical impedance tomography (EIT) is a useful noninvasive tool for monitoring ventilation finding its way into the clinical setting. The focus of this review is to discuss the balance between the potential for EIT as a clinical monitor accepting a level of uncertainty and the scientific demand for absolute perfection.
|
|
| 8. |
- Olegård, Cecilia, 1967, et al.
(författare)
-
Validation and clinical feasibility of nitrogen washin/washout functional residual capacity measurements in children.
- 2010
-
Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 54:3, s. 370-6
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The functional residual capacity (FRC) is an important parameter in pediatric respiratory monitoring but it is difficult to assess in the clinical setting. We have introduced a modified N(2) washout method utilizing a change of F(I)O(2) of 0.1 for FRC measurement in adult respiratory monitoring. This study validated the algorithm in a pediatric lung model and investigated the stability and feasibility in a pediatric peri-operative and intensive care setting. METHODS: The lung model was ventilated in combinations of ventilatory modes, CO(2) production, model FRC and respiratory rates. Sixteen children from 10 days to 5 years were studied peri-operatively with controlled ventilation using a Mapleson D system and in the intensive care unit using a Servo-i ventilator in a supported spontaneous mode. FRC was measured during stable metabolic, respiratory and circulatory periods at positive end expiratory pressure of 3-4 and 7-8 cmH(2)O. RESULTS: In the model and in the clinical setting, we found an excellent agreement between washout and washin measurements of FRC as well as acceptable coefficients of repeatability. CONCLUSION: FRC was satisfactorily measured by a modified N(2) algorithm and may be included as a monitoring variable in pediatric respiratory care. Pediatric FRC monitoring demands strictly stable conditions as measurements are performed close to the limits of the monitor's specifications.
|
|
| 9. |
- Sand, Lena, et al.
(författare)
-
Effect of patient position and PEEP on hepatic, portal and central venous pressures during liver resection.
- 2011
-
Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:9, s. 1106-12
-
Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that blood loss during liver resection may be reduced if central venous pressure (CVP) is kept at a low level. This can be achieved by changing patient position but it is not known how position changes affect portal (PVP) and hepatic (HVP) venous pressures. The aim of the study was to assess if changes in body position result in clinically significant changes in these pressures.
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Ulrich, Roger, 1946, et al.
(författare)
-
Towards a design theory for reducing aggression in psychiatric facilities
- 2012
-
Ingår i: ARCH 12: ARCHITECTURE / RESEARCH / CARE / HEALTH. 12/11/2012 → 14/11/2012. Gothenburg.. ; , s. 12-
-
Konferensbidrag (refereegranskat)abstract
- The paper proposes a tentative theory for designing psychiatric environments to foster reduced aggression and violence. A basic premise underlying the design theory is that environmental and psycho-social stressors mediate and trigger aggression. The theory posits that aggression will be reduced if the facility has been designed with an evidence-based bundle of stress-reducing environmental characteristics that are identified and discussed. To make possible a tentative empirical evaluation of the theory, findings are described from a study that compared aggressive incidents in three Swedish psychiatric hospitals of different design. A newer hospital was evaluated as superior to both an old hospital it replaced and another comparison hospital (control) with respect to having nearly all the environmental features identified in the stress-reducing bundle of the design theory. Findings from restraint use data were consistent with the design theory prediction that aggression would be lower in the newer hospital having several stress-reducing environmental features than in either the old or control hospitals. The use of chemical and physical restraints decreased substantially in the new hospital compared to the old hospital it replaced. By contrast, restraint use increased in the control hospital that cared for comparable psychiatric patients according to similar treatment protocols during the same period. The design theory and preliminary findings suggest the possibility that providing better psychiatric buildings with design guided by the best available evidence and theory can play an important role in reducing the serious patient and staff safety problem of aggressive behavior.
|
|
