Search results for "Intensive Care Medicine"
showing 10 items of 2228 documents
Management of Patients With Aortic Dissection
2008
Cardiovascular diseases have become the leading cause of death in countries with high medical standards. Acute aortic syndromes—particularly acute aortic dissection—are playing an increasingly important part in this development (1). Acute aortic dissection has an extremely high mortality rate after the occurrence of an initial manifestation, so a standardized treatment algorithm is crucial for patient survival. On the basis of selected recent publications, the aim of this study was to review the current status of the management of aortic dissection and formulate recommendations for treatment.
Heart valve tissue engineering: how far is the bedside from the bench?
2015
Heart disease, including valve pathologies, is the leading cause of death worldwide. Despite the progress made thanks to improving transplantation techniques, a perfect valve substitute has not yet been developed: once a diseased valve is replaced with current technologies, the newly implanted valve still needs to be changed some time in the future. This situation is particularly dramatic in the case of children and young adults, because of the necessity of valve growth during the patient's life. Our review focuses on the current status of heart valve (HV) therapy and the challenges that must be solved in the development of new approaches based on tissue engineering. Scientists and physicia…
Arterial and mixed venous blood gas status during apnoea of intubation--proof of the Christiansen-Douglas-Haldane effect in vivo.
1989
The Christiansen-Douglas-Haldane effect, in short the Haldane effect, describes the dependence of the CO2 binding of blood on the degree of oxygenation of haemoglobin. Under the physiological conditions of an ‘open’ system between blood and alveoli the partial pressure of arterial C02 (PaCO2), must be less than that of mixed venous blood (P[Formula: see text]CO2). During the unphysiological conditions of a ‘closed’ system, e.g. hyperoxic apnoea, i.e. continuous oxygen uptake without CO2 delivery by the lungs, the Paco2 will not only approximate the P[Formula: see text]CO2 but will even exceed it. Without the Haldane effect, rapid adjustment of Paco2 to P[Formula: see text]CO2 would be expe…
Extra Corporeal Oxygenation & Ozonation, EBOO & AQUAPHERESIS method of Ozone Therapy, Clinical Application in Chronic Diseases [abstract]
2018
Introduction: The top 10 causes of death around the world are usually ranked with heart diseases, cancers, drugs/medication/iatrogenic chemicals, strokes etc. These are totally detectable, predictable, avoidable, preventable because it is classified as non-communicable diseases. Acute diseases are denoted by acute inflammation which has intensive cell-cell communications, resulting intensive repair rebuilding rehabilitation and it is life extending. Often it is self defensive and we over come it. The real culprit for chronic diseases is chronic inflammations, denoted by constant & silent, undetectable & insensible lost of cell-cell signaling, basement membrane disease, tight junctio…
Arterial hypertension in cancer: The elephant in the room
2019
The great therapeutical success achieved by oncology is counterbalanced by growing evidences of cardiovascular (CV) toxicity due to many antineoplastic treatments. Cardiac adverse events may cause premature discontinuation of effective oncologic treatments or occur as late events undermining the oncologic success. Arterial hypertension is both the most common comorbidity in cancer patients and a frequent adverse effect of anticancer therapies. A pre-existing hypertension is known to increase the risk of other cardiac adverse events due to oncologic treatments, in particular heart failure. Moreover, as a strict association between cancer and CV diseases has emerged over the recent years, var…
European society of hypertension position paper on ambulatory blood pressure monitoring
2013
Ambulatory blood pressure monitoring (ABPM) is being used increasingly in both clinical practice and hypertension research. Although there are many guidelines that emphasize the indications for ABPM, there is no comprehensive guideline dealing with all aspects of the technique. It was agreed at a consensus meeting on ABPM in Milan in 2011 that the 34 attendees should prepare a comprehensive position paper on the scientific evidence for ABPM.This position paper considers the historical background, the advantages and limitations of ABPM, the threshold levels for practice, and the cost-effectiveness of the technique. It examines the need for selecting an appropriate device, the accuracy of dev…
Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation
2012
Introduction. Circulatory failure secondary to hypovolemia is a common situation in critical care patients. Volume replacement is the first option for the treatment of hypovolemia. A possible complication of volume loading is pulmonary edema, quantified at the bedside by the measurement of extravascular lung water index (ELWI). ELWI predicts progression to acute lung injury (ALI) in patients with risk factors for developing it. The aim of this study was to assess whether fluid loading guided by the stroke volume variation (SVV), in patients presumed to be hypovolemic, increased ELWI or not.Methods. Prospective study of 17 consecutive postoperative, fully mechanically ventilated patients dia…
Illumination Correction on MR Images
2006
Objective. An important artifact corrupting Magnetic Resonance Images is the rf inhomogeneity, also called bias artifact. This anomaly produces an abnormal illumination fluctuation on the image, due to variations of the device magnetic field. This artifact is particularly strong on images acquired with a device specialized on upper and lower limbs due to their coil configuration. A method based on homomorphic filtering aimed to suppress this artifact was proposed by Guillemaud. This filter has two faults: it doesnt provide an indication about the cutoff frequency (cf) and introduces another illumination artifact on the edges of the foreground. This work is an improvement to this method because i…
The AVL-mode: a safe closed loop algorithm for ventilation during total intravenous anesthesia.
1994
The Adaptive Lung Ventilation Controller (ALV-Controller) represents a new approach to closed loop control of ventilation. It is based on a pressure controlled ventilation mode. Adaptive lung ventilation signifies automatic breath by breath adaptation of breathing patterns to the lung mechanics of an individual patient. The specific goals are to minimize work of breathing, to maintain a preset alveolar ventilation and to prevent the occurrence of intrinsic PEEP. We ventilated 5 patients undergoing major abdominal procedures using ALV. ALV was tolerated well in all patients. Alveolar ventilation was preset between 5500 and 6500 ml/min. Serial dead space (Vds) and respiratory time constant (r…
Successful treatment of a patient with ARDS after pneumonectomy using high-frequency oscillatory ventilation.
1999
High frequency oscillatory ventilation (HFOV) was used in a patient who developed the acute respiratory distress syndrome 5 days following a right pneumonectomy for bronchogenic carcinoma. When conventional pressure-controlled ventilation failed to maintain adequate oxygenation, HFOV dramatically improved oxygenation within the first few hours of therapy. Pulmonary function and gas exchange recovered during a 10-day period of HFOV. No negative side effects were observed. Early use of HFOV may be a beneficial ventilation strategy for adults with acute pulmonary failure, even in the postoperative period after lung resection.