The Experts below are selected from a list of 267 Experts worldwide ranked by ideXlab platform
G Schmalisch - One of the best experts on this subject based on the ideXlab platform.
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functional Residual Capacity measurement by heptafluoropropane in ventilated newborn lungs in vitro and in vivo validation
Critical Care Medicine, 2006Co-Authors: Hans Proquitte, Ariane Kusztrich, Volker Auwarter, Fritz Pragst, Roland R Wauer, G SchmalischAbstract:Objective: Heptafluoropropane is an inert gas commercially used as propellant for inhalers. Since heptafluoropropane can be detected in low concentrations, it could also be used as a tracer gas to measure functional Residual Capacity and ventilation homogeneity. The aim of the present study was to validate functional Residual Capacity measurements by heptafluoropropane wash-in/wash-out (0.8%) during mechanical ventilation in small, surfactant-depleted lungs using a newborn piglet model. Design: Prospective laboratory and animal trial. Setting: Animal laboratory in a university setting. Subjects: Sixteen newborn piglets (age <12 hrs, median weight 1390 g [705-4200 g]) before and after surfactant depletion (Pao 2 <100 torr in Fio 2 = 1.0) by lung lavage. Interventions: Heptafluoropropane was measured with a new infrared mainstream sensor connected with the flow sensor of the Drager Babylog 8000. Accuracy and precision of the measurement technique were tested in a mechanical lung model with a volume range from 11 to 35 mL. Reproducibility of the method and its sensitivity to detect changes of functional Residual Capacity were assessed in vivo by variation of ventilatory variables. Measurements and Main Results: In vitro the absolute error of functional Residual Capacity was <1 mL (relative errors <3%) with a coefficient of variation <4%. The coefficient of variation of consecutive in vivo measurements was only slightly higher (<5.1%). Measurement of heptafluoropropane concentrations in blood showed no significant accumulation for repeated functional Residual Capacity measurements within short time periods. After lung lavage, the functional Residual Capacity decreased from 20.9 mL/kg to 14.5 mL/kg (p <.05) despite increased ventilatory pressures, and lung clearance index (p <.001) and moment ratios (p <.01) increased significantly due to uneven alveolar ventilation. In healthy lungs, the increase in peak inflation pressure and positive end-expiratory pressure by 3-4 cm H 2 O had only a moderate effect on functional Residual Capacity (20.9 ± 8.6 vs. 26.0 ±11.9 mL/kg, p =.17) and no effect on ventilatory homogeneity, whereas in surfactant-depleted lungs the functional Residual Capacity increased from 14.5 ± 6.7 mL/kg to 29.9 ± 12.6 mL/kg (p <.001) and lung clearance index and moment ratios decreased significantly (p <.01). Conclusions: Heptafluoropropane is a suitable tracer gas for precise functional Residual Capacity measurements tested in vitro and allows for reproducible measurements in ventilated small lungs without any adverse effects on mechanical ventilation. The sensitivity of the method is sufficiently high to demonstrate the effect of changes in ventilatory settings on the functional Residual Capacity and ventilation homogeneity.
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Functional Residual Capacity measurement by heptafluoropropane in ventilated newborn lungs: in vitro and in vivo validation.
Critical Care Medicine, 2006Co-Authors: Hans Proquitte, Ariane Kusztrich, Volker Auwarter, Fritz Pragst, Roland R Wauer, G SchmalischAbstract:Objective: Heptafluoropropane is an inert gas commercially used as propellant for inhalers. Since heptafluoropropane can be detected in low concentrations, it could also be used as a tracer gas to measure functional Residual Capacity and ventilation homogeneity. The aim of the present study was to validate functional Residual Capacity measurements by heptafluoropropane wash-in/wash-out (0.8%) during mechanical ventilation in small, surfactant-depleted lungs using a newborn piglet model. Design: Prospective laboratory and animal trial. Setting: Animal laboratory in a university setting. Subjects: Sixteen newborn piglets (age
Wolfgang Eichler - One of the best experts on this subject based on the ideXlab platform.
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Functional Residual Capacity-guided alveolar recruitment strategy after endotracheal suctioning in cardiac surgery patients.
Critical Care Medicine, 2011Co-Authors: Hermann Heinze, Wolfgang Eichler, J Karsten, Beate Sedemund-adib, Matthias Heringlake, Torsten MeierAbstract:Objective:To determine whether the results of functional Residual Capacity measurements after endotracheal suctioning could guide the decision to perform an alveolar recruitment maneuver and thus improve lung function.Design:Prospective, randomized, controlled interventional study.Setting:Intensive
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Functional Residual Capacity changes after different endotracheal suctioning methods.
Anesthesia & Analgesia, 2008Co-Authors: Hermann Heinze, Beate Sedemund-adib, Matthias Heringlake, Ulrich W. Gosch, Wolfgang EichlerAbstract:BACKGROUND: Our primary objective was to investigate the effects of three different endotracheal suctioning procedures on functional Residual Capacity (FRC). METHODS: Using a crossover design, postoperative cardiac surgery patients (n = 20) received three different suctioning methods in randomized order: closed suctioning during pressure-controlled ventilation, closed suctioning during volume-controlled ventilation, and open suctioning. FRC was measured before and 20 min after the intervention. RESULTS AND CONCLUSIONS: FRC is reduced in postcardiac surgery patients after suctioning, regardless of which method is used. Certain patients may have very pronounced changes of FRC. Routine FRC measurements could complement respiratory monitoring to optimize respiratory therapy.
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The accuracy of the oxygen washout technique for functional Residual Capacity assessment during spontaneous breathing.
Anesthesia & Analgesia, 2007Co-Authors: Hermann Heinze, Bernhard Schaaf, Jochen Grefer, Karl Friedrich Klotz, Wolfgang EichlerAbstract:BACKGROUND:Measurement of functional Residual Capacity (FRC) is of considerable interest for monitoring patients with lung injury. The lack of instruments has impeded routine bedside FRC measurement. Recently, a simple automated method for FRC assessment by O2 washout has been introduced. We designe
Diederik Gommers - One of the best experts on this subject based on the ideXlab platform.
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functional Residual Capacity and absolute lung volume
Current Opinion in Critical Care, 2014Co-Authors: Diederik GommersAbstract:Purpose of Review: To discuss the role of measuring functional Residual Capacity (FRC) during mechanical ventilation to improve patient ventilator settings in order to prevent ventilator-induced lung injury. Recent Findings: Nowadays, FRC can be measured without the use of tracer gases and without disconnection from the ventilator. It is shown that FRC can provide additional information to optimize the ventilator setting; for example, FRC measurements can differentiate between responders and nonresponders after a recruitment maneuver, and in combination with dynamic compliance one can differentiate between recruitment and overdistention during a positive end-expiratory pressure trial. In addition, FRC measurements enable not only to estimate stress and strain at the bedside, but also to estimate ventilation inhomogeneity. Summary: In conclusion, measuring FRC could be extremely valuable during mechanical ventilation, but clinical studies are needed to prove whether this technique will improve outcome.
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Functional Residual Capacity measurements during mechanical ventilation in ICU patients
Critical Care, 2008Co-Authors: Ido G. Bikker, J Van Bommel, D. Dos Reis Miranda, Diederik GommersAbstract:The level of positive end-expiratory pressure (PEEP) is important to avoid ventilator-induced lung injury (VILI) by preventing alveolar collapse and alveolar overdistension. One of the mechanisms of application of optimal PEEP could be measurement of the functional Residual Capacity or end-expiratory lung volume (EELV) in mechanically ventilated patients. Recently, GE Healthcare introduced a multibreath open-circuit nitrogen technique to measure the EELV during mechanical ventilation. The aim of this study was to measure the EELV levels at three different PEEP levels in ventilated patients with different diseases.
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Open lung ventilation improves functional Residual Capacity after extubation in cardiac surgery.
Critical Care Medicine, 2005Co-Authors: Dinis Reis Miranda, Ard Struijs, Peter M. Koetsier, Robert J. Van Thiel, Ronald M. Schepp, Wim C. J. Hop, Jan Klein, Burkhard Lachmann, Ad J.j.c. Bogers, Diederik GommersAbstract:Objective:After cardiac surgery, functional Residual Capacity (FRC) after extubation is reduced significantly. We hypothesized that ventilation according to the open lung concept (OLC) attenuates FRC reduction after extubation.Design:A prospective, single-center, randomized, controlled clinical stud
Hans Proquitte - One of the best experts on this subject based on the ideXlab platform.
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functional Residual Capacity measurement by heptafluoropropane in ventilated newborn lungs in vitro and in vivo validation
Critical Care Medicine, 2006Co-Authors: Hans Proquitte, Ariane Kusztrich, Volker Auwarter, Fritz Pragst, Roland R Wauer, G SchmalischAbstract:Objective: Heptafluoropropane is an inert gas commercially used as propellant for inhalers. Since heptafluoropropane can be detected in low concentrations, it could also be used as a tracer gas to measure functional Residual Capacity and ventilation homogeneity. The aim of the present study was to validate functional Residual Capacity measurements by heptafluoropropane wash-in/wash-out (0.8%) during mechanical ventilation in small, surfactant-depleted lungs using a newborn piglet model. Design: Prospective laboratory and animal trial. Setting: Animal laboratory in a university setting. Subjects: Sixteen newborn piglets (age <12 hrs, median weight 1390 g [705-4200 g]) before and after surfactant depletion (Pao 2 <100 torr in Fio 2 = 1.0) by lung lavage. Interventions: Heptafluoropropane was measured with a new infrared mainstream sensor connected with the flow sensor of the Drager Babylog 8000. Accuracy and precision of the measurement technique were tested in a mechanical lung model with a volume range from 11 to 35 mL. Reproducibility of the method and its sensitivity to detect changes of functional Residual Capacity were assessed in vivo by variation of ventilatory variables. Measurements and Main Results: In vitro the absolute error of functional Residual Capacity was <1 mL (relative errors <3%) with a coefficient of variation <4%. The coefficient of variation of consecutive in vivo measurements was only slightly higher (<5.1%). Measurement of heptafluoropropane concentrations in blood showed no significant accumulation for repeated functional Residual Capacity measurements within short time periods. After lung lavage, the functional Residual Capacity decreased from 20.9 mL/kg to 14.5 mL/kg (p <.05) despite increased ventilatory pressures, and lung clearance index (p <.001) and moment ratios (p <.01) increased significantly due to uneven alveolar ventilation. In healthy lungs, the increase in peak inflation pressure and positive end-expiratory pressure by 3-4 cm H 2 O had only a moderate effect on functional Residual Capacity (20.9 ± 8.6 vs. 26.0 ±11.9 mL/kg, p =.17) and no effect on ventilatory homogeneity, whereas in surfactant-depleted lungs the functional Residual Capacity increased from 14.5 ± 6.7 mL/kg to 29.9 ± 12.6 mL/kg (p <.001) and lung clearance index and moment ratios decreased significantly (p <.01). Conclusions: Heptafluoropropane is a suitable tracer gas for precise functional Residual Capacity measurements tested in vitro and allows for reproducible measurements in ventilated small lungs without any adverse effects on mechanical ventilation. The sensitivity of the method is sufficiently high to demonstrate the effect of changes in ventilatory settings on the functional Residual Capacity and ventilation homogeneity.
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Functional Residual Capacity measurement by heptafluoropropane in ventilated newborn lungs: in vitro and in vivo validation.
Critical Care Medicine, 2006Co-Authors: Hans Proquitte, Ariane Kusztrich, Volker Auwarter, Fritz Pragst, Roland R Wauer, G SchmalischAbstract:Objective: Heptafluoropropane is an inert gas commercially used as propellant for inhalers. Since heptafluoropropane can be detected in low concentrations, it could also be used as a tracer gas to measure functional Residual Capacity and ventilation homogeneity. The aim of the present study was to validate functional Residual Capacity measurements by heptafluoropropane wash-in/wash-out (0.8%) during mechanical ventilation in small, surfactant-depleted lungs using a newborn piglet model. Design: Prospective laboratory and animal trial. Setting: Animal laboratory in a university setting. Subjects: Sixteen newborn piglets (age
Hermann Heinze - One of the best experts on this subject based on the ideXlab platform.
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Functional Residual Capacity-guided alveolar recruitment strategy after endotracheal suctioning in cardiac surgery patients.
Critical Care Medicine, 2011Co-Authors: Hermann Heinze, Wolfgang Eichler, J Karsten, Beate Sedemund-adib, Matthias Heringlake, Torsten MeierAbstract:Objective:To determine whether the results of functional Residual Capacity measurements after endotracheal suctioning could guide the decision to perform an alveolar recruitment maneuver and thus improve lung function.Design:Prospective, randomized, controlled interventional study.Setting:Intensive
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Functional Residual Capacity changes after different endotracheal suctioning methods.
Anesthesia & Analgesia, 2008Co-Authors: Hermann Heinze, Beate Sedemund-adib, Matthias Heringlake, Ulrich W. Gosch, Wolfgang EichlerAbstract:BACKGROUND: Our primary objective was to investigate the effects of three different endotracheal suctioning procedures on functional Residual Capacity (FRC). METHODS: Using a crossover design, postoperative cardiac surgery patients (n = 20) received three different suctioning methods in randomized order: closed suctioning during pressure-controlled ventilation, closed suctioning during volume-controlled ventilation, and open suctioning. FRC was measured before and 20 min after the intervention. RESULTS AND CONCLUSIONS: FRC is reduced in postcardiac surgery patients after suctioning, regardless of which method is used. Certain patients may have very pronounced changes of FRC. Routine FRC measurements could complement respiratory monitoring to optimize respiratory therapy.
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The accuracy of the oxygen washout technique for functional Residual Capacity assessment during spontaneous breathing.
Anesthesia & Analgesia, 2007Co-Authors: Hermann Heinze, Bernhard Schaaf, Jochen Grefer, Karl Friedrich Klotz, Wolfgang EichlerAbstract:BACKGROUND:Measurement of functional Residual Capacity (FRC) is of considerable interest for monitoring patients with lung injury. The lack of instruments has impeded routine bedside FRC measurement. Recently, a simple automated method for FRC assessment by O2 washout has been introduced. We designe
