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A Net

Publications and source records attributed to A Net.

62 records · Page 4Linked to original sources
PubMed1986

Effect of intrinsic positive end-expiratory pressure on respiratory compliance.

We evaluated the influence of intrinsic positive end-expiratory pressure (PEEPi) on the measurement of static respiratory compliance in 15 adult patients with acute respiratory failure under mechanical ventilation. Modifying the inspiratory/expiratory ratio from 1:2 to 2:1, and the respiratory frequency from 15 to 20 and 25 breath/min significantly changed compliance values. Because PEEPi can increase the work of breathing, we suggest adjusting ventilatory variables to minimize PEEPi.

Adult↗
PubMed1986

Massive pulmonary embolism: short-term effects of thrombolytic treatment.

This study assessed the short-term effects of thrombolytic treatment in 38 patients with massive pulmonary embolism. Thirty-two were treated with streptokinase and six with urokinase. Intrapulmonary artery instillation of fibrinolytic agents was utilized except in 3 patients. There was a marked hemodynamic and arteriographic improvement (p less than 0.0005) in 33 patients (86.8%). Four patients (10.5%) died because of treatment failure. In these cases the fibrinogen concentration remained above 1 gr/liter during therapy. Bleeding was detected in 22 patients (57.8%) but was most often related to puncture or cut-down sites, and only 2 patients (5.2%) had major bleeding. One patient (2.6%) had cerebral hemorrhage. It is concluded that "classic" thrombolytic treatment is to be chosen in life-threatening pulmonary embolism. However, the difficulties sometimes encountered in producing an intense lytic effect and its low fibrinolytic specificity for the thrombus do not permit the obtainment of better results.

Acute Disease↗
PubMed1986

Post-neurosurgical and spontaneous gram-negative bacillary meningitis in adults.

In order to evaluate the clinical aspects of gram-negative bacillary meningitis (GNBM) we reviewed the charts of 20 adult patients with the discharge diagnosis of meningitis caused by gram-negative bacilli (bacteriologically proved) seen between 1973 and 1984. Nine patients had post-neurosurgical (post-NS) GNBM and 11 patients spontaneous (S) GNBM; the mean age of the former was 42 +/- 16 years and of the latter 56 +/- 14 years (p less than 0.05). The overall mortality rate was 50% (33% in the post-NS group and 64% in the S group). The glucose levels in CSF were significantly lower in the patients who died. Patients treated with combined aminoglycoside therapy presented a lower mortality rate than those treated with intravenous aminoglycoside only (25% versus 70%). We suggest that if aminoglycoside therapy is employed, these antibiotics must be administered both intravenously and directly into CNS.

Adult↗
PubMed1983

Erroneous interpretation of pulmonary capillary wedge pressure in massive pulmonary embolism.

Pulmonary capillary wedge pressure (WP) values obtained after catheterization of a pulmonary artery (PA) totally occluded by thrombus may be erroneously interpreted. The left lower lobe PA was catheterized in 13 anesthetized dogs. Measurements of mean pulmonary artery pressure (MPAP) and WP were performed before and after total occlusion of the PA by a clamp located 1 cm from the tip of the catheter. There was a difference between pulmonary artery occluded pressure (PAoP), MPAP, and WP, both in normovolemic and overload conditions (p less than .01). The PAoP was not equivalent either to WP or to MPAP. In massive pulmonary embolism, WP may not reflect left ventricular end-diastolic pressure (LVEDP).

Animals↗
PubMed1981

[Left ventricular function. Study during artificial ventilation with PEEP in the dog (author's transl)].

According to Powers et collaborators the hypothesis that intramyocardial vessels may be collapsed in artificially ventilated patient with added PEEP, could be arisen. So, myocardial ischemia may explain why in some of those ones there appear signs of left ventricular failure. To test whether this reasoning was correct we measured LVEDP in normal dogs submitted to increasing levels of PEEP up to 40 cm H2O. Our results seem to point towards the following conclusions: a) In normal dogs, Starling relation is not altered and remains within the same hypercontractility pattern. b) As PEEP increases, ventricular function remains within the same curve up to 30 cm H2O and jumps to a higher contractility curve at 40 cm H2O of PEEP. All of this would suggest that under our experimental conditions it does not seem reasonable to assume the existence of left ventricular failure due to PEEP influence.

Animals↗
PubMedDate not supplied

[Disseminated infection caused by Trichosporon beigelii in a patient with acute leukemia].

We report a case of disseminated infection produced by Trichosporon beigelii in a woman with acute leukemia and we review the cases described in the literature. In our patient the agent was isolated in the blood and in the bronchoalveolar aspirate. The infection was detected at the time the patient was under granulocytopenia produced by cytostatic therapy with involvement of the bones, kidney, lung, and skin. Although this mycotic agent is commonly sensitive in vitro to amphotericin B, there is not experience enough to recommend it and the mortality is high. Infection by Trichosporon beigelii should be considered in the differential diagnosis of patients with granulocytopenia and infection. This might contribute to improve the prognosis of the disease since and appropriate diagnosis and treatment would be established.

Adult↗