ABSTRACT
BACKGROUND: The aim of this study was to evaluate the interest of end expiratory volume (EELV) measurement after cardiac surgery. METHODS: After stabilization, four EELV measurements were performed at one hour intervals during three hours using the nitrogen washout technique. EELV was compared to the predicted functional residual capacity (FRC) volume. The relationships between EELV and static compliance of the respiratory system, the PaO2/FiO2 ratio and the body mass index were studied. In addition, a recruitment maneuver was performed using a fixed 45 cm H2O pressure control ventilation during 2 minutes between the second and third EELV measurement in half of the patients. Forty one patients were enrolled and 21 of them received the recruitment maneuver (RM). RESULTS: Measured EELV corresponded to 52% of the predicted value. It remained stable during the whole study period. EELV correlated well with the PaO2/FiO2 ratio (r2 = 0.40, p <0.0001) and with compliance of the respiratory system (r2 = 0.525, p < 0.0001). EELV was inversely correlated to the body mass index (r2 = 0.165, p = 0.008). RM did not significantly improve EELV. CONCLUSIONS: EELV is profoundly reduced after cardiac surgery. Measuring EELV is a new tool that is now available during mechanical ventilation. It seems to bring some new robust and possibly useful information. Recruitment maneuvers using sighs does not modify this volume.
Subject(s)
Cardiac Surgical Procedures/methods , Lung Volume Measurements/methods , Postoperative Care/methods , Aged , Airway Extubation , Body Mass Index , Female , Hemodynamics/physiology , Humans , Length of Stay , Lung Compliance/physiology , Male , Middle Aged , Oxygen/blood , Respiration, ArtificialABSTRACT
A 80-year-old European woman was admitted for a cardiac syndrome which mimics acute coronary insufficiency, with apical akinesis and basal hyperkinesis. The first description of this syndrome (Tako-Tsubo cardiomyopathy) was reported in Japanese patients in the 90's. Recently this reversible left ventricular cardiomyopathy was also described in USA and Europe in white patients. This cardiomyopathy often develops in older women, after emotional or physical stress. The etiology remains unknown.
Subject(s)
Cardiomyopathies/diagnosis , Ventricular Dysfunction, Left/diagnosis , Aged, 80 and over , Coronary Angiography , Diagnosis, Differential , Echocardiography , Electrocardiography , Female , Humans , Myocardial Ischemia/diagnosisABSTRACT
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia and it is also a common cause of sinusitis, otitis media, bacteremia and meningitis. The increasing resistance to antimicrobial agents, now endemic in many countries, reflects an uncontrolled use of antibiotics. A good antibiotics policy and vaccination are at the moment the only way to control efficaciously the increasing antibiotic resistance of Streptococcus pneumoniae.
Subject(s)
Drug Resistance, Bacterial , Pneumococcal Infections/drug therapy , Streptococcus pneumoniae/drug effects , Streptococcus pneumoniae/pathogenicity , Belgium/epidemiology , Humans , Pneumococcal Infections/epidemiology , Pneumococcal Infections/transmission , Public Health , Risk FactorsABSTRACT
A group of 100 totally or subtotally myeloperoxidase (MPO)-deficient individuals was compared to a reference population of 118 probands selected at random. Data for a protective effect of the deficiency against cardiovascular damage are presented. On the other hand, a significantly higher occurrence of severe infections and chronic inflammatory processes was noted among the deficient patients. An increased incidence of cancer among the MPO-deficient individuals was not demonstrated.
