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1.
Leukemia ; 30(3): 545-54, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26488113

RESUMO

We conducted a comprehensive analysis of 28 recurrently mutated genes in acute myeloid leukemia (AML) in 271 patients with de novo AML. Co-mutations were frequently detected in the intermediate cytogenetic risk group, at an average of 2.76 co-mutations per patient. When assessing the prognostic impact of these co-mutations in the intermediate cytogenetic risk group, overall survival (OS) was found to be significantly shorter (P=0.0006) and cumulative incidence of relapse (CIR) significantly higher (P=0.0052) in patients with complex molecular genetic abnormalities (CMGAs) involving three or more mutations. This trend was marked even among patients aged ⩽65 years who were also FLT3-ITD (FMS-like tyrosine kinase 3 internal tandem duplications)-negative (OS: P=0.0010; CIR: P=0.1800). Moreover, the multivariate analysis revealed that CMGA positivity was an independent prognostic factor associated with OS (P=0.0007). In stratification based on FLT3-ITD and CEBPA status and 'simplified analysis of co-mutations' using seven genes that featured frequently in CMGAs, CMGA positivity retained its prognostic value in transplantation-aged patients of the intermediate cytogenetic risk group (OS: P=0.0002. CIR: P<0.0001). In conclusion, CMGAs in AML were found to be strong independent adverse prognostic factors and simplified co-mutation analysis to have clinical usefulness and applicability.


Assuntos
Aberrações Cromossômicas , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/genética , Proteínas de Neoplasias/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas Estimuladoras de Ligação a CCAAT/genética , Proteínas Estimuladoras de Ligação a CCAAT/metabolismo , Cromossomos Humanos Par 16 , Cromossomos Humanos Par 21 , Cromossomos Humanos Par 8 , Análise Citogenética , DNA (Citosina-5-)-Metiltransferases/genética , DNA (Citosina-5-)-Metiltransferases/metabolismo , DNA Metiltransferase 3A , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Dioxigenases , Feminino , Expressão Gênica , Humanos , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/patologia , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/metabolismo , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo , Nucleofosmina , Prognóstico , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas/metabolismo , Recidiva , Estudos Retrospectivos , Análise de Sobrevida , Tirosina Quinase 3 Semelhante a fms/genética , Tirosina Quinase 3 Semelhante a fms/metabolismo
2.
FEBS Lett ; 269(1): 218-20, 1990 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-2387405

RESUMO

We have studied metallothionein (MT) induction by three primary inducers; a heavy metal, a glucocorticoid and a cytokine, and by the combinations of these inducers in the cultured cells. MT-protein was synergistically induced by either a cytokine or a heavy metal with a glucocorticoid hormone and was additively induced by the combination of a cytokine and a heavy metal, but MT-mRNA levels were not completely correlated with MT-protein levels. These results suggest that posttranscriptional regulation may be involved in the synergistic induction of MT-protein. We propose a possible mechanism in which marked MT induction by stress in vivo is dependent on the combined effect of two or more inducers, because marked MT induction is not seen by an injection of a plausible dose of either a glucocorticoid hormone or a cytokine in vivo.


Assuntos
Metalotioneína/biossíntese , Northern Blotting , Linhagem Celular , Dexametasona/farmacologia , Sinergismo Farmacológico , Fator de Crescimento Epidérmico/farmacologia , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Humanos , Fígado , Metalotioneína/genética , RNA Mensageiro/genética , Estresse Fisiológico/fisiopatologia , Zinco/farmacologia
3.
Chest ; 101(1): 285-6, 1992 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1729093

RESUMO

We report the effect of pressure support ventilation (PSV) on auto-PEEP in a patient with asthma. The patient showed a high level of auto-PEEP during spontaneous breathing through a T-piece. PSV effectively decreased auto-PEEP and inspiratory muscle effort with increasing levels of PSV.


Assuntos
Asma/terapia , Respiração com Pressão Positiva , Idoso , Asma/fisiopatologia , Feminino , Humanos , Pressão , Mecânica Respiratória
4.
J Thorac Cardiovasc Surg ; 86(3): 388-92, 1983 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-6350726

RESUMO

Gas exchange was measured in eight patients undergoing high-frequency ventilation (HFV) during intrathoracic operations for lung cancer. HFV facilitated the operation because the exposed lung moved only slightly to ventilate and stayed in a less expanded state. Intermittent positive-pressure breathing (IPPB) (control) was switched to HFV 20 minutes after the pleural cavity was opened. HFV either was conducted alone (HFV alone) or was superimposed on a hypoventilation equal to the dead space (HFV on VD). The driving pressure and frequency of HFV were set at 0.5 kg/cm2 using 3, 6, and 12 Hz with an FI02 of 0.50. The only statistically significant difference in arterial PO2 between IPPB and HFV occurred when the HFV alone was used at 12 Hz. Significant differences in arterial PCO2 values existed between IPPB and HFV alone when the HFV was at 6 and 12 Hz, and between HFV alone and HFV on VD at 12 Hz. The arterial pH values were lower at 6 and 12 Hz in HFV alone and were significantly different from pH values during IPPB. Acidosis was due to the respiratory component of HFV only. The metabolic component remained unchanged. It was concluded that the gas exchange was adequately maintained at 3 Hz during HFV alone. The intrathoracic operation was facilitated by less movement as the frequency increased, although the lung volume tended to expand. The gas exchange, particularly the elimination of carbon dioxide, worsened during the use of HFV alone. However, HFV on VD continued to maintain an adequate gas exchange and facilitate the operation.


Assuntos
Respiração Artificial/métodos , Cirurgia Torácica/métodos , Adulto , Idoso , Feminino , Humanos , Concentração de Íons de Hidrogênio , Ventilação com Pressão Positiva Intermitente , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue
5.
Intensive Care Med ; 15(6): 364-7, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2681311

RESUMO

We compared the effects of pressure support ventilation (PSV) with those of assist control ventilation (ACV) on the breathing pattern, work of breathing and blood gas exchange in 8 patients with acute respiratory failure. During ACV, the tidal volume was set at 10 ml/kg, and the inspiratory flow was set at 50 to 70 l/min. During PSV, the pressure support level selected was 27 +/- 5 cm H2O to make the breathing pattern regular. Tidal volume was significantly higher (908 +/- 179 ml vs. 633 +/- 96 ml) during PSV than during ACV at a lower peak airway pressure. Respiratory frequency was lower (15 +/- 4 breaths/min vs. 24 +/- 5 breaths/min) during PSV than during ACV, associated with a lower duty cycle, which improved synchrony between the patient and the ventilator. The oxygen cost of breathing, an estimate based on the inspiratory work added by a ventilator and the oxygen consumption, did not change significantly. PaO2 was significantly higher during PSV than during ACV. We conclude that PSV using high levels of pressure support can improve the breathing pattern and oxygenation and fully sustain the patient's ventilation while matching his inspiratory efforts.


Assuntos
Respiração Artificial/métodos , Insuficiência Respiratória/terapia , Adulto , Idoso , Resistência das Vias Respiratórias , Humanos , Masculino , Respiração com Pressão Positiva , Troca Gasosa Pulmonar , Trabalho Respiratório
6.
Intensive Care Med ; 15(8): 491-4, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2607036

RESUMO

We assessed the effect of pressure support ventilation (PSV) on breathing patterns and the work of breathing in 10 postoperative patients. Minute ventilation (VE) increased by 8% with 5 cm H2O PSV and 10% with 10 cm H2O PSV compared to 0 cm H2O PSV. The increase in VE was achieved by increased mean inspiratory flow (24% with 5 cm H2O PSV and 67% with 10 cm H2O PSV) and a decrease in duty cycle (13% with 5 cm H2O PSV and 39% with 10 cm H2O PSV). The decrease in duty cycle along with a decrease in respiratory frequency allowed a greater expiratory time including a rest period for the respiratory muscles, which might minimize the risk of muscle fatigue. Furthermore, the inspiratory work added by the ventilator was near zero with 5 cm H2O PSV and 10 cm H2O PSV. Oxygen consumption also decreased significantly with 5 cm H2O PSV. We conclude that PSV improves the breathing patterns and minimizes the work of breathing spontaneously via a ventilator.


Assuntos
Respiração Artificial , Respiração/fisiologia , Trabalho Respiratório/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Gasometria , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Consumo de Oxigênio , Pressão Parcial
7.
Intensive Care Med ; 11(2): 61-4, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-4039342

RESUMO

Prostaglandin E1 was administered intravenously to 10 patients who had the adult respiratory distress syndrome associated with severe infection in order to investigate its hemodynamic effects. Infusion of PGE1 significantly decreased the mean pulmonary arterial pressure, mean systemic arterial pressure, pulmonary vascular resistance and systemic vascular resistance, and increased the cardiac index, oxygen delivery and oxygen consumption. No significant difference was noted in the intrapulmonary shunt fraction. These results indicate that administration of PGE1 improves pulmonary hemodynamics and tissue oxygenation in patients with acute respiratory distress syndrome, by reducing right ventricular afterload and increasing the cardiac index.


Assuntos
Consumo de Oxigênio/efeitos dos fármacos , Prostaglandinas E/uso terapêutico , Circulação Pulmonar/efeitos dos fármacos , Síndrome do Desconforto Respiratório/tratamento farmacológico , Vasodilatadores/uso terapêutico , Idoso , Alprostadil , Avaliação de Medicamentos , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Respiração Artificial , Síndrome do Desconforto Respiratório/fisiopatologia
8.
Ann Thorac Surg ; 37(6): 491-6, 1984 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-6428336

RESUMO

High-frequency ventilation (HFV) of the jet type was evaluated for facilitation of intrathoracic operations because HFV does not necessitate ventilatory movement of the lung and reduces the volume of the lung. The feasibility of HFV as a substitute for the current respiratory management of intermittent positive-pressure ventilation (IPPV) was determined in 12 patients with cancer of the lung by employing two types of HFV-HFV alone (Group 1) and HFV on physiological dead-space volume (VD) (Group 2). For the 6 patients in Group 1, HFV was set at a frequency of 3 Hz and a driving pressure of 0.5 kg/cm2. For the 6 patients in Group 2, HFV was set at 6 Hz with the same driving pressure but was superimposed on a small tidal volume equal to a dead space. High-frequency ventilation facilitated intrathoracic operations because of the disappearance of ventilatory movement and the reduced volume. No significant difference between the groups was found for arterial oxygen tension. Arterial carbon dioxide tension (PaCO2) in patients in Group 1 remained in the normal range, although it was slightly acidotic. The PaCO2 in Group 2 was acidotic. Therefore, it was concluded that HFV alone can be substituted for IPPV in gas exchange and provides good accessibility to the operative field.


Assuntos
Dióxido de Carbono/sangue , Neoplasias Pulmonares/cirurgia , Oxigênio/sangue , Troca Gasosa Pulmonar , Respiração Artificial/métodos , Adulto , Idoso , Feminino , Humanos , Concentração de Íons de Hidrogênio , Período Intraoperatório , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pressão Parcial
9.
Neurosci Lett ; 124(1): 13-6, 1991 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-1713315

RESUMO

In order to clarify acute-phase response in brain, we investigated induction of metallothionein (MT) genes by administrating an endotoxin (lipopolysaccharide) in rat intraperitoneum. We performed in situ hybridization on the serial brain sections to identify the cells expressing the MT genes in acute-phase. After endotoxin administration, transcripts of MT genes were detected in the arachnoideal, ependymal cells and glial cells around the Purkinje cells of the cerebellum, while no significant induction of the MT genes by zinc ion was observed in brain. These results suggest that the acute-phase response occurs specifically in at least these 3 non-neuronal cells.


Assuntos
Proteínas de Fase Aguda/biossíntese , Química Encefálica/efeitos dos fármacos , Endotoxinas/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Lipopolissacarídeos/farmacologia , Metalotioneína/biossíntese , Proteínas de Fase Aguda/genética , Animais , Masculino , Metalotioneína/genética , Hibridização de Ácido Nucleico , RNA Mensageiro/biossíntese , Ratos , Ratos Endogâmicos , Zinco/farmacologia
10.
Naunyn Schmiedebergs Arch Pharmacol ; 335(6): 686-91, 1987 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-3627285

RESUMO

The effects of halothane, enflurane, ketamine and pentobarbital on brain histamine dynamics were examined in mice. Brain histamine and tele-methylhistamine, a predominant metabolite of brain histamine, were simultaneously measured by high-performance liquid chromatography with fluorescence detection. Anaesthesia with the four agents had no effect on brain histamine content. The tele-methylhistamine content significantly increased during 1 h and 2 h anaesthesia with halothane (0.051 mmol/l or 0.76 mol/l) and 2 h anaesthesia with enflurane (0.11 mol/l or 0.16 mol/l). Enflurane and pentobarbital significantly inhibited the histamine depletion induced by alpha-fluoromethylhistidine (50 mg/kg, intraperitoneally), a specific inhibitor of histidine decarboxylase, suggesting that these agents decrease the histamine turnover. However, halothane and ketamine were ineffective in this respect. These results emphasize that various anaesthetics have different influences on brain histamine dynamics. Since there have been findings suggesting that brain histaminergic systems are involved in physiological functions such as regulation of blood pressure, body temperature and hormone secretion, changes in the brain histamine turnover should be given due attention with regard to physiological changes during anaesthesia.


Assuntos
Anestésicos/farmacologia , Química Encefálica/efeitos dos fármacos , Histamina/metabolismo , Animais , Enflurano/farmacologia , Meia-Vida , Halotano/farmacologia , Histidina Descarboxilase/antagonistas & inibidores , Ketamina/farmacologia , Masculino , Metilistaminas/metabolismo , Metilistidinas/antagonistas & inibidores , Metilistidinas/farmacologia , Camundongos , Pentobarbital/farmacologia
11.
Acta Med Okayama ; 44(4): 209-15, 1990 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1978766

RESUMO

The interaction of four inhalational anesthetics (sevoflurane, isoflurane, enflurane and halothane) with pancuronium and vecuronium and also their prejunctional actions at the neuromuscular junction were quantitatively studied using rat phrenic nerve-hemidiaphragm preparations. To investigate the prejunctional effects of inhalational anesthetics, a train-of-four ratio (T4/T1) and the tetanus ratio (the ratio of the final response to the initial response during tetanus) were evaluated. All four inhalational anesthetics markedly potentiated the neuromuscular blockade of twitch response caused by either pancuronium or vecuronium with halothane and enflurane being the most potent both on a % concentration basis and on a MAC (minimum alveolar concentration) basis. Although none of the four inhalational anesthetics had any effects on the T4/T1 ratio, they produced variable effects on the tetanus ratio. Sevoflurane had little effect on the tetanus ratio, whereas 1 and 2% isoflurane and 1, 2 and 3% enflurane increased the tetanus ratio and 5% halothane and 5% enflurane significantly reduced the tetanus ratio. Halothane and enflurane had the most potent depressant action of the four inhalational anesthetics both on the % concentration basis and on the MAC basis. These results indicate that the main site of action of inhalational anesthetics is a postjunctional site at the neuromuscular junction and that they do not seem to act on prejunctional sites at the concentrations used in clinical situations.


Assuntos
Anestésicos/farmacologia , Éteres Metílicos , Junção Neuromuscular/efeitos dos fármacos , Pancurônio/farmacologia , Brometo de Vecurônio/farmacologia , Animais , Sinergismo Farmacológico , Enflurano/farmacologia , Éteres/farmacologia , Halotano/farmacologia , Técnicas In Vitro , Isoflurano/farmacologia , Masculino , Ratos , Ratos Endogâmicos , Sevoflurano
12.
Acta Med Okayama ; 36(5): 399-406, 1982 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7180573

RESUMO

This study used a Shimadzu IP-1B capillary type isotachophoretic apparatus with a potential gradient detector. An ipp-1 withdrawal cell was fitted to this and a technique for withdrawing individual components directly through this port was developed using a microsyringe. The recovery rate was up to 45% for individual target components. When 100% withdrawal of the target component was attempted by withdrawing a volume four times the calculated volume (so that the zones both before and after the target component were also included), the best recovery rate was only 78%. In all cases, the results varied less than 3%. The limit for analysis of individual components of a 0.01 M solution was around 3 microliters. If this volume was exceeded, the ion quantity was too large for the volume of the microcapillary tube and mixed zones formed such that complete separation and analysis of individual components became impossible.


Assuntos
Eletroforese/instrumentação , Citratos/análise , Ácido Cítrico , Eletroforese/métodos , Lítio/análise
13.
Acta Med Okayama ; 42(4): 183-92, 1988 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-3177003

RESUMO

The direct determination by gas chromatography of blood levels of anesthetic agents has been difficult because of the water content of blood. In the present study, the method of Yokota et al. (1967) was modified by improving the packing materials of the column, the blood sample vaporizer and the flow-path during analysis. As a result, accurate and reproducible determination of halothane, enflurane and isoflurane dissolved in blood was achieved. With this system, blood in which halothane, enflurane and isoflurane had been dissolved could be analyzed without changing the column between samples. Moreover, each sample was prepared in less than 10 min, and more than 100 consecutive determinations could be made with excellent reproducibility. The coefficient of variation was less than 3.8%.


Assuntos
Cromatografia Gasosa/métodos , Enflurano/sangue , Halotano/sangue , Isoflurano/sangue , Humanos , Temperatura
14.
Acta Med Okayama ; 34(1): 19-30, 1980 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-6446836

RESUMO

Renal cortex was studied during experimentally induced ischemia. A transient increase in anerobic glycolysis occurred with concomitant swelling of both the Golgi apparatus and mitochondria. These intracytoplasmic organelles underwent marked changes in their intracellular positions. Infolding of cytoplasmic membrane at the basal side of proximal tubule cells increased in complexity and proceeded to enclose various intracytoplasmic microorganelles such as mitochondria and the Golgi apparatus. Piling up in layers was particularly marked around mitochondria. This piling up appeared as myelin-like structures on the free surface of, and within, proximal tubule cells, and followed disruption of the brush border at the free surface. Histological examination of thin sections showed that the fused portions of this brush border were actually brush border cytoplasmic membrane piled up in layers giving the appearance of myelin-like structures. After two hours of ischemia, parts of the membrane of these myelin-like structures were disrupted. Large vacuoles developed and these were thought to be related to the large vacuoles seen during cell degeneration.


Assuntos
Isquemia/patologia , Túbulos Renais Proximais/ultraestrutura , Rim/irrigação sanguínea , Fosfatase Ácida/análise , Animais , Glucuronidase/análise , Histocitoquímica , Túbulos Renais Proximais/análise , Lipídeos/análise , Coelhos , Fatores de Tempo
15.
Acta Med Okayama ; 41(1): 19-23, 1987 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3494383

RESUMO

The involvement of macrophages in the induction of metallothionein (MT) synthesis by bacterial endotoxin was studied in vitro. Rat peritoneal macrophages were incubated with endotoxin. The incubation medium from endotoxin-activated macrophages accelerated MT synthesis by human hepatic Chang cells. However, the incubation medium from non-activated macrophages did not. Endotoxin added to the culture medium of Chang cells was ineffective in inducing MT synthesis. The contents of zinc, copper and cadmium, which are primary inducers of MT, in the incubation medium of macrophages in the presence of endotoxin were not different from those in the absence of endotoxin. These results suggest that MT synthesis is induced by endotoxin-treated macrophages.


Assuntos
Endotoxinas/farmacologia , Macrófagos/fisiologia , Metalotioneína/biossíntese , Animais , Células Cultivadas , Interleucina-1/fisiologia , Ativação de Macrófagos/efeitos dos fármacos , Masculino , Ratos , Ratos Endogâmicos , Zinco/análise
16.
Masui ; 38(9): 1181-7, 1989 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-2572709

RESUMO

In 105 adult patients under halothane anesthesia, the neuromuscular blocking effects of vecuronium and pancuronium were determined with prior succinylcholine 1 mg.kg-1 administration and without. Force of the evoked twitch increased 123.7% of control after recovery from succinylcholine-induced block. Prior administration of succinylcholine was associated with a leftward shift of dose-response curve of vecuronium or pancuronium. Onset of the force reduction from initial dose (0.08 mg.kg-1) was faster and recovery from initial and maintenance doses (0.02 mg.kg-1) were slower. This potentiating effect persisted at least 2 hours.


Assuntos
Junção Neuromuscular/efeitos dos fármacos , Pancurônio/farmacologia , Succinilcolina/farmacologia , Brometo de Vecurônio/farmacologia , Adulto , Sinergismo Farmacológico , Humanos , Pessoa de Meia-Idade
17.
Masui ; 38(8): 1048-53, 1989 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-2810699

RESUMO

Midazolam 0.2mg.kg-1 or diazepam 0.2mg.kg-1 was used as an induction agent in a modified NLA. Plasma concentrations of midazolam or diazepam were measured with benzodiazepines screen method, which was based on enzyme immunoassay. Pharmacokinetic analysis is based on the plasma concentration-time courses after a bolus injection. The distribution half-life (T alpha 1/2) of midazolam, 1.24 minutes, was shorter than that of diazepam, 3.85 minutes. The elimination half-life (T beta 1/2) of midazolam, 5.44 hours, was similar to that of diazepam, 5.02 hours. The initial fall-off in the alpha-phase was due to the distribution of the drug from plasma to the peripheral compartment, while the drop in the beta-phase was caused by redistribution from the peripheral compartment and total elimination of the drug. Midazolam was thought to be useful as an induction agent in a modified NLA, because midazolam is distributed to the peripheral compartment faster than diazepam. As midazolam has a long elimination half-life as that of diazepam, prolongation of its effects has to be considered when a large dose or continuous infusion is employed.


Assuntos
Midazolam/sangue , Neuroleptanalgesia , Adulto , Idoso , Diazepam/sangue , Meia-Vida , Humanos , Pessoa de Meia-Idade
18.
Kokyu To Junkan ; 39(2): 143-5, 1991 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-2017594

RESUMO

The purpose of this study was to evaluate whether airway occlusion pressure (P0.1) would be a useful predictor for successful weaning in mechanically ventilated patients with acute respiratory failure. We studied 23 marginal weaning candidates. Fourteen patients were able to be weaned from the ventilator, and 9 patients were not able to be weaned. P0.1 and other respiratory parameters were measured just prior to weaning and at the end of weaning or at the time of discontinuation of weaning. The mean value of P0.1 in the failed group was higher than that in the successful group both before and after weaning periods. However, P0.1 varied widely among patients and did not separate the failure group from the success group because of overlap between the two. There were significant differences between the two groups of the conventional weaning parameters, such as respiratory rate, minute ventilation, PaO2, and oxygen equivalent. We conclude that P0.1 is helpful to predict successful weaning. However, it can not be used as a single parameter for weaning because of the wide variations of absolute values among patients with acute respiratory failure.


Assuntos
Respiração Artificial , Insuficiência Respiratória/diagnóstico , Desmame do Respirador , Doença Aguda , Idoso , Resistência das Vias Respiratórias , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Respiratória/fisiopatologia
19.
Kokyu To Junkan ; 38(3): 269-72, 1990 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-2330461

RESUMO

We assessed breathing patterns during pressure support ventilation (PSV) and its relationship with the work of breathing in 10 postoperative patients. With increasing levels of pressure support, minute ventilation and tidal volume increased with a decrease in respiratory frequency. Increased minute ventilation was achieved by increased mean inspiratory flow. Duty cycle, however, decreased with PSV. This decrease might allow the diaphragm a longer rest period between contractions, which might decrease the risk of diaphragmatic fatigue. Furthermore, PSV reduced the inspiratory work added by a ventilator to near zero. Oxygen consumption was also decreased with PSV. We conclude that PSV improved the breathing patterns and minimized the work of breathing spontaneously via a ventilator.


Assuntos
Respiração Artificial , Respiração , Respiradores de Pressão Negativa , Adulto , Idoso , Idoso de 80 Anos ou mais , Gasometria , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Período Pós-Operatório , Troca Gasosa Pulmonar , Espirometria , Desmame do Respirador
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