Seven individuals within the mlkg group died from septic shock as a 
result of gangrene or perforation in the GI tract with peritonitis. ConclusionThe use of massive tidal volume for postoperative mechanical ventilation does not improve postoperative complications or mortality.Offered on line http:ccforum.comsupplementsSPLung recruitment manoeuvres reduce gastric mucosal blood flow in ICU patientsSJ Claesson, S Lehtipalo, O WinsDepartment of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care, UmeUniversity Hospital, S Ume Sweden IntroductionThe use of recruitment manoeuvres (RM) has lately been introduced into clinical practice for therapy of atelectasis in the course of mechanical ventilation. Transient higher airway pressures, including these employed in RM, could cause adverse basic or regional circulatory effects. The aim of this study was to evaluate effects of RM on gastric mucosal blood flow, systemic oxygenation and respiratory mechanics. MethodsNine ICU individuals with acute lung injury, age , APACHE II , had been studied. Gastric mucosal blood flow was measured constantly with laser Doppler APS-2-79 cost flowmetry (LDF). Imply arterial (MAP), central venous (CVP), oesophageal, abdominal and airway pressures had been also measured constantly. Cardiac output was measured by arterial pulse contour evaluation (PICCO). 3 Bay 59-3074 site consecutive RMs separated by a min pause had been studied, the two initial were 
performed with inspiratory stress (Pinsp) cmHO, inspiratory time (Tinsp) s, expiratory stress (Pexp) cmHO and expiratory time (Texp) s for min. The third RM was performed with Pinsp cmHO, Tinsp s, Pexp cmHO, Texp s for min. Blood gas measurements were performed ahead of, at the finish of, and min following each and every RM. ResultsWhen comparing values ahead of RM with values obtained soon after RM preliminary information indicate that three consecutiveTable Just before RM MAP (mmHg) CI (lminm) Immediately after RM LDF (PU) PaO (kPa) n . Mean SEM. P RMs didn’t significantly change MAP, HR, PaO or dynamic compliance. There was a significant decrease in LDF, CI plus a considerable increase in SVRI. Three patients demonstrated a drastic enhance in PaO throughout all RMs, but this raise was not sustained following the RMs have been terminated. ConclusionThree consecutive recruitment manoeuvres decreased gastric mucosal perfusion and cardiac index without the need of any advantageous effect on oxygenation.PAsymmetry in lung pathology and shortterm effects of independent lung ventilation (ILV) on pulmonary mechanics and gas exchange in patients with blunt chest traumaS Milanov, M Milanov, E Giurov Emergency Institute `Pirogov’, Totleben , Sofia, Bulgaria Independent lung ventilation has been made use of in sufferers with asymmetric lung pathology. Within this study we applied ILV in consecutive ventilated sufferers with blunt chest trauma with inclusion criteria POFiO without the need of physical or roentgenographic proof of unilateral pulmonary dis
ease. Eight in the individuals PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26525239 demonstrated paradoxical PEEPCPAP effect (worsening of pulmonary mechanics, gas exchange and enhance in shunt with PEEP application) prior to institution of ILV. Immediately after application of ILV with the sufferers demonstrated pulmonary mechanics asymmetry amongst left and right lung. Within this group of patients we continued with ILV and applied differential PEEP levels (cmHO for standard lung and . for diseased lung, optimized with continual flow approach) with different tidal volumes for each lungs and amount of Pplat cmHO. Pulmonary mechanics, gas exchange and total physique oxygen delivery w.Seven individuals inside the mlkg group died from septic shock because of gangrene or perforation on the GI tract with peritonitis. ConclusionThe use of massive tidal volume for postoperative mechanical ventilation does not raise postoperative complications or mortality.Available online http:ccforum.comsupplementsSPLung recruitment manoeuvres decrease gastric mucosal blood flow in ICU patientsSJ Claesson, S Lehtipalo, O WinsDepartment of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care, UmeUniversity Hospital, S Ume Sweden IntroductionThe use of recruitment manoeuvres (RM) has recently been introduced into clinical practice for remedy of atelectasis for the duration of mechanical ventilation. Transient higher airway pressures, including these employed in RM, may well lead to adverse general or regional circulatory effects. The aim of this study was to evaluate effects of RM on gastric mucosal blood flow, systemic oxygenation and respiratory mechanics. MethodsNine ICU patients with acute lung injury, age , APACHE II , have been studied. Gastric mucosal blood flow was measured continuously with laser Doppler flowmetry (LDF). Imply arterial (MAP), central venous (CVP), oesophageal, abdominal and airway pressures had been also measured continuously. Cardiac output was measured by arterial pulse contour evaluation (PICCO). Three consecutive RMs separated by a min pause had been studied, the two initially were performed with inspiratory pressure (Pinsp) cmHO, inspiratory time (Tinsp) s, expiratory stress (Pexp) cmHO and expiratory time (Texp) s for min. The third RM was performed with Pinsp cmHO, Tinsp s, Pexp cmHO, Texp s for min. Blood gas measurements have been performed before, in the finish of, and min following each and every RM. ResultsWhen comparing values just before RM with values obtained after RM preliminary information indicate that three consecutiveTable Ahead of RM MAP (mmHg) CI (lminm) Just after RM LDF (PU) PaO (kPa) n . Mean SEM. P RMs didn’t significantly change MAP, HR, PaO or dynamic compliance. There was a substantial decrease in LDF, CI and also a significant enhance in SVRI. Three individuals demonstrated a drastic enhance in PaO through all RMs, but this improve was not sustained immediately after the RMs had been terminated. ConclusionThree consecutive recruitment manoeuvres decreased gastric mucosal perfusion and cardiac index with no any beneficial impact on oxygenation.PAsymmetry in lung pathology and shortterm effects of independent lung ventilation (ILV) on pulmonary mechanics and gas exchange in individuals with blunt chest traumaS Milanov, M Milanov, E Giurov Emergency Institute `Pirogov’, Totleben , Sofia, Bulgaria Independent lung ventilation has been utilised in patients with asymmetric lung pathology. Within this study we applied ILV in consecutive ventilated sufferers with blunt chest trauma with inclusion criteria POFiO without the need of physical or roentgenographic proof of unilateral pulmonary dis
ease. Eight from the individuals PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26525239 demonstrated paradoxical PEEPCPAP effect (worsening of pulmonary mechanics, gas exchange and boost in shunt with PEEP application) prior to institution of ILV. Just after application of ILV of the patients demonstrated pulmonary mechanics asymmetry amongst left and right lung. In this group of individuals we continued with ILV and applied differential PEEP levels (cmHO for regular lung and . for diseased lung, optimized with continuous flow method) with unique tidal volumes for both lungs and amount of Pplat cmHO. Pulmonary mechanics, gas exchange and total physique oxygen delivery w.
