By A. Gullo
Developing sectors within the extensive care box - and in severe care medication usually - require particular degrees of competence having a similar universal denominator: an in-depth wisdom of human pathophysiology. even if this quantity offers lots of subject matters in consistent evolution, as witnessed by means of the gathering of chapters compiled by means of a number of researchers, this version comprises, particularly, fields within which choice making on the patient’s bedside prevails over theoretical argumentation. In different phrases, the 1st and most appropriate message this version desires to supply is for the reader to concentration his/her recognition on evidence-based medicine.
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Extra resources for Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: Proceedings of the 21st Postgraduate Course in Critical Medicine: Venice-Mestre, Italy - November 10-13, 2006
Hedenstierna G, Lundquist H, Lundh B et al (1989) Pulmonary densities during anesthesia. An experimental study on lung morphology and gas exchange. Eur Respir J 2:528–535 34. Hedenstierna G, Stranberg A, Brismar B et al (1985) Functional residual capacity, thoracoabdominal dimensions, and central blood volume during general anesthesia Lung, respiratory mechanics, artificial ventilation 27 with muscle paralysis and mechanical ventilation. Anesthesiology 62:247–254 35. Pelosi P, Ravagnan I, Giurati G et al (1999) Positive end-expiratory pressure improves respiratory function in obese but not in normal subjects during anesthesia and paralysis.
When the alveoli open up compliance increases, and it persists throughout alveolar recruitment. However, after a certain point compliance falls. The benefits of the use of PEEP come in part from the resulting increase in FRC. The shape of the P–V curve and the value of LIP may vary according to the end-expiratory lung volume that marks the beginning of inspiration . Increasing PEEP values can eliminate the LIP and decrease the compliance at the linear portion of the curve. These phenomena may theoretically reflect recruitment of some parts of the lung and distension or overdistension of other regions.
Culver BH (2004) Respiratory mechanics. In: Albert RK, Stephen G, Spiro J, Jett R (eds) Clinical respiratory medicine, 2nd edn. Mosby, St Louis, pp 61–70 2. Mead J, Takishima T, Leith D (1970) Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol 28:596–608 3. Milic-Emili J, Gottfried SB, Rossi A (1987) Non-invasive measurement of respiratory mechanics in ICU patients. Int J Clin Monit Comput 4:11–20 4. Gottfried SB, Rossi A, Higgs BD et al (1985) Noninvasive determination of respiratory system mechanics during mechanical ventilation for acute respiratory failure.