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Biomedical subjects

A Braschi

Publications and source records attributed to A Braschi.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Nitric oxide inhalation test in patients with ARDS: preliminary assessment of the effect on arterial oxygenation].

OBJECTIVE: Inhaled NO can improve arterial oxygenation in ARDS. We evaluated the incidence and the magnitude of this effect during a short test of NO inhalation. This was performed in 24 consecutive mechanically ventilated patients with ARDS in order to assess the interest of NO for the therapy of hypoxemia in each case. DESIGN: Retro-spective study. SETTING: ICU in a University Hospital. PATIENTS: 24 hypoxemic patients with ARDS (lung injury score, LIS, 2.9 +/- 0.52), treated with conventional mechanical ventilation. INTERVENTIONS: Tests were performed using a mean inhalatory NO dose of 14 +/- 6 ppm. A pair of PaO2 data was obtained for each patient from two blood gas analysis, performed one just before and one 15 min after the start of NO inhalation. RESULTS: The mean baseline PaO2 was 76 +/- 21 mmHg and significantly increased with NO inhalation to 97 +/- 34 mmHg (p = 0.0001). Considering the individual response to NO, patients were arbitrarily classified as responders when the increase of PaO2 from baseline was > or = 10%. Sixteen patients were identified as responders, showing a mean increase of PaO2 from baseline by 40 +/- 26%, while the remaining 8 patients resulted non responders (mean change 1 +/- 5.7%). In no case a clinically significant decrease of PaO2 was observed during NO inhalation. The response to NO did not correlate with the LIS (r = 0.019) and with baseline PaO2 (r = 0.31). CONCLUSIONS: Inhaled NO doses of 14 +/- 6 ppm increased on the average the PaO2 in a group of ARDS patients, the individual response being however variable. A deterioration of arterial oxygenation was never observed. Even if the criteria for predicting the response to NO still remain to be defined, a short test seems to reliably provide a first estimate of the magnitude of the response.

Administration, Inhalation↗
PubMed1995

Whole lung lavage.

Bronchoalveolar lavage is universally employed as a diagnostic procedure and also, both in the massive (whole lung) and limited forms, has important therapeutic applications. Since the second half of the century whole lung lavage (WLL) has been applied in patients with pulmonary alveolar proteinosis and has proved successful. The procedure has improved over the years in terms of safety and efficacy, whilst indications and methods for WLL are not yet completely defined and standardized. In this paper, we summarize the history of the development of WLL, and describe the procedure used eight times in five patients in our department.

Adult↗
PubMed1990

[Effects of hypertrophy on cardiac systolic and diastolic performance in athletes with mild hypertension].

Aims of the study has been the evaluation of morphological and functional aspects of left ventricle in subjects undergoing mild hypertension and sport adaptation effects. These evaluations have been carried out by Echo-Doppler both at rest and during sharp increase in after load induced by isometric stress. Together with the morphological parameters represented by mass index and by radius to thickness ratio, we have studied stroke volume and transmitral flow pattern assessing the maximum flow velocity during rapid filling phase (E), during atrial contraction phase (A) and their ratio (E/A). We have studied 31 male subjects from 39 to 60 (average 47) exercising twice or three times a week (in the main, aerobic sports such as road cycling). They were subdivided into two groups, the first included 16 subjects with mild hypertension (AP = 155 +/- 9/97 +/- 5 mmHg) the second included 15 normotensive subjects without known pathologies, comparable for age and body surface (AP = 125 +/- 15/77 +/- 10 mmHg). Hypertensive subjects exercising regularly, showed a mass index (164 +/- 42 g/m2) significantly higher than the controls (139 +/- 35 g/m2, P less than 0.01) but they ke a normal filling pattern at rest and similar stroke volume values. During isometric exercise instead, the velocities of E and A waves showed a different trend in the two groups with a higher reduction in E/A ratio in hypertensive subjects. The per cent decrease in this ratio turned out to be 15% in the control group and 33% in hypertensive subjects (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Body iron status in critically ill patients: significance of serum ferritin.

Serial measurements of blood haemoglobin, serum iron, serum transferrin, total iron-binding capacity, transferrin per cent saturation and serum ferritin were determined in 51 post-operative critically ill patients to investigate body iron status in severely stressed patients. The results showed decreased blood haemoglobin, serum iron, serum transferrin and transferrin saturation compared to an increase in serum ferritin levels. These results indicate that there is inadequate availability of iron to tissues (secondary to rearrangement of body iron to the advantage of the iron storage compartment), which is often present in severely critically ill patients. A positive correlation was found between the initial (ferritin) levels and SAPS (r = 0.41, p less than 0.01). In addition, the increase of ferritin concentration parallels a worsening of the clinical status in severely ill patients. This is due to enhanced release by the macrophage system. From this, we consider serum ferritin as an acute-phase protein and a useful marker of the severity of the clinical status. It appears to be useful in predicting the patient's outcome, but is not reliable in evaluating iron stores in stressed patients.

Adolescent↗
PubMed1989

Measurement of the flow-resistive properties of double-lumen bronchial tubes in vitro.

This study measures the resistance to gas flow of different double-lumen bronchial tubes used for separate ventilation of each lung in critically ill patients. Different-sized Robertshaw and Carlens' tubes were studied, as well as a new device that consisted of a cuffed bronchial catheter introduced through a standard tracheal tube. The pressure-flow relationship was curvilinear in all cases. Robertshaw and Carlens' tubes were generally found to have bronchial and tracheal channels with almost similar resistance and offered total resistances similar to those of 7.0-8.0 mm internal diameter tracheal tubes. The new device had a higher resistance than others of equal external diameter. This must be taken into account when its use is recommended for prolonged respiratory support.

Airway Resistance↗
PubMed1988

A new method for separate lung ventilation.

Separate lung ventilation is obtained with selective intubation of the main bronchus by an appropriate cuffed tube inserted through a standard orotracheal tube. Ventilation is carried out separately through the bronchial tube on one side and the residual tracheal tube lumen on the other side. This method, used in 144 patients, greatly simplifies the technique of bronchial intubation and offers many advantages over commercially available double-lumen tubes.

Bronchi↗
PubMed1987

A continuous flow intermittent mandatory ventilation with continuous positive airway pressure circuit with high-compliance reservoir bag.

Unstable inspiratory pressure may reduce the benefits of intermittent mandatory ventilation and impose a greater work of breathing than some patients can tolerate. The authors evaluated a continuous flow intermittent mandatory ventilation with continuous positive airway pressure apparatus provided with a 10-L high compliance reservoir bag, separated from the ventilator circuit by a one-way valve. A pulmonary simulator was tested to generate a wide range of inspiratory peak flow rates. Pressures and flow rates were examined in different sections of the system, using PEEP levels up to 15 mm Hg and different fresh gas flow rates. The circuit offers many advantages, particularly considering the low inspiratory pressure drop and the low fresh gas flow rates needed for optimal function.

Equipment Design↗
PubMed1985

Functional evaluation of a CPAP circuit with a high compliance reservoir bag.

Continuous positive airway pressure is widely used in the treatment of ARF and an evaluation of the systems is important. The authors used an artificial model to test a continuous flow system with a high compliance reservoir bag. The results confirm that the system is effective in maintaining positive pressure stability within a wide range of inspiratory peak flow rates, even when a low fresh gas flow rate is employed. Nevertheless, rebreathing of expired gases is possible and may be noticeable at high expiratory flow rates, caused by the high compliance of the reservoir bag.

Acute Disease↗