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Biomedical subjects

G Boldrini

Publications and source records attributed to G Boldrini.

At least 37 records · Page 2Linked to original sources
PubMed1988

Calorimetric response to amino acid infusion in sepsis and critical illness.

The effect of the infusion of mixed amino acids with glucose and fat on metabolic rate (MR) in sepsis (S) and in nonseptic trauma (NS) was investigated. The results demonstrated that diet-induced thermogenesis (specific dynamic action) controlled in S and in NS 25% and 18% of the MR variability, respectively (r2 = .25 and .18, p less than .01 for both). Also, diet-induced thermogenesis represented a quantitatively relevant portion of the total MR. There was a larger thermogenic effect of amino acids in S with respect to NS (22.3 vs. 5.7 cal/mg N, p less than .01) with a concomitantly increased thermogenic effect of fat. The results suggest the importance of recognizing the thermogenic effect of administered nutrients as an important determinant of MR during calorimetric measurements. The finding of an enhanced thermogenic effect of amino acids and fat in S also implies the need for more complete investigations of the impact of these substrates in modifying oxidative and energy metabolism in S.

Adult↗
PubMed1988

A simple method for rapid estimate of pulmonary venous admixture.

Data from 2,298 measurements of pulmonary venous admixture (QS/QT) performed in 733 patients were analyzed and processed in order to develop a method for rapid and reliable estimation of QS/QT by a simplified approach. Formulae and charts were obtained, which are easily suitable for use in all settings, and permit estimation of QS/QT with an 85%-93% control of its variability (r2 = 0.85-0.93, p less than 0.0001) simply on the basis of the measured arterial and central venous O2 tensions or saturations.

Adolescent↗
PubMed1987

[Comparison of ultrasound and radiology in the intraoperative diagnosis of nephrolithiasis].

Both intraoperative ultrasonography and radiology were utilized as a surgical aid while operating on 53 patients with renal lithiasis. A thorough comparison was made between the two imaging techniques: intraoperative US showed higher levels of sensitivity and accuracy, while specificity was maximal in intraoperative radiology. Intraoperative US proved to be a versatile and safe diagnostic procedure--as well as easy and quick to perform--whose accuracy in localizing stones as well as residual fragments appeared to be extremely high. Intraoperative US assistance during surgical procedures for renal lithiasis proves thus to be of the utmost importance in urologic practice.

Evaluation Studies as Topic↗
PubMed1986

Cardiorespiratory and metabolic effects of buflomedil: case reports.

An extensive study has been performed of the cardiovascular, respiratory and metabolic effects of buflomedil. The results indicate that the drug, at the administered dose, does not alter the patient physiological stability. An improved perfusion regimen in peripheral tissues and an optimization of cardiac energetics are also directly or indirectly implied in the results.

Aged↗
PubMed1985

The physiologic meaning of the respiratory index in various types of critical illness.

Seven hundred and sixty cardiorespiratory studies, from 151 critically ill or high-risk general surgical patients with extrapulmonary (S) or pulmonary (P) sepsis, cirrhotic liver disease (L), or cardiac failure (C), were analyzed to assess the determinants of a simple, easily obtained measure of respiratory oxygen exchange, the respiratory index (RI). The pattern of cardiorespiratory abnormalities was studied and correlated with the change in RI. The most important relations were with shunt (QS/QT), mixed venous O2 (PvO2), VD, and VE. Higher F1O2 and positive end-expiratory pressure (PEEP) were needed as the RI rose, indicating a greater severity of illness. Regression analysis of all types of critically ill patients and surgical controls showed that QS/QT, PvO2, and F1O2 interacted together to explain most of the variability of the RI. The regressions in each homogeneous patient disease category were all highly significant (p less than .0001) but had somewhat similar coefficients and explained the variability in RI to different degrees. The data suggest that patients with extrapulmonary sepsis or cirrhotic liver disease have an increase in RI (over that in controls) primarily due to a large increase in CI at the high QS/QT caused by the ventilation/perfusion (VA/QT) maldistribution characteristic of these diseases. However, patients with P or C have a disproportionate rise in RI at any given QS/QT compared to that in high-flow states alone, suggesting in P a direct alveolar limitation of oxygen exchange over and above any level of VA/QT mismatching, and suggesting in C a disproportionate decrease in PvO2 that magnifies the QS/QT effect even though VA/QT is more uniform.

Biometry↗
PubMed1984

Metabolism and nutrition in surgical sepsis.

The treatment of sepsis involves, in addition to the aggression of the septic focus by antibiotic and surgical means, the support of physiological functions, in particular the metabolic-nutritional support. The Authors base the description of the relevant aspects of metabolic-nutritional support in sepsis on the results of studies performed in their Clinical Research Center and in other Centers.

Fat Emulsions, Intravenous↗
PubMed1983

Quantification of the determinants of arterial hypoxemia in critically ill patients.

A quantification of the determinants of arterial hypoxemia was performed in 376 cardiorespiratory measurements obtained from 180 critically ill patients. Statistical analysis showed that pulmonary venous admixture (Qsp/Qt) could explain only 48% of the PaO2 variability in the sample of measurements taken (r2 = 0.48), while the effect of central venous O2 tension (PVO2) brought the total explained PaO2 variability up to 82% (total r2 = 0.82). These findings imply that pulmonary function is not the only determinant of PaO2; the PVO2-mediated effect of other cardiovascular and metabolic determinants must be recognized in the clinical setting.

Cardiac Output↗
PubMed1983

Cardiorespiratory and metabolic adequacy and their relation to survival in sepsis.

Cardiorespiratory and metabolic data were collected in 36 septic patients and 80 patients critically ill after nonseptic general surgery or trauma. Septic patients, particularly nonsurviving septics, showed early and sustained increases in metabolic rate, oxygen consumption, cardiac work, and minute ventilatory volume. They had lower levels of respiratory quotient and total peripheral resistance than nonseptic patients. High cardiac work was related to increasing oxygen transport. Both increases in metabolic utilization with high CO2 production, and abnormal increases in VD/VT appeared responsible for the higher minute ventilatory volumes. Respiratory quotient was negatively related to metabolic rate; this relation was modulated by the rate of caloric intake and, in nonseptic patients, was also influenced by the hemodynamic state. These data suggest that poor prognosis in sepsis is characterized by an early sustained stress response with more severe abnormalities in cardiovascular, metabolic, and respiratory function than is seen in the nonseptic stress response. The need for early support of physiologic functions and early and aggressive nutritional intervention is emphasized.

Carbon Dioxide↗
PubMed1982

Effects of supine versus sitting bedrest upon blood gas tensions, cardiac output, venous admixture and ventilation-perfusion ratio in man after upper abdominal surgery.

The effects of body position (sitting versus supine) on respiratory and haemodynamic patterns were evaluated in nine patients who have undergone upper abdominal surgery. Posture showed no significant influence upon arterial blood gas tensions, while in the sitting position mean central venous oxygen tension lowers and arterial-venous oxygen content difference rises. In seated patients cardiac output was notably reduced. Pulmonary gas exchange analysis, according to Riley's method, showed that the sitting position allows a higher alveolar ventilation-pulmonary capillaries perfusion ratio, as well as a lower degree of venous admixture.

Abdomen↗