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Biomedical subjects

L Tos

Publications and source records attributed to L Tos.

24 records · Page 2Linked to original sources

[Importance of measurement of systemic oxygen transport and tissue oxygenation in the treatment of acute respiratory insufficiency].

The patients with acute respiratory failure of different etiology are presented. The results of hemodynamic measurements together with those of oxygen transport and tissue oxygenation are given. The results reveal that in hypovolemic shock the transport system of oxygen and tissue oxygenation have been soon normalized by adequate therapy. However, more complicated is the condition of patients with sepsis and adult respiratory distress syndrome (ARDS) with disturbances in microcirculation. In them the oxygen uptake (VO2) is directly dependent upon the oxygen transport (DO2) i.e. much higher values of DO2 should be maintained by therapeutic measures than in conditions with intact microcirculation. According to their own experiences and data from the literature the authors consider that in patients with ARF in whom by the conventional methods the condition cannot be improved an invasive monitoring for following the hemodynamic measurements of oxygen transport and tissue oxygenation should be indicated for successful treatment.

Acute Disease

[The effect of positive end-expiratory pressure on gas exchange and hemodynamics].

The effects of positive end-expiratory pressure (PEEP) on arterial and mixed venous blood oxygenation as well as the effects on systemic and pulmonary circulation were studied in 15 patients with adult respiratory distress syndrome (ARDS) on mechanical ventilation. The measurements of arterial and mixed venous blood oxygen pressure (PaO2, PvO2), heart rate (HR), central venous pressure (CVP), pulmonary wedge pressure (WP), mean pulmonary arterial pressure (Ppa), mean systemic arterial pressure (Psa) and cardiac output (CO) were performed at 0, 5, 10 and 15 cm H2O PEEP. The positive effect of + 10 cm H2O on arterial oxygenation was found (PaO2 raised from 11.49 +/- 3.5 kPa to 13.3 +/- 3.3 kPa). Ppa raised too, from 23 +/- 7.6 mm Hg to 26 +/- 7 mm Hg. Psa and CO lowered at + 15 cm PEEP. Psa from 85 +/- 17 mm Hg to 73 +/- 17 mm Hg as well as CO from 8.22 +/- 1.1 l/min to 6.91 +/- 1.40 l/min. Authors conclude that PEEP can be accepted form of therapy in the treatment of refractory hypoxemia in patients with ARDS. Despite this beneficial effect, PEEP may adversely affect cardiovascular function. As with any therapy, the optimum PEEP "dose" should be tailored to each patient according to his needs and response.

Adolescent