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Biomedical subjects

M Müller

Publications and source records attributed to M Müller.

At least 271 records · Page 15Linked to original sources
PubMed2001

Soft tissue concentrations of ciprofloxacin in obese and lean subjects following weight-adjusted dosing.

OBJECTIVE: To investigate whether weight adjusted ciprofloxacin dosing results in comparable target site concentrations in obese and lean subjects. DESIGN: Comparative study in two populations. SUBJECTS: Twelve obese subjects (mean weight 122+/-22.6 kg, 28-52 y, male&ratio;female ratio 4&ratio;8) and 12 age- and sex-matched lean controls (mean weight 59+/-8.6 kg). METHODS: Sampling of interstitial space fluid by means of calibrated in vivo microdialysis after a weight-adjusted intravenous bolus dose of 2.85 mg/kg ciprofloxacin. Analysis of drug concentration by high pressure liquid chromatography. RESULTS: We found significantly higher peak and trough levels of ciprofloxacin in plasma for obese subjects (9.97+/-5.64 and 0.44+/-0.10 microg/ml vs 2.59+/-1.06 and 0.19+/-0.09 microg/ml in lean subjects, P<0.05), while concentration-time curves of interstitial fluid of muscle and subcutaneous fat did not differ between the groups. Tissue penetration, expressed as AUC(tissue)/AUC(plasma) ratio was significantly lower in obese subjects (0.45+/-0.27 vs 0.82+/-0.36, P<0.01). CONCLUSION: We conclude that the penetration process into the interstitial space fluid is impaired in obese subjects. Therefore antibiotic doses need not be adjusted for an increase in fat/water ratio. Weight-adjusted dosing based on actual body weight will yield adequate tissue levels for ciprofloxacin.

Adult↗
PubMed2001

Activity and expression of the multidrug resistance proteins P-glycoprotein, MRP1, MRP2, MRP3 and MRP5 in de novo and relapsed acute myeloid leukemia.

The multidrug resistance proteins (MRPs) MRP1, MRP2, MRP3, MRP5 and P-glycoprotein (P-gp) act in concert with each other to give a net resultant pump function in acute myeloid leukemia (AML). The aim of the present study was to analyze the activity of these proteins, which might be upregulated at relapse as compared with de novo AML due to clonal selection. The mRNA expression and activity of P-gp and the MRPs were determined with RT-PCR and flow cytometry, in conjunction with phenotype, as measured with the monoclonal antibodies CD34, CD38 and CD33, in 30 paired samples of de novo and relapsed AML. P-gp and MRP activity varied strongly between the cases (rhodamine 123 efflux-blocking by PSC833: 5.4+/-7.7, and carboxyfluorescein efflux-blocking by MK-571: 4.3+/-6.7, n = 60). P-gp and MRP activity were increased in 23% and 40% of the relapse samples, and decreased in 30% and 20% of the relapse samples, respectively (as defined by a difference of >2 x standard deviation of the assays). Up- or downregulation of mRNA expression was observed for MDR1 (40%), MRP1 (20%), MRP2 (15%), MRP3 (30%), and MRP5 (5%). Phenotyping demonstrated a more mature phenotype in 23% of the relapsed AML cases, and a more immature phenotype in 23% of the relapses, which was independent of the karyotypic changes that were observed in 50% of the studied cases. P-gp and MRP activity correlated with the phenotypic changes, with higher P-gp and MRP activities in less mature cells (r = -0.66, P < 0.001 and r = -0.31, P = 0.02, n = 58). In conclusion, this study shows that P-gp and MRP activity are not consistently upregulated in relapsed AML. However, P-gp and MRP activities were correlated with the maturation stage as defined by immune phenotype, which was observed to be different in 46% of the relapses.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2001

The signal-to-noise ratio as the measure for the quantification of lysophospholipids by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry.

The subject of this report is the determination of lysophospholipids; lysophosphatidylcholine, lysophosphatidylethanolamine, lysophosphatidylserine and lysophosphatidic acid, by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). The mean signal-to-noise ratio (S/N) was used for the first time as a measure of lysophospholipid concentration. Two different sample preparation procedures were applied, the 'standard' procedure and the 'premix' in order to check to what extent these methods influence the results of the lysophospholipid quantification. Results can be summarised as follows: (a) All classes of lysophospholipids can be easily and sensitively analysed by MALDI-TOF MS. The smallest detectable amount of lysophospholipids was 0.09 pmol on the sample plate. That is about two orders of magnitude lower than the amount detectable by standard chromatographic methods. (b) The mean S/N of all peaks detected in the positive ion mass spectra can be used as a measure of the lysophospholipid concentration. Whereas the S/N for neutral lysophospholipids correlated with the applied concentrations only when the samples were analysed as 'premix', the sample preparation and application procedure did not influence the quantification of acidic lysophospholipids. The standard deviations were not higher than 10% of the mean value. (c) All spectra were additionally analysed in the presence of CsCl. The addition of caesium ions makes the peak identification unambiguous in phospholipid mixtures, but the Cs adducts of lysophospholipids do not properly reflect their concentration and, therefore, they were not useful for quantification. (d) The applicability of the method was demonstrated on the organic extract of human neutrophils.

Humans↗
PubMed2001

Population dynamics and antagonistic potential of enterococci colonizing the phyllosphere of grasses.

AIMS: To investigate the spatial and temporal dynamics of enterococci colonizing forage grass and their ability to produce bacteriocins. METHODS AND RESULTS: Enterococci could be detected on above-ground plant parts throughout the growing season, with high continuity but low cell numbers (2.60 x 101-6.16 x 104 cfu g-1 fresh matter). A total of 750 strains were isolated and identified by their whole-cell protein patterns as Enterococcus faecalis (7.9%), Ent. mundtii (7.9%), Ent. casseliflavus (5.5%), Ent. faecium (5.2%) and Ent. sulfureus (0.1%). The vast majority of the strains (69.7%) formed a homogeneous 16S rDNA genotype that differed from those of known enterococci. A screening for antagonistic activity using an agar spot test revealed that 18.4% of all isolates were potential antagonists. Partially-purified proteins extracted from cell-free culture supernatant fluids of various species were characterized as pH- and heat-stable bacteriocins active against a wide range of lactic acid bacteria, clostridia and Listeria. The producing strains were antagonistically active even on 'phylloplane agar' at temperatures between 4 and 37 degrees C. CONCLUSION: Enterococci are a common part of the epiphytic microflora of grasses, displaying probably some antagonistic activity. SIGNIFICANCE AND IMPACT OF THE STUDY: The results provide new information on the distribution, species diversity and antagonistic potential of enterococci in the phyllosphere.

Antibiosis↗
PubMed2001

Identification of plant-associated enterococci.

AIMS: Enterococcus isolates from forage grass were subjected to taxonomical investigations and tested for antibiotic resistance. METHODS AND RESULTS: The identification procedure included phenotypic characterizations, restriction analyses of polymerase chain reaction-amplified 16S rDNA, whole-cell protein profile analyses and 16S rDNA sequence analyses. Agar diffusion tests were performed to detect antibiotic resistance. CONCLUSION: The isolates were identified as belonging to the species Enterococcus faecium, Ent. mundtii, Ent. casseliflavus, Ent. faecalis and Ent. sulfureus. However, the majority of isolates differed distinctly in their restriction patterns from those of known species. They formed a group of a homogeneous 16S rDNA genotype (VI). The 16S rDNA sequence of a representative isolate revealed the closest relationship to the species Ent. faecalis (similarity of 97.4%). All isolates were sensitive to vancomycin, but almost all were resistant to gentamycin and streptomycin. SIGNIFICANCE AND IMPACT OF THE STUDY: The taxonomical investigations suggest that the isolates of the 16S rDNA genotype VI represent a new plant-associated Enterococcus species.

Bacterial Typing Techniques↗
PubMed2001

Interaction of hemoglobin with enterobacterial lipopolysaccharide and lipid A. Physicochemical characterization and biological activity.

The interaction of hemoglobin (Hb) with endotoxins [i.e. with enterobacterial deep rough mutant lipopolysaccharide (LPS) Re and the "endotoxic principle" of LPS, lipid A] was investigated using a variety of physical techniques and with two biological assays, tumor necrosis factor (TNF)-alpha induction in human mononuclear cells and the Limulus amebocyte lysate (LAL) assay. Fourier-transform IR-spectroscopic experiments indicate nonelectrostatic binding to the hydrophobic moiety with a slight rigidification of the lipid A acyl chains, and an increase in the inclination of the lipid A backbone with respect to the membrane surface from 35 degrees to more than 40 degrees due to Hb binding, but no change of the predominantly alpha-helical secondary structures of Hb due to LPS binding. From isothermal titration calorimetry, the molar [Hb] : [endotoxin] binding ratio lies between 1 : 3 and 1 : 5 molar. Synchrotron radiation X-ray diffraction measurements indicate a reorientation of the lipid A aggregates from one cubic structure to another, the final structure belonging to space group Q224. The LPS-induced TNF-alpha production of mononuclear cells is enhanced by Hb, whereas in the LAL assay an LPS concentration-dependent increase or decrease was observed. Although a detailed mechanism of action cannot be given, the enhancement of LPS bioactivity can be understood in the light of the previously presented conformational concept; Hb induces an increase in the conical shape of the lipid A moiety of LPS, higher cross-section of the hydrophobic than the hydrophilic part, and of the inclination angle of the diglucosamine backbone with respect to the direction of the acyl chains.

Animals↗
PubMed2001

Immunohistological demonstration of erythroid cells in canine bone marrow.

In an immunohistological/cytological study of canine bone marrow, the aim was to demonstrate canine erythroid cells with the help of various commercially available antibodies against human antigens (monoclonal antibody against glycophorin A, polyclonal antibodies against haemoglobin and spectrin). In order to preserve possible cross-reacting epitopes various fixation methods (cross-linking, precipitating and dehydrating fixing agents, partly in combination with unmasking measures), decalcification techniques [acid or ethylenediaminetetraacetic acid (EDTA) decalcification] and tissue-embedding methods (paraffin embedding, cryostat sectioning technique) were used. Alternative methods, such as the preparation of cell smears and immunoblotting, were also employed. The only result that was of use for routine diagnostic procedures (paraffin sections) was that obtained by using polyclonal antibodies against haemoglobin. Best results were achieved when tissue was fixed in a formaldehyde-glutaraldehyde mixture, decalcified in EDTA and treated with microwave irradiation. The primary antibody was used in a dilution of 1:500 and incubated for 16 h. With the exception of mature red blood cells and proerythroblasts, different stages of erythrocytopoietic cells in canine bone marrow were shown to be arranged in erythrons. The polyclonal antibody against spectrin also showed clear cross-reactivity, but was only employable in other systems (immunoblotting). The monoclonal antibody against glycophorin A reacted only when used on human tissue or cells.

Animals↗
PubMed2001

Induction of Mdr1b expression by tumor necrosis factor-alpha in rat liver cells is independent of p53 but requires NF-kappaB signaling.

The multidrug resistance protein Mdr1b in rats is up-regulated during liver regeneration after partial hepatectomy or after endotoxin treatment. We hypothesize that up-regulation of Mdr1b in these models is TNF-alpha-dependent. The mechanism of Mdr1b activation by TNF-alpha is unknown as TNF-alpha can signal through various pathways, including NF-kappaB and p53, transcription factors for which binding sites in the Mdr1b promoter have been identified. We aimed to elucidate the mechanism of up-regulation of Mdr1b by TNF-alpha. We selectively used constructs expressing dominant negative Fas-associated death domain protein (FADD), TNF receptor associated factor-2 (TRAF2) or IkappaB to inhibit pathways downstream of the TNF receptor. Further, the proteasome inhibitor MG-132 was used, which prevents the breakdown of IkappaB. We show a critical role for NF-kappaB in activation of Mdr1b gene expression both in primary rat hepatocytes and in rat hepatoma H-4-II-E cells. Because p53 is up-regulated by TNF-alpha in an NF-kappaB-dependent manner and the Mdr1b promoter contains a p53 binding site, we used liver cells expressing a dominant negative p53 to show that TNF-alpha up-regulation of Mdr1b is independent of functional p53. Using transient transfection assays, we show that Mdr1b up-regulation correlates with activation of the promoter. Mutation of the NF-kappaB site in the Mdr1b promoter prevents its induction by TNF-alpha. In conclusion our results show that activation of the rat Mdr1b gene by TNF-alpha is a result of NF-kappaB signaling and independent of p53.

ATP Binding Cassette Transporter, Subfamily B↗
PubMed2001

Calcium stores in differentiated Dictyostelium discoideum: prespore cells sequester calcium more efficiently than prestalk cells.

Dictyostelium discoideum pseudoplasmodia exhibit a gradient of the cytosolic free Ca2+-concentration ([Ca2+]i) along their anterior-posterior axis involved in cell-type specific differentiation. [Ca2+]i is high in prestalk and low in prespore cells. We determined the content and localization of calcium and other elements in cryosectioned cells of pseudoplasmodia and fruiting bodies by X-ray microanalysis. Granular stores rich in Ca, Mg and P were identified. Average Ca was higher in prespore than prestalk granules (225vs 111 mmol/kg dry weight). Total Ca stored in granules was also higher in prespore than prestalk cells. The amount of P and S in granules differed between the two cell types indicating different store composition. In spores mean granular Ca was 120 mmol/kg dry weight. Stalk cells had smaller granules with 360 mmol Ca/kg dry weight. Complementary to microanalysis, vesicular Ca2+-fluxes were studied in fractionated cell homogenates. The rate of Ca2+-uptake was higher in pellet fractions of prespore than prestalk amoebae (4.7 vs 3.4 nmol/min x mg). Ca2+-release was greater in supernatant fractions from prestalk than prespore cells (16.5vs 7.7 nmol/10(8)cells). In summary, prestalk and prespore cells possess qualitatively different, high-capacity stores containing distinct amounts of Ca and probably being involved in regulation of the anterior-posterior [Ca2+]i-gradient.

Animals↗
PubMed2001

[Topical Mitomycin C for the prophylaxis of recurrent haze after excimer laser photorefractive keratectomy (PRK) - a pilotstudy of 5 patients].

PURPOSE: Corneal haze is a severe complication after excimer laser PRK and may lead to a compromised visual performance and regression. Currently, corticosteroids are topically applied to inhibit the appearance of haze. However, this therapy is not always successful in preventing haze. Various animal studies have shown that topical applied mitomycin C reduces keratocyte activity and collagen synthesis and subsequently haze. MATERIAL AND METHODS: We have treated 5 patients (5 eyes) with severe haze and regression after PRK. In all eyes we have mechanically debrided the haze and 0.02 % mitomycin C was applied to the area of previous ablation for 1 minute. In 2 eyes we have only performed the debridement, whereas in 3 eyes we also have performed a re-PRK after the laser ablation the mitomycin was applied. The postop follow-up was 9 months. RESULTS: In all eyes the surgery and the postop time was without any complications. The haze could be removed in all eyes completely and in the entire postop period recurrent haze was not more than trace. Regression could be eliminated in the three eyes with a re-PRK, whereas the 2 eyes without re-PRK still remained myop. We could not observe any mitomycin C associated complications on the conjunctiva or cornea. CONCLUSION: Topical applied mitomycin C seems to be a promising therapy to prevent recurrent haze after a second PRK procedure. As mitomycin C can be associated with a variety of serious complications, it should only be used in patients with high risk of haze.

Adult↗
PubMed2001

Angioplasty increases target site concentrations of ciprofloxacin in patients with peripheral arterial occlusive disease.

OBJECTIVE: Patients with peripheral arterial occlusive disease are prone to soft tissue infections and frequently require antibiotics. To date, however, it is not known whether improvement of arterial blood flow by angioplasty of stenosis increases antibiotic concentrations in ischemic lesions. PATIENTS AND METHODS: All patients were scheduled to undergo elective percutaneous transluminal angioplasty (n = 10). Following a single, 400-mg dose of ciprofloxacin, drug concentrations in plasma, ischemic and healthy soft tissue; arterial peak systolic velocity; and ankle-brachial pressure index were assessed before and after angioplasty. Unbound ciprofloxacin concentrations were measured at the site of infection with use of in vivo microdialysis. RESULTS: Angioplasty increased peak systolic velocity and ankle-brachial pressure index compared with baseline (P <.002). Before angioplasty area under concentration-time curve (AUC(0-300)) values for ciprofloxacin were lower in ischemic tissue than in healthy tissue, with median values of 7.1 mg.h/L (range, 3.5-13.0) and 11.3 mg.h/L (range, 3.4-19.0), respectively (P =.03). After angioplasty AUC(0-300) values were identical in ischemic and healthy adipose tissue; median AUC(0-300) values were 8.0 mg.h/L (range, 4.0-20.7) and 8.5 mg.h/L (range, 4.4-22.9), respectively (P =.7). A combined in vivo pharmacokinetic/in vitro pharmacodynamic simulation based on tissue concentration data indicates that this difference in pharmacokinetics is also reflected in antimicrobial effect. CONCLUSION: Antibiotic concentrations are reduced significantly in ischemic lesions compared to those of healthy adipose tissue in patients with peripheral arterial occlusive disease. From the present data it might be speculated that improvement of arterial blood flow at the affected extremity is associated with increased cure rates of soft tissue infections in these patients.

Adipose Tissue↗
PubMed2001

Comparison of color-flow Doppler scanning, power Doppler scanning, and frequency shift for assessment of carotid artery stenosis.

OBJECTIVE: We investigated the accuracy of color-flow Doppler (CD) scanning, power Doppler (PD) scanning, and peak systolic Doppler frequency shift (PSF) in assessment of carotid artery stenosis with angiography used as gold standard, including the measurement techniques used in the North American Symptomatic Carotid Surgery Trial (NASCET) and the European Carotid Surgery Trial (ECST). METHODS: Fifty-eight consecutive patients diagnosed for carotid artery surgery underwent color-coded duplex sonography and angiography. The duplex examination included the assessment of PSF and the videotaping of sagittal images in CD and PD mode from the proximal common carotid artery to the distal internal carotid artery. Two experienced examiners performed the studies, but once one examiner had done the taping, the other examiner was allowed only to review the tape. Separately, each examiner reviewed the tapes and determined by cursor settings each stenosis according to NASCET and ECST. For interobserver agreement kappa statistic was used. To compare with angiography (degree of stenosis 40%, 50%, 60%, 70%, and 80%) sensitivity, specificity, positive and negative predictive values, and overall accuracy were calculated. PSF cut-off frequencies were based on receiver operator curve analysis. RESULTS: Because interobserver agreement in CD and PD was good (chance-corrected kappa > 0.6), further analysis used the between-observer mean value for each stenosis. With the NASCET measurement technique, accuracy of Doppler techniques to distinguish a 50% stenosis was 89% for PSF, 91% for CD, and 93% for PD; for a 70% stenosis it was 83% for PSF, 84% for CD, and 81% for PD. With the ECST measurement technique, accuracy to distinguish a 70% stenosis was 86% for PSF, 88% for CD, and 86% for PD; for an 80% stenosis it was 87% for PSF, 87% for CD, and 77% for PD. CONCLUSION: CD and PD carotid artery stenosis measurements are highly reproducible, and in our hands provided accuracy equal to PSF.

Aged↗
PubMed2001

Inhibition of the human erythrocytic glutathione-S-transferase T1 (GST T1) by thimerosal.

We have investigated the interaction of thimerosal, a widely used antiseptic and preservative, with the human erythrocytic GST T1 (glutathione-S-transferase T1). This detoxifying enzyme is expressed in the erythrocytes of solely the human species and it displays a genetic polymorphism. Due to this polymorphism about 25% of the individuals of the caucasian population lack this activity ("non-conjugators"), while 75% show it ("conjugators") (Hallier, E., et al., 1993). Using our newly developed HPLC-fluorescence detection assay (Müller, M., et al., 2001) we have profiled the kinetics of enzyme inhibition in erythrocyte lysates of two individuals previously identified as "normal conjugator" (medium enzyme activity) and "super-conjugator" (very high activity). For the normal conjugator we have determined a 2.77 mM thimerosal concentration to inhibit 50% of the GST T1 activity. In the case of the super-conjugator a 2.3 mM thimerosal concentration causes a 50% inhibition of the enzyme activity. For both phenotypes a 14.8 mM thimerosal concentration results in residual enzyme activities equal to those typically detected in non-conjugator lysates. Thus, sufficiently high doses of thimerosal may be able to change the phenotypic status of an individual--at least in vitro--by inhibition of the GST T1 enzyme.

Anti-Infective Agents, Local↗
PubMed2001

Nucleolar protein allocation and ultrastructure in bovine embryos produced by nuclear transfer from embryonic cells.

In the present study, immunofluorescence confocal laser scanning microscopy, autoradiography following (3)H-uridine incubation, and transmission electron microscopy were used to evaluate the nucleolar protein localization, transcriptional activity, and nucleolar ultrastructure during genomic reprogramming in bovine embryos reconstructed by nuclear transfer from in vitro-produced bovine morulae to activated cytoplasts. During the first cell cycle (one-cell embryos), no autoradiographic labelling was detected. Ultrastructurally, whorls consisting of densely packed fibrillar material were observed instead of nucleoli. During the second, third, and fourth cell cycle (two-, four-, and tentative eight-cell embryos), autoradiographically unlabelled nuclei contained vacuolated bodies consisting of densely packed fibrillar material. Also, during the fourth cell cycle, the first nucleoplasmic autoradiographic labelling was observed, but still without formation of fibrillo-granular nucleoli. During the fifth cell cycle (tentative 16-cell embryos), the nuclei displayed autoradiographic labelling over both nucleoplasm and presumptive nucleoli, and the formation of fibrillo-granular nucleoli was observed. In a certain proportion of blastomeres, however, abnormal patterns of nucleolar formation and apoptosis were noted. During the first two cell cycles, labelling of RNA polymerase I, fibrillarin, upstream binding factor (UBF), nucleolin (C23), and nucleophosmin (B23) was localized to nuclear entities. During the third cell cycle, labelling of topoisomerase I was observed in addition. During the fourth and fifth cell cycles, a substantial portion of the embryos presented blastomeres that lacked labelling of several of these nucleolar proteins. In conclusion, the nuclear transfer procedure was associated with remodelling of the nucleoli to an inactive form, followed by reformation of fibrillo-granular nucleoli during the fifth cell cycle. Moreover, a certain proportion of blastomeres failed to form functional nucleoli with respect to both ultrastructural organization and protein allocation.

Animals↗
PubMed2001

Recovery and neurological examination after remifentanil-desflurane or fentanyl-desflurane anaesthesia for carotid artery surgery.

We studied 44 patients undergoing carotid endarterectomy (CEA) to compare recovery after general anaesthesia with desflurane supplemented with either remifentanil or fentanyl. Remifentanil was infused at 0.1 microg kg(-1) min(-1) and desflurane was adjusted at 2 vol% end-tidal. Fentanyl was given as a bolus dose of 2 microg kg(-1) before induction and repeated at skin incision; desflurane was adjusted as needed. Times for early recovery and response to simple neurological tests (digit symbol substitution test (DSST) and Trieger dot test (TDT)) were measured 30, 60 and 90 min after operation. Emergence from remifentanil-desflurane anaesthesia was significantly quicker than that from fentanyl-desflurane anaesthesia: mean times to extubation were 4.1 (SD 1.7) and 8.2 (4.9) min, respectively; mean times for patients to state their name correctly were 6.0 (2.8) and 13.8 (9.0) min, respectively. Patients in the remifentanil-desflurane group successfully performed neurological tests significantly earlier than those in the fentanyl-desflurane group; for example, patients in the former group completed the arm holding test at 7.9 (3.0) min, while those in the latter group did this at 20.6 (19.7) min (P < or = 0.01). Intermediate recovery was less impaired at 30 min (DSST, TDT) and at 60 min (DSST). More rapid awakening and an earlier opportunity for neurological examination suggest that remifentanil-desflurane is a suitable alternative to a standard fentanyl-based general anaesthetic technique in patients undergoing CEA.

Adult↗
PubMed2001

Combination of external chest wall oscillation with continuous positive airway pressure.

We studied the effects of continuous positive airway pressure (CPAP) on pulmonary gas exchange during external chest wall oscillation (ECWO), and the relationship with obesity, in nine patients with normal body weight (group 'N') and 10 obese patients (group 'O'). During ECWO with CPAP 5, PaCO2 decreased in group 'O' (6.0 (SD 0.8) to 5.6 (0.5) kPa, P<0.05), whereas it increased in group 'N' at all levels (P<0.01). Arterial PO(2) (P<0.001) was greater and PaCO2 (P<0.01) less in group 'N' during CPPV and ECWO plus CPAP. We also compared the haemodynamic effects of ECWO plus CPAP with those of continuous positive pressure ventilation (CPPV). ECWO plus CPAP and CPPV were applied for 30 min to 6 ASA III patients. Cardiac output (CI 2.7 (0.5) vs 2.1 (0.2) litre x min(-1) x m(-2), P<0.05) and stroke volume (SVI 49 (9) vs 32 (6) ml x m(-2), P<0.05) were greater during ECWO plus CPAP than with CPPV. ECWO is less effective in obese individuals than in those with normal body weight, and the effect of CPAP in overweight individuals is small.

Adult↗