We have recently shown that end-expiratory lobar alveolar gas concentrations vary with body position (1). Erect man has higher oxygen and lower carbon dioxide concentrations and a higher R.Q. in the right upper lobe than in the right lower lobe. Supine man has no significant difference between these lobes in R.Q. but the oxygen concentration is lower and the carbon dioxide higher in the upper l...

INTRODUCTION Lung-protective ventilation reduced acute respiratory distress syndrome (ARDS) mortality. To minimize ventilator-induced lung injury (VILI), tidal volume is limited, high plateau pressures are avoided, and positive end-expiratory pressure (PEEP) is applied. However, the impact of specific ventilatory patterns on VILI is not well defined. Increasing inspiratory time and thereby the ...

BACKGROUND AND OBJECTIVES Chronic obstructive pulmonary disease (COPD) is defined as a syndrome characterized by usually progressive chronic airflow limitation which is associated to a bronchial hyperresponsiveness and is partially reversible. Noninvasive mechanical ventilation is an alternative treatment for patients with COPD exacerbations. The objective of the literature reviews was to verif...

The diagnosis of pulmonary embolism may be confounded by a clinical presentation that is often subtle or atypical. Therefore pulmonary angiography, although invasive, has been widely used to prove pulmonary embolism. The aim of this review is to discuss the value of non-invasive techniques, such as lung scan and chest computed tomography scan, in the diagnosis of pulmonary embolism. Ventilation...

AIM To summarise the evidence on the efficacy of elective high frequency ventilation compared with conventional ventilation in preterm infants with respiratory distress syndrome. METHODS A search from 1987 onwards was made on Embase, Medline, and the Cochrane Library. A questionnaire was also circulated during an international meeting on high frequency ventilation. To be included in the data ...

OBJECTIVE To examine if mechanical ventilation with positive end-expiratory pressure (PEEP) combined with intra-aortic balloon pump (IABP) provided a better outcome than IABP alone for the treatment of cardiogenic shock after acute myocardial infarction in patients aged > 60 years. METHODS This was a retrospective analysis of data from patients in cardiogenic shock, refractory to pharmacologi...

BACKGROUND The role of gravity in the redistribution of pulmonary blood flow during one-lung ventilation (OLV) has been questioned recently. To address this controversial but clinically important issue, we used an experimental approach that allowed us to differentiate the effects of gravity from the effects of hypoxic pulmonary vasoconstriction (HPV) on arterial oxygenation during OLV in patien...

The mechanical characteristics of the ventilated lung can only be interpreted when the volume of the lung, the elastic properties, and the degree of airway obstruction have been accurately quantified by pulmonary function testing. More gentle ventilation strategies (permissive hypercapnia) are used, and the efficacy of mechanical ventilation can be verified in the intensive care unit. Pulmonary...