scholarly journals Effects of methylene blue on gas exchange and myocardial function in refractory septic shock with acute lung injury

Critical Care ◽  
10.1186/cc68 ◽  
1997 ◽  
Vol 1 (Suppl 1) ◽  
pp. P076
Author(s):  
M Andresen ◽  
A Dougnac ◽  
M Alvarez ◽  
G Hernandez ◽  
O Diaz ◽  
...  
Keyword(s):  
Septic Shock ◽  
Methylene Blue ◽  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Myocardial Function ◽  
Refractory Septic Shock

Use of methylene blue in patients with refractory septic shock: Impact on hemodynamics and gas exchange

1998 ◽  
Vol 13 (4) ◽  
pp. 164-168 ◽  
Author(s):  
Max Andresen ◽  
Alberto Dougnac ◽  
Orlando Diaz ◽  
Glen Hernandez ◽  
Luis Castillo ◽  
...  
Keyword(s):  
Septic Shock ◽  
Methylene Blue ◽  
Gas Exchange ◽  
Shock Impact ◽  
Refractory Septic Shock

Colloidal gold particles as a new in vivo marker of early acute lung injury

2004 ◽  
Vol 287 (4) ◽  
pp. L867-L878 ◽  
Author(s):  
Kai Heckel ◽  
Rainer Kiefmann ◽  
Martina Dörger ◽  
Mechthild Stoeckelhuber ◽  
Alwin E. Goetz
Keyword(s):  
Electron Microscopy ◽  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Colloidal Gold ◽  
Microvascular Permeability ◽  
Arterial Oxygen ◽  
Control Group ◽  
Gold Particles

Permeability of the endothelial barrier to large molecules plays a pivotal role in the manifestation of early acute lung injury. We present a novel and sensitive technique that brings microanatomical visualization and quantification of microvascular permeability in line. White New Zealand rabbits were anesthetized and ventilated mechanically. Rabbit serum albumin (RSA) was labeled with colloidal gold particles. We quantified macromolecular leakage of gold-labeled RSA and thickening of the gas exchange distance by electron microscopy, taking into account morphology of microvessels. The control group receiving a saline solution represented a normal gas exchange barrier without extravasation of gold-labeled albumin. Infusion of lipopolysaccharide (LPS) resulted in a significant displacement of gold-labeled albumin into pulmonary cells, the lung interstitium, and even the alveolar space. Correspondingly, intravital fluorescence microscopy and digital image analysis indicated thickening of width of alveolar septa. The findings were accompanied by a deterioration of alveolo-arterial oxygen difference, whereas wet/dry ratio and albumin concentration in the bronchoalveolar lavage fluid failed to detect that early stage of pulmonary edema. Inhibition of the nuclear enzyme poly(ADP-ribose) synthetase by 3-aminobenzamide prevented LPS-induced microvascular injury. To summarize: colloidal gold particles visualized by standard electron microscopy are a new and very sensitive in vivo marker of microvascular permeability in early acute lung injury. This technique enabling detailed microanatomical and quantitative pathophysiological characterization of edema formation can form the basis for evaluating novel treatment strategies against acute lung injury.

scholarly journals METHYLENE BLUE IN REFRACTORY SEPTIC SHOCK

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A2558
Author(s):  
Mouhanned Eliliwi ◽  
Jennifer Meyfeldt ◽  
Stephanie Hart ◽  
Eliot Friedman
Keyword(s):  
Septic Shock ◽  
Methylene Blue ◽  
Refractory Septic Shock

Short-term Cardiorespiratory Effects of Proportional Assist and Pressure-support Ventilation in Patients with Acute Lung Injury/Acute Respiratory Distress Syndrome

2006 ◽  
Vol 105 (4) ◽  
pp. 703-708 ◽  
Author(s):  
Eumorfia Kondili ◽  
Nectaria Xirouchaki ◽  
Katerina Vaporidi ◽  
Maria Klimathianaki ◽  
Dimitris Georgopoulos
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Distress Syndrome ◽  
Short Term ◽  
Support Ventilation

Background Recent data indicate that assisted modes of mechanical ventilation improve pulmonary gas exchange in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Proportional assist ventilation (PAV) is a new mode of support that amplifies the ventilatory output of the patient effort and improves patient-ventilator synchrony. It is not known whether this mode may be used in patients with ALI/ARDS. The aim of this study was to compare the effects of PAV and pressure-support ventilation on breathing pattern, hemodynamics, and gas exchange in a homogenous group of patients with ALI/ARDS due to sepsis. Methods Twelve mechanically ventilated patients with ALI/ARDS (mean ratio of partial pressure of arterial oxygen to fractional concentration of oxygen 190 +/- 49 mmHg) were prospectively studied. Patients received pressure-support ventilation and PAV in random order for 30 min while maintaining mean airway pressure constant. With both modes, the level of applied positive end-expiratory pressure (7.1 +/- 2.1 cm H2O) was kept unchanged throughout. At the end of each study period, cardiorespiratory data were obtained, and dead space to tidal volume ratio was measured. Results With both modes, none of the patients exhibited clinical signs of distress. With PAV, breathing frequency and cardiac index were slightly but significantly higher than the corresponding values with pressure-support ventilation (24.5 +/- 6.9 vs. 21.4 +/- 6.9 breaths/min and 4.4 +/- 1.6 vs. 4.1 +/- 1.3 l . min . m, respectively). None of the other parameters differ significantly between modes. Conclusions In patients with ALI/ARDS due to sepsis, PAV and pressure-support ventilation both have clinically comparable short-term effects on gas exchange and hemodynamics.

scholarly journals Derecruitment Test and Surfactant Therapy in Patients with Acute Lung Injury

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Alexey A. Smetkin ◽  
Vsevolod V. Kuzkov ◽  
Konstantin M. Gaidukov ◽  
Lars J. Bjertnaes ◽  
Mikhail Y. Kirov
Keyword(s):  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Predictive Value ◽  
Conventional Therapy ◽  
Therapy Group ◽  
Lung Mechanics ◽  
Lung Water ◽  
Mechanically Ventilated ◽  
Water Index

Introduction. A recruitment maneuver (RM) may improve gas exchange in acute lung injury (ALI). The aim of our study was to assess the predictive value of a derecruitment test in relation to RM and to evaluate the efficacy of RM combined with surfactant instillation in patients with ALI.Materials and Methods. Thirteen adult mechanically ventilated patients with ALI were enrolled into a prospective pilot study. The patients received protective ventilation and underwent RM followed by a derecruitment test. After a repeat RM, bovine surfactant (surfactant group,n=6) or vehicle only (conventional therapy group,n=7) was instilled endobronchially. We registered respiratory and hemodynamic parameters, including extravascular lung water index (EVLWI).Results. The derecruitment test decreased the oxygenation in 62% of the patients. We found no significant correlation between the responses to the RM and to the derecruitment tests. The baseline EVLWI correlated with changes in SpO2following the derecruitment test. The surfactant did not affect gas exchange and lung mechanics but increased EVLWI at 24 and 32 hrs.Conclusions. Our study demonstrated no predictive value of the derecruitment test regarding the effects of RM. Surfactant instillation was not superior to conventional therapy and might even promote pulmonary edema in ALI.

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