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In 14 critically ill patients in stable cardiopulmonary status, right ventricular ejection fraction (RVEF) was measured by thermodilution technique and by radionuclear (gated first pass) technique. The pulmonary artery catheter was equipped with a fastresponse thermistor and an intracardiac ECG monitor. In addition, the proximal lumen ended in a 3-hole port(More)
To assess whether hyponatremia in acute neurological patients is associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or with the cerebral salt-wasting syndrome (CSWS). Clinical, controlled, prospective study. Department of intensive care of a tertiary care academic hospital. Forty acute neurological patients with(More)
We studied the effects of metabolic and respiratory acidosis (pH 7.20) and alkalosis (pH 7.60) on pulmonary vascular tone in 32 pentobarbital-anesthetized dogs ventilated with hyperoxia (inspired oxygen fraction, FIO2 0.40) and with hypoxia (FIO2 0.10). Ventilation, pulmonary capillary wedge pressure (Ppw), and cardiac output (3 l.min-1.m-2) were maintained(More)
The last events before death were analyzed in 258 patients who died in our ICU. Deepening coma (104 patients) and acute circulatory failure (90 patients) were the most common events preceding death. Catastrophic events accounted for only 12% of deaths. In 168 (65%) of 258 patients, death was considered inevitable and CPR was not performed. Furthermore, 22(More)
OBJECTIVE We tested the hypothesis that carbon monoxide might participate in the modulation of hypoxic pulmonary vasoconstriction (HPV) by prostacyclin (PGI2) and nitric oxide. DESIGN Prospective, interventional study. SETTING University laboratory. SUBJECTS Nineteen intact anesthetized mongrel dogs. INTERVENTIONS Right heart catheterization for the(More)
Tissue Doppler imaging (TDI) was used to obtain additional insight into the cardiac adaptation to severe pulmonary arterial hypertension. Pulmonary hemodynamics and right and left ventricular function were investigated in 18 untreated patients, 12 with pulmonary arterial hypertension and 6 with chronic thromboembolic pulmonary hypertension. Fourteen(More)
We analyzed the serum anion gap (AG = sodium plus potassium minus chloride plus bicarbonate, N = 11-21 mEq/l), serum uric acid and urea concentrations in hyponatremia of various origins. We found that characteristic chemical patterns emerged in association with different hypotonic states: Low uric acid concentration was typically observed in the SIADH and(More)
Hypoxic pulmonary vasoconstriction continues to attract interest more than half a century after its original report because of persistent mystery about its biochemical mechanism and its exact physiological function. Recent work suggests an important role for pulmonary arteriolar smooth muscle cell oxygen-sensitive voltage-dependent potassium channels.(More)
RATIONALE Prostacyclin therapy improves patients with pulmonary arterial hypertension, but whether this is attributable to an improved inotropic state of the right ventricle in addition to a decreased pulmonary arterial pulmonary vascular resistance remains unclear. OBJECTIVES We measured the effects of prostacyclin on load-independent measurements of(More)
Pigs have been reported to present with a stronger pulmonary vascular reactivity than many other species, including dogs. We investigated the pulmonary vascular impedance response to autologous blood clot embolic pulmonary hypertension in anesthetized and ventilated minipigs (n = 6) and dogs (n = 6). Before embolization, minipigs, compared with dogs,(More)