Intravenous versus nebulized ceftazidime in ventilated piglets with and without experimental bronchopneumonia: Comparative effects of helium and nitrogen

Background: Lung deposition of intravenous cephalosporins is low. The lung deposition of equivalent doses of ceftazidime administered either intravenously or by ultrasonic nebulization using either nitrogen-oxygen or helium-oxygen as the carrying gas of the aerosol was compared in ventilated piglets with and without experimental bronchopneumonia. Methods: Five piglets with noninfected lungs and 5 piglets with Pseudomonas aeruginosa experimental bronchopneumonia received 33 mg/kg ceftazidime intravenously. Ten piglets with noninfected lungs and 10 others with experimental P. aeruginosa bronchopneumonia received 50 mg/kg ceftazidime by ultrasonic nebulization. In each group, the ventilator was operated in half of the animals with a 65%/35% helium-oxygen or nitrogen-oxygen mixture. Animals were killed, and multiple lung specimens were sampled for measuring ceftazidime lung tissue concentrations by high-performance liquid chromatography. Results: As compared with intravenous administration, nebulization of ceftazidime significantly increased lung tissue concentrations (17 ± 13 vs. 383 ± 84 μg/g in noninfected piglets and 10 ± 3 vs. 129 ± 108 μg/g in piglets with experimental bronchopneumonia; P < 0.001). The use of a 65%/35% helium-oxygen mixture induced a 33% additional increase in lung tissue concentrations in noninfected piglets (576 ± 141 μg/g; P < 0.001) and no significant change in infected piglets (111 ± 104 μg/g). Conclusion: Nebulization of ceftazidime induced a 5- to 30-fold increase in lung tissue concentrations as compared with intravenous administration. Using a helium-oxygen mixture as the carrying gas of the aerosol induced a substantial additional increase in lung deposition in noninfected piglets but not in piglets with experimental bronchopneumonia. © 2005 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc.

Echocardiographic Doppler estimation of pulmonary artery pressure in critically ill patients with severe hypoxemia

BACKGROUND: In spontaneously breathing cardiac patients, pulmonary artery pressure (PAP) can be accurately estimated from the transthoracic Doppler study of pulmonary artery and tricuspid regurgitation blood flows. In critically ill patients on mechanical ventilation for acute lung injury, the interposition of gas between the probe and the heart renders the transthoracic approach problematic. This study was aimed at determining whether the transesophageal approach could offer an alternative. METHODS: Fifty-one consecutive sedated and ventilated patients with severe hypoxemia (arterial oxygen tension/fraction of inspired oxygen < 300) were prospectively studied. Mean PAP measured from the pulmonary artery catheter was compared with several indices characterizing pulmonary artery blood flow assessed using transesophageal echocardiography: preejection time, acceleration time, ejection duration, preejection time on ejection duration ratio, and acceleration time on ejection duration ratio. In a subgroup of 20 patients, systolic PAP measured from the pulmonary artery catheter immediately before withdrawal was compared with Doppler study of regurgitation tricuspid flow performed immediately after pulmonary artery catheter withdrawal using either the transthoracic or the transesophageal approach. RESULTS: Weak and clinically irrelevant correlations were found between mean PAP and indices of pulmonary artery flow. A statistically significant and clinically relevant correlation was found between systolic PAP and regurgitation tricuspid flow. In 3 patients (14%), pulmonary artery pressure could not be assessed echocardiographically. CONCLUSIONS: In hypoxemic patients on mechanical ventilation, mean PAP cannot be reliably estimated from indices characterizing pulmonary artery blood flow. Systolic PAP can be estimated from regurgitation tricuspid flow using either transthoracic or transesophageal approach. © 2008 American Society of Anesthesiologists, Inc.

Impacto tecnológico y productivo de la minería del cobre en la industria chilena, 1955-1988

Incluye Bibliografía

A cerâmica do povo Paiter Suruí de Rondônia: continuidade e mudança cultural, 1970-2010

Pós-graduação em Artes - IA

A contribuição do pensamento de Rousseau na construção da antropologia como disciplina acadêmica no século XIX

Pós-graduação em Ciências Sociais - FFC

O elogio da frugalidade em A nova Heloisa de Rousseau

Pós-graduação em Filosofia - FFC

Rousseau e Molière: uma análise sobre a crítica do riso e da ridicularização

Pós-graduação em Filosofia - FFC

Le promeneur littéraire dans le romantisme français

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Práticas de leitura contemporâneas: representações discursivas do leitor inscritas na revista Veja

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Vésper

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Sentimento e subjetividade em Rousseau e nos primeiros ramânticos alemães

O objetivo desta dissertação é estabelecer as relações existentes entre Rousseau, Kant e os primeiros românticos alemães. A partir da perspectiva estabelecida pela Terceira Crítica, de Kant, nos voltaremos para as obras de Rousseau e do Romantismo (particularmente, as de Novalis e Schlegel) para extrair delas dois conceitos fundamentais, o de sentimento e o de subjetividade. Acreditamos, assim, poder esclarecer, por meio das próprias obras de Rousseau e dos primeiros românticos, o autêntico significado das noções de sentimento e de subjetividade, de modo a não só recuperar o verdadeiro valor filosófico de tais obras, mas, sobretudo, para mostrar o uso consciente delas na determinação de suas posturas frente ao pretenso “racionalismo” dominante no pensamento moderno.

Aspectos sincrônicos e diacrônicos da música eletroacústica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Um caso de espionagem na obra de Rousseau: o conde d'Antraigues

The count d’Antraigues, rousseauist and monarchist, became an anti-revolutionary secret agent during the French Revolution. This paper aims to prove that a girondin lecture of Rousseau approachs recent efforts to remove the hobbesianism from his thought. In other words, an anti-revolutionary conservative critic is the opposite of a present conservative critic.

Direito natural e política em Rousseau

We intend to present how the principles of political right that are at the convention that founds the political and moral body are resultant of Rousseau's natural right critiques. From restrictions to the established by philosophical tradition, Rousseau proposes his own thinking system and his own method, where the notions of nature, morality and legitimacy become a fecund field to his readers.