Measurement of positive end-expiratory pressure (PEEP)-induced alveolar recruitment using the pressure–volume (PV) curve

<p><b>Copyright information:</b></p><p>Taken from "Clinical review: Bedside assessment of alveolar recruitment"</p><p>Critical Care 2003;8(3):163-169.</p><p>Published online 22 Oct 2003</p><p>PMCID:PMC468885.</p><p>Copyright © 2004 BioMed Central Ltd</p> The PV curves of the respiratory system recorded from zero end-expiratory pressure (ZEEP) and from PEEP are superimposed on a common volume axis. '0' volume corresponds to the end-expiratory lung volume (EELV) on ZEEP. The first point of the PEEP PV curve corresponds to the increase in EELV induced by PEEP (Δ EELV). On this example, the recruitment induced by PEEP is measured at a pressure of 20 cmHO

Enriched Air Nitrox Breathing Reduces Venous Gas Bubbles after Simulated SCUBA Diving: A Double-Blind Cross-Over Randomized Trial

<div><p>Objective</p><p>To test the hypothesis whether enriched air nitrox (EAN) breathing during simulated diving reduces decompression stress when compared to compressed air breathing as assessed by intravascular bubble formation after decompression.</p><p>Methods</p><p>Human volunteers underwent a first simulated dive breathing compressed air to include subjects prone to post-decompression venous gas bubbling. Twelve subjects prone to bubbling underwent a double-blind, randomized, cross-over trial including one simulated dive breathing compressed air, and one dive breathing EAN (36% O₂) in a hyperbaric chamber, with identical diving profiles (28 msw for 55 minutes). Intravascular bubble formation was assessed after decompression using pulmonary artery pulsed Doppler.</p><p>Results</p><p>Twelve subjects showing high bubble production were included for the cross-over trial, and all completed the experimental protocol. In the randomized protocol, EAN significantly reduced the bubble score at all time points (cumulative bubble scores: 1 [0–3.5] vs. 8 [4.5–10]; P < 0.001). Three decompression incidents, all presenting as cutaneous itching, occurred in the air versus zero in the EAN group (P = 0.217). Weak correlations were observed between bubble scores and age or body mass index, respectively.</p><p>Conclusion</p><p>EAN breathing markedly reduces venous gas bubble emboli after decompression in volunteers selected for susceptibility for intravascular bubble formation. When using similar diving profiles and avoiding oxygen toxicity limits, EAN increases safety of diving as compared to compressed air breathing.</p><p>Trial Registration</p><p><a href="http://www.isrctn.com/ISRCTN31681480" target="_blank">ISRCTN 31681480</a></p></div

Intravascular bubble scores of two air dives.

<p>Intravascular bubble scores of two air dives.</p

Intravascular bubble score.

<p>Intravascular bubble score.</p

Inclusion and randomization flow diagram.

<p>EAN = Enriched air nitrox.</p

Simulated diving profile.

<p>Study compression profile as used for all simulated dives to a maximum depth of 28 msw, followed by two decompression steps at 6 msw and 3 msw. For further details see text.</p

Additional file 4: of Comparison of the efficacy and safety of FP-1201-lyo (intravenously administered recombinant human interferon beta-1a) and placebo in the treatment of patients with moderate or severe acute respiratory distress syndrome: study protocol for a randomized controlled trial

Sample Consent Form. (PDF 133 kb

Additional file 3: of Comparison of the efficacy and safety of FP-1201-lyo (intravenously administered recombinant human interferon beta-1a) and placebo in the treatment of patients with moderate or severe acute respiratory distress syndrome: study protocol for a randomized controlled trial

Guidelines for general support. (PDF 286 kb

Additional file 2: of Comparison of the efficacy and safety of FP-1201-lyo (intravenously administered recombinant human interferon beta-1a) and placebo in the treatment of patients with moderate or severe acute respiratory distress syndrome: study protocol for a randomized controlled trial

List of Ethical Committee approvals already in place. (PDF 403 kb