By K. Hillman (auth.), Antonino Gullo M.D. (eds.)
Developing sectors within the in depth Care box – and in serious Care medication more often than not – require particular degrees of competence having a similar universal denominator: an in-depth wisdom of human pathophysiology. even if this quantity provides lots of issues in consistent evolution, as witnessed by means of the gathering of chapters compiled by means of a number of researchers, this version contains, particularly, fields within which decision-making on the patient’s bedside prevails over theoretical argumentation. In different phrases, the 1st and superior message this variation desires to offer is for the reader to concentration his/her realization on evidence-based medicine.
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Extra info for Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: Proceedings of the 21st Postgraduate Course in Critical Care Medicine Venice-Mestre, Italy — November 10–13, 2006
Chest 116:9S–15S 18. Webb HH, Tieney DF (1974) Experimental pulmonary edema due to intermittent positive pressure ventilation with high inflation pressures: protection by positive end-expiratory pressure. Am Rev Respir Dis 110:556–565 19. Egan EA (1976) Effect of lung inflation on alveolar permeability to solutes. Ciba Found Symp 38:101–114 20. Dreyfuss D, Soler P, Basset G et al (1988) High inflation pressure pulmonary edema: respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure.
Under this condition, the sigmoidal shape is not observed in normal subjects during tidal ventilation, since breathing takes place at the linear portion of the P–V curve. An important phenomenon observed in P–V curves is hysteresis. To achieve the same lung volume, more pressure must be applied during inflation than deflation (Fig. 1) [2, 5]. Because the dependent regions of the lung have a natural tendency to collapse at low volumes, even the normal pressure–volume curve of the lung displays some degree of hysteresis .
Elastic fibres are a rich component of the connective tissue in the smaller bronchi and bronchioles. The smooth muscle stops at the portals of the respiratory zone, but elastic and collagen fibres contribute to the alveolar wall and form an irregular, wide-meshed net of delicate, interlacing fibres . At the end of a deep breath, about 80% of the lung volume is taken up by air, 10% by blood, and only the remaining 10% by tissue. Because this small mass of tissue is spread over an enormous area, the tissue framework of the lung must be extraordinary delicate.
Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: Proceedings of the 21st Postgraduate Course in Critical Care Medicine Venice-Mestre, Italy — November 10–13, 2006 by K. Hillman (auth.), Antonino Gullo M.D. (eds.)