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Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Specific Measurements

Specific Measurements We collected pulmonary lymph in graduated heparinized tubes. From pooled lymph specimens, we measured total protein and albumin concentrations (in grams per deciliter) by the Biuret method using an automated system (Auto Analyzer, Technicon Instruments); duplicate samples differed by less than 5 percent. At the time of lymph collection, we also measured total…

Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Experimental Protocol

Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Experimental Protocol

Experimental Protocol Baseline studies were performed over a 120-minute period approximately three to four days after recovery from preliminary surgery. Pulmonary lymph was collected and measured for volume every 15 minutes; lymph was pooled at the end of the two-hour baseline period for measurement of total protein and albumin. At the midpoint of this baseline…

Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Materials and Methods

Experimental Preparation Ten mature Suffolk sheep, weighing 30 to 40 kg (0.9 to 1.2 m2 of body surface area), were prepared with chronic lymph fistulae using a modification of the technique described by Staub et al. Before study the sheep were premedicated with atropine sulfate and were then anesthetized and intubated. We cannulated the aorta…

Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Outcome

Dobutamine had no net effect on pulmonary fluid flux in the nonseptic studies. In contrast, its effects in the septic state were inconsistent. At a dose of 5μg/kg/ min, a modest (24 percent) increase in QL was demonstrable when compared to baseline, while no significant change was evident with the 10μLg/kg/min dose; with an increase…

Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Lungs microvascular

Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Lungs microvascular

Since dobutamine has been recommended as an adrenergic receptor agonist which might be used in preference to dopamine when systemic flows require pharmacologic support in ARDS, we studied its effects on fluid flux in an animal model of peritonitis which is characterized by lung microvascular injury. This model seems more representative of early clinical sepsis…

Effect of Dobutamine on Lung Microvascular Fluid Flux in Sheep with “Sepsis Syndrome”: Discussion

The flow-dependency of systemic Vo2, which is frequently demonstrable when ARDS complicates the “sepsis syndrome,” may clinically dictate the use of P-adrenergic receptor agonists when cardiac output (hence systemic oxygen transport) is not deemed sufficient to satisfy peripheral oxygen needs. Theoretically, the administration of (3-adrenergic receptor agonists could increase pulmonary microvascular fluid flux in ARDS…

Impact of Diagnosis-Related Groups’ Prospective Payment on Utilization of Medical Intensive Care: Length of Stay and Deaths

Length of Stay and Deaths Analysis of Medicare MICU vs nonMICU indicates an average length of stay of 24.9 days for patients receiving medical intensive care compared with 9.9 days for nonMICU patients in 1985. The average number of days in the MICU was 5.4 days (22 percent of the average total stay of 24.9…

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