2,833 publications from this institution
The postoperative period after laparotomy is characterized by a decrease in pulmonary volumes combined with a maldistribution of the ventilation and the perfusion. Together with manual techniques, intermittent pressure breathing and incentive spirometry have been suggested to maintain open alveoli and to prevent atelactasissis. The shortcomings related to the use of pressure-controlled devices include patient's resistance to the technique, overinflation of normal alveoli, excessive total ventilation, decrease in venous return and various gastrointestinal side effects. The incentive spirometry has been designed to promote sustained maximal inspirations and reproduce sighing mechanisms. The decrease in pleural pressure can result in high transpulmonary pressures. For many investigators, incentive spirometry represents a very easy and efficient method to prevent atelectasis.
SCOPUS: ed.j
Editorial
1. The stimulation of dopaminergic receptors is in principle attractive to increase urine and sodium excretion in patients with compromised renal blood flow. 2. However, a protective role of dopaminergic agents on renal function has not been well established. Most of the trials have been performed with dopamine, a substance which can have vasoconstrictive properties, even at relatively low doses in the critically ill patient. 3. Perhaps other dopaminergic agents without alpha-adrenergic effects such as dopexamine could be more advantageous. Randomized, prospective, controlled clinical studies should be performed to test the hypothesis that dopaminergic agents can reduce the incidence of acute tubular necrosis in critically ill patients.
