Comparison of superior vena caval and femoroiliac venous pressure measurements during normal and inverse ratio ventilation.

OBJECTIVE: The aim of this study was to estimate the agreement between superior vena caval pressure (SVCP) and femoroiliac venous pressure (FIVP) measurements by using short (<20 cm) femoral catheters commonly used in an adult intensive care unit. In addition, the effects of two modes of ventilation on agreement were assessed. DESIGN: Measurements of central venous pressure were recorded from both sites by using the same pressure transducer connected to the catheters via a three-way stopcock. SVCP and FIVP were recorded at 5-min intervals for 40 mins with the patient in the supine position. Recordings were taken from ventilated patients during a randomized crossover sequence of normal and inverse ratio ventilation (IRV). Analyses included Pearson's correlation (r), intraclass correlation (ri), Bland-Altman plots, and repeated measures analysis of variance with crossover tests for period and period-treatment interactions. SETTING: Adult intensive care unit. PATIENTS: Adult intensive care patients. MEASUREMENTS: Central venous pressure. RESULTS: Twenty-two patients were enrolled in the study, giving 162 paired measurements; r was .97 (p < .0001), and ri was .96. The bias for SVCP-FIVP measurements was -0.75 mm Hg (95% confidence interval = -1.31 to -0.18), with 95% limits of agreement of -3.30 to 1.81 mm Hg. Seventeen patients were suitable for randomization to normal ratio ventilation and IRV. IRV significantly increased SVCP and FIVP (p < .002). Tests for the effect of mode of ventilation on agreement (p = .36), for period (p = .26), and for period-treatment interaction (p = .84) were not significant. CONCLUSION: The study showed excellent overall agreement with acceptable clinical agreement for SVCP and FIVP measurements that was not affected by changing the mode of ventilation. IRV significantly increased central venous pressure measurements from both catheter sites but had no effect on overall agreement.

Direct demonstration of production of transforming growth factor activity by embryonic chick tissue.

The presence of transforming growth factor activity in early chick embryos was directly demonstrated by the ability of limb and tail buds to induce anchorage independent division in NRK 49 f cells. Colony number increased with limb bud number and developmental stage. Medium conditioned by tail buds contained some stimulating effect, and strongly promoted the action of other transforming growth factors.

A microwell assay for anchorage independent cell growth.

We describe modifications of the conventional assay for anchorage independent growth of fibroblasts that enable the assay to be carried out in microwell plates, as opposed to the conventional Petri dishes. The microwell assay is a good discriminator of final EGF concentrations in the range 10-100 picograms/ml, and can be used to detect absolute amounts of EGF below 2 pg. Addition of TGF beta to EGF enhances colony formation in the microassay in the usual manner. We describe the use of this microassay to identify and map local production of transforming growth factor activity by the component pieces of individual chick embryos. Transforming activity was identified in all the stages tested (Hamburger and Hamilton stages 13-23). Highest levels were found near the mid-line of the embryo. No clear differences in the cranio-caudal axis have so far been identified. This technique will enable the spatial and temporal distribution of transforming activity throughout vertebrate embryos to be completely mapped. It seems likely that this mapping process will help elucidate the normal role of transforming growth factors in embryos.