Biomedical subjects
B Carman
Publications and source records attributed to B Carman.
A crisis and its solution: setting up the UK clinical virology network.
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Molecular techniques should now replace cell culture in diagnostic virology laboratories.
Cell cultures have been important historically for the development of virology. However, I will argue that they are no longer essential for a diagnostic laboratory and should be replaced with nucleic acid detection methods. This change of technology should be cost-neutral once the full costs to the laboratory of cell cultures, including staff time, are calculated. Molecular methods are more sensitive than cell cultures and provide answers much more rapidly, especially for negative samples. Since negative results are frequently as important to our clinical colleagues as positive results, we should change now to routine diagnostic services based upon nucleic acid detection.
A prospective, randomized comparison of the Volume Diffusive Respirator vs conventional ventilation for ventilation of burned children. 2001 ABA paper.
UNLABELLED: The Volume Diffusive Respirator (VDR) is a high-frequency time cycled pressure ventilator that can ventilate, oxygenate, and promote secretion removal. The VDR provides ventilation at lower airway pressures than those required for conventional ventilation in the pressure control mode (PCV). A prospective, randomized, institutional review board-approved study was conducted comparing the VDR to PCV in burned children with respiratory failure from all causes. METHODS: Pediatric burn patients requiring ventilation were stratified by presence of inhalation injury and ventilated by VDR or PCV to achieve predefined arterial blood gases. RESULTS: Sixty-four patients were prospectively assigned ventilator type; 32 to VDR, 32 to PCV. Data are reported as mean + SEM. Patient age was 7.4 + 0.7 years, TBSA was 56 + 3%, and number of patients with inhalation injuries was 55 (86%). Maximum peak inspiratory pressure with the VDR was significantly less than with PCV (30.9 + 0.8 cm H2O vs 39.5 + 1.8 cm H2O,P < 0.05) and the best PaO2 /FIO2 ratio was significantly higher with the VDR compared with PCV (563 + 15 vs 507 + 13, P < 0.05). No patient in the VDR group had evidence of barotrauma compared with two in the PCV group. Five patients in the PCV group died compared with two in the VDR group. CONCLUSION: Patients ventilated with the VDR required significantly lower peak inspiratory pressure and achieved a significantly higher PaO2 /FIO2 ratio compared with PCV. This demonstrates the VDR is a safe and effective method of ventilation for pediatric burn patients and it offers advantages when compared with conventional ventilation.