Adult and pediatric fellowship programs in critical care medicine.
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Biomedical subjects
Publications and source records attributed to D M Greenbaum.
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Indications for the use of therapy with continuous positive airway pressure (CPAP) in spontaneously breathing patients are increasing in number. The value of this technique without tracheal intubation was investigated in 14 patients with acute respiratory distress. In most patients (eight patients, or 57 percent) the technique was successful, as evidenced by avoidance of the necessity for tracheal intubation and improvements in clinical appearance, arterial oxygen pressure, and chest x-ray films. Complications were observed in three patients, but these necessitated discontinuation of therapy in only one. The use of this technique allows avoidance of endotracheal intubation and mechanical ventilation, with their attendant risks.
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Immediate intensive therapy is of major importance in the initial management of patients with dissecting aortic aneurysm. The Doppler ultrasound stethoscope is a noninvasive tool which may be used in the diagnosis and management of this disease. A case is presented in which this instrument was used to diagnose and follow the progress of a patient with acute aortic dissection. Further use of this device for similar disorders can be expected.
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