Notes of a biology-watcher. Ponds.
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Biomedical subjects
Publications and source records attributed to L Thomas.
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Twenty seven patients on artificial ventilation were studied in terms of gas exchange, respiratory mechanics and haemodynamics. The characteristics of acute respiratory failure (dead space effect, shunt effect, disturbances in respiratory mechanics) may be identified and their severity determined. The effects of adjusting artificial ventilation settings (tidal volume, frequency, inspiration/expiration ratio, inspiratory flow, end expiratory pressure, inspired oxygen fraction) may be studied and better adapted to the individual functional requirements of each patient. An organigram of settings based upon the experience gained in this series is suggested.
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Prerequisites for success in domiciliary assisted respiration for chronic respiratory insufficiency are the understanding of the patient and his active participation in the treatment as well as adjustment and attitude of his environment. The authors report their experience in 89 patients. Spirographic data were obtained in 72 patients which permitted subdivision into a group with restrictive disturbances and one with obstructive changes. The differences in prognosis in these two groups of patients were surprising. The survival rates in the obstructive diseases after 3, 5 and 10 years were 54%, 38% and 33% respectively; the corresponding values for the restrictive diseases were 84%, 84% and 69%. These differences are statistically significant. The restrictive changes are therefore considerably more favorable to assess, also with respect to a better quality of life.
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