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Biomedical subjects

S Izenberg

Publications and source records attributed to S Izenberg.

6 recordsLinked to original sources
PubMed2001

Effect of inner cannula removal on the work of breathing imposed by tracheostomy tubes: a bench study.

BACKGROUND: Tracheotomy has been used to assist in weaning patients from mechanical ventilation. Some patients fail to be weaned from the ventilator despite tracheostomy. We hypothesized that removing the inner cannula from the tracheostomy tube would decrease the tube's imposed work of breathing (WOB(IMP)). METHODS: The hypothesis was tested using a lung model, by measuring the change in WOB(IMP) when the inner cannula was removed. A mechanical lung model was developed using a test lung to simulate a spontaneously breathing patient. WOB(IMP) was measured with a commercially available lung mechanics monitor. Shiley size 6, 8, and 10 nonfenestrated tracheostomy tubes were tested with the inner cannula in and out. Breathing conditions were simulated using tidal volumes (V(T)) of 300 and 500 mL matched with breathing frequencies of 12, 24, and 32 breaths per minute, by using a ventilator to simulate spontaneous breathing through one side of the test lung. RESULTS: Under all the tested breathing conditions, WOB(IMP) for each of the 3 tracheostomy tubes was significantly reduced (p < 0.05) when the inner cannula was removed. Also, as simulated spontaneous inspiratory flow demand increased (ie, as V(T) and/or frequency were increased), WOB(IMP) also increased, and vice versa. With the cannula removed, WOB(IMP) was not significantly different between the size 6 and 8 tubes nor between the size 8 and 10 tubes when V(T) was 300 mL and frequency was 12 breaths per minute. CONCLUSIONS: There was a significant decrease in WOB(IMP) with each tube when the inner cannula was removed. WOB(IMP) increased with an increase in inspiratory flow demand (ie, increase in V(T) and/or frequency), as well as when tube size decreased. In weaning a tracheostomized patient from mechanical ventilation, increasing the internal diameter of the tube by removing the inner cannula may be beneficial. Further study is needed to determine if these findings are clinically important.

Analysis of Variance↗
PubMed1996

Portal vein embolization following shotgun-pellet injuries to the abdomen.

Multiple missile emboli are rare. The most likely setting for their occurrence is multiple penetrating injuries from birdshot. Such is this case of this 26-year-old man with birdshot injuries to the torso penetrating the portal vein and embolizing to the liver, producing infarcts and death.

Abdominal Injuries↗
PubMed1996

Delayed posttraumatic tamponade.

Delayed cardiac tamponade is a rare phenomenon with two primary causes: delayed hemorrhage after an acute injury or delayed pericarditis with effusion. We present a case of cardiac tamponade 4 weeks after injury, with findings compatible with delayed hemorrhage and pericarditis. Our case emphasizes the need for follow-up of patients with penetrating chest trauma for several months after injury; echocardiography should be used if symptoms of tamponade appear.

Adult↗
PubMed1992

In vivo phosphorus NMR spectroscopy of skin using a crossover surface coil.

A modified crossover surface coil with minimal B1 field penetration was used for collection of skin phosphorus NMR spectra. Projection imaging experiments show that the coil-sensitive volume is uniform at the phosphorus frequency, but strikingly nonuniform at the proton frequency. Experiments with an in vitro phosphorus phantom, designed to simulate skin and underlying tissue, demonstrated that 45.1% (+/- 1.2%) of total signal was derived from Sprague-Dawley rat skin and 19.3% (+/- 1.4%) of total signal was derived from Fischer-344 rat skin. 31P MR spectra of rat skin in vivo permitted resolution of four phosphorus compounds: nucleoside triphosphates, phosphocreatine (PCr), inorganic phosphate (Pi), and phosphomonoester. Spectra collected after skin flap surgery in Fischer-344 rats showed a 50.1% (+/- 7.6%) reduction in the ratio of PCr/Pi within 30 min of surgery, compared to presurgical PCr/Pi levels (P less than 0.01). Skin phosphorus spectra are potentially useful for assessment of skin flap and skin graft viability.

Animals↗
PubMedDate not supplied

Treatment of postextubation stridor in a pediatric patient with burns: the role of heliox.

Stridor is a common problem in patients with burns after extubation, especially in children and in those with facial burns or airway injuries. The usual treatments for severe respiratory distress, such as reintubation and tracheotomy, carry substantial risks for patients. We report our successful treatment of severe postextubation stridor in a 7-year-old patient with burns with the administration of heliox in addition to more traditional therapies, review the literature about the use of heliox in postextubation stridor, and suggest cases in which its use may prevent the need for more hazardous interventions.

Burns↗