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Biomedical subjects

T J Gallagher

Publications and source records attributed to T J Gallagher.

62 records · Page 4Linked to original sources
PubMedDate not supplied

Intermittent inspiratory chest tube occlusion to limit bronchopleural cutaneous airleaks.

A significant bronchopleural cutaneous fistula (BPCF) developed in a 36-year-old female who required mechanical ventilation for acute respiratory failure. Progressive increase in arterial PCO2 to 75 torr occurred because of inability to effect satisfactory alveolar ventilation. Insertion of unidirectional values into the chest tube drainage apparatus, which were closed synchronously each time the ventilator cycled to the inspiratory phase, allowed effective alveolar ventilation to be achieved with subsequent reduction of arterial CO2 to previous levels. Both high inspiratory (120 torr) and expiratory (23 torr) positive pressures were employed with intermittent mandatory ventilation (IMV). Deleterious effects on cardiopulmonary function were not observed, and the patient was weaned successfully from mechanical support with spontaneous closure of the BPCFs.

Adult↗
PubMedDate not supplied

Terminology update: optimal PEEP.

The term, optimal PEEP, requires redefinition in the light of new clinical data. With the onset of acute respiratory failure heralded by blood gas evidence of decreased oxygenation, PEEP is supplied in quantities sufficient to restore intrapulmonary shunt (Qsp/Qt) to a preselected goal of 15%. This is compatible with published criteria defining adequate blood gas exchange. Now rather than permitting reduction of cardiac output to be the end point of PEEP application, selective cardiovascular interventions to support preload, contractility, or afterload are made as appropriate so that cardiac function may be maintained until the preselected endpoint of shunt reduction of 15% can be made.

Adult↗
PubMedDate not supplied

Carbon dioxide laser burn of laryngotracheobronchial mucosa.

A CO2 laser fire in the laryngotracheobronchial tree occurred because of an increase in fraction of inspired oxygen to greater than 40%. An endotracheal tube was ignited and caused a severe burn of respiratory mucosa that required treatment in a burn intensive care unit. The patient had surprisingly few immediate respiratory complications and was discharged from the hospital 25 days after the burn.

Burns, Chemical↗