PubMed · 5397210
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K Riegel. 1969. [Analysis of lung function].. https://pubmed.ncbi.nlm.nih.gov/5397210/
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Non-invasive intermittent positive pressure ventilation (NIPPV) at home is the treatment of choice for patients with chronic respiratory insufficiency secondary to severe kyphoscoliosis. Our aim was to compare clinical course, blood gases and lung function after one month of domiciliary NIPPV with two types of ventilator and to assess sleep pattern changes in patients enrolled in a prospective, randomized crossover study. Ten patients with chronic respiratory insufficiency due to kyphoscoliosis were enrolled and randomly assigned to the first device. After one month of use, the patients underwent clinical and functional examinations and polysomnographic studies while using the ventilator. The same protocol was applied with the second device after a ten-day washout period. Baseline polysomnographs showed fragmented sleep with low percentages of deep non-REM sleep and of REM sleep, as well as respiratory patterns characterized by very high frequencies coinciding with significant desaturations. In all cases symptoms and arterial blood gas improvements were significant, with no differences between the two treatment periods. The percentages of time spent with SaO2 below 90% of reference in sleep studies were significantly lower than baseline with both ventilators. All but one patient had better tolerance of the bilevel positive airway pressure (BIPAP) support mode than of the volumetric ventilator. Our study shows that NIPPV is equally effective for patients with kyphoscoliosis whether administered with a volumetric ventilator or a BIPAP device. Subjective response and tolerance seem to be slightly better with BIPAP.
BACKGROUND: The objective of this study was to determine the allowable platelet content limits for apheresis platelets stored for 7 days in a platelet storage bag (COBE ELP, Gambro BCT). METHODS: Apheresis platelets under controlled concentration and volume per bag were stored in plasma up to 8 days at 22 degrees C with horizontal agitation. Routinely evaluated in vitro platelet parameters were followed. Oxygen consumption was directly measured with a Clark-type electrode. All components were cultured in aerobic medium on Day 7. RESULTS: Twenty-four components were evaluated in storage configurations (median [range], 340 [110-402] mL, 1.32 [0.99-2.45] x 10(6) platelets/microL, and 4.8 [1.4-5.9] x 10(11) platelets/bag). No bacterial contamination was detected. One component had a pH value at 22 degrees C of below 6.0 before Day 5 with attendant loss of all other in vitro function measures. The pH value at 22 degrees C was maintained above 6.2 for the remaining 23 components. A pH value of greater than 7.4 was observed at some point in storage for 13 of 23 units, although platelet function or activation was not adversely affected. Aerobic metabolic function was maintained over 7 days with O2 consumption of 321 micromol per hour per 10(12) platelets on Day 7. CONCLUSION: Although a continuing decline of platelet in vitro characteristics can be observed for storage beyond 5 days, apheresis platelets in plasma stored 100 to 400 mL per bag, 1.0 x 10(6) to 2.5 x 10(6) platelets per microL, and a maximum of 5.1 x 10(11) platelets per bag maintained in vitro platelet characteristics over 7 days of storage.
Monitoring with pulse oximetry might improve patient outcome by enabling an early diagnosis and, consequently, correction of perioperative events that might otherwise cause postoperative complications or even death. The aim of the study was to clarify the effect of perioperative monitoring with pulse oximetry and to identify the adverse outcomes that might be prevented or improved by its use. Trials were identified by computerized searches of the Cochrane Library, MEDLINE, EMBASE, and by checking the reference lists of trials and review articles. All controlled trials that randomized patients to either pulse oximetry or no pulse oximetry during the perioperative period, including in the operating and recovery room, were included in the study. The search identified six reports. Of these 6 reports, 4 studies with data from 21,773 patients were considered eligible for analysis. Two studies specifically addressed the outcomes in question; both found no effect on the rate of postoperative complications using perioperative pulse oximetry. Hypoxemia was reduced in the pulse oximetry group both in the operating room and in the recovery room. During observation in the recovery room, the incidence of hypoxemia in the pulse oximetry group was 1.5-3 times less. There were postoperative complications in 10% of the patients in the oximetry group and in 9.4% in the control group. The duration of hospital stay was a median of 5 days in both groups, and an equal number of in-hospital deaths was registered in both groups. The studies confirmed that pulse oximetry could detect hypoxemia and related events. However, given the relatively small number of patients studied and the rare events being sought, the studies were not able to show an improvement in various outcomes.