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At least 199 records · Page 11Linked to original sources
PubMed1992

Cardiac arrhythmias during postural drainage and chest percussion of critically ill patients.

In this study we determine the prevalence and type of arrhythmias that occur during postural drainage and chest percussion (PDP) of critically ill patients, and identify those patients who are most at risk of developing them. We monitored the vital signs and ECGs of 72 ICU patients during their initial PDP treatment. Eight patients (11.1 percent) had development of major arrhythmias, 18 (25 percent) had minor arrhythmias, and 46 (63.9 percent) had none. Increased age (p < 0.0001) and the presence of acute cardiac disorders (p < 0.001) were associated with increased risk of arrhythmias. Individuals experiencing major arrhythmias had a significantly decreased BP and respiratory rate with an increased heart rate during PDP. We conclude that arrhythmias are common during PDP of critically ill patients and recommend that ICU patients be carefully monitored during PDP. When considering PDP for older patients and patients with acute cardiac disease, physicians should carefully weigh the risk of arrhythmias against the benefits of this treatment.

Adolescent↗
PubMed1999

Effect of combined kinetic therapy and percussion therapy on the resolution of atelectasis in critically ill patients.

BACKGROUND: Some critically ill patients have difficulty in mobilizing their respiratory secretions. These patients can develop pulmonary atelectasis that may result in hypoxemia. There are some data to show that atelectasis may be prevented by turning a patient from side to side utilizing special beds. STUDY OBJECTIVES: To determine the role of kinetic therapy (KT) combined with mechanical percussion (P) in the resolution of established atelectasis of the lungs and hypoxemia in critically ill, hospitalized patients. (KT was defined as rotation of a patient along the longitudinal axis of > or = 40 degrees to each side continuously.) DESIGN: Prospective and randomized study (2:1 test to control group). PATIENTS: Twenty-four patients with respiratory failure, either mechanically ventilated or spontaneously breathing, who demonstrated segmental, lobar, or unilateral entire lung atelectasis were studied. SETTING: Medical ICU and adult respiratory ward in a county hospital in New York. INTERVENTIONS: Seventeen patients were treated with KT combined with mechanical P using a KT system (Triadyne Kinetic Therapy System; KCI; San Antonio, TX). Seven patients received manual repositioning and manual P every 2 h. Both groups received similar conventional therapy with inhaled bronchodilators and suctioning. RESULTS: Partial or complete resolution of atelectasis was seen in 14 of 17 patients (82.3%) in the test group as compared with 1 of 7 patient (14.3%) in the control group. The median duration to resolution of atelectasis was 4 days in the test group. Bronchoscopy was performed in 3 of 7 patients in the control group, but in none of the patients in the test group. A cost of $720 was incurred per patient for utilizing the specialty beds for a mean duration of 4 days. An improvement in oxygenation index occurred in the test group (change in baseline PaO2/fraction of inspired oxygen from 207.4+/-106.7 mm Hg to 318+/-100.7 mm Hg) at the end of therapy, while the control group showed a reduction over a similar duration of time (181.3+/-96.3 mm Hg to 112+/-21.2 mm Hg). CONCLUSIONS: KT and mechanical P therapy resulted in significantly greater partial or complete resolution of atelectasis as compared with conventional therapy. There was a generalized trend toward statistical significance in the improvement of oxygenation and a reduced need for bronchoscopy in the group receiving KT and P therapy.

Aged↗
PubMed1984

Postoperative chest percussion with postural drainage in obese patients following gastric stapling.

Vigorous respiratory therapy can prevent the development of postoperative pulmonary complications which occur with increased frequency after upper abdominal surgery. Obesity poses an additional risk factor. To study the effects of postoperative chest percussion with postural drainage (CPT), 53 consecutive patients undergoing Roux-en-Y gastric stapling procedures for treatment of morbid obesity were randomized to two groups. Both received identical postoperative respiratory care, except the study group received additional CPT. It was concluded that the addition of CPT to patients without prior chronic lung disease undergoing upper abdominal surgery caused patient discomfort, increased hospital cost, and failed to affect the incidence of postoperative pulmonary complications.

Adolescent↗
PubMed1980

Autoregulation of cerebral blood flow after experimental fluid percussion injury of the brain.

To test the hypothesis that concussive brain injury autoregulation of cerebral blood flow (CBF), 24 cats were subjected to hemorrhagic hypotension in 10-mm Hg increments while measurements were made of arterial and intracranial pressure, CBF, and arterial blood gases. Eight cats served as controls, while eight were subjected to mild fluid percussion injury of the brain (1.5 to 2.2 atmospheres) and eight to severe injury (2.8 to 4.8 atmospheres). Injury produced only transient changes in arterial and intracranial pressure, and no change in resting CBF. Impairment of autoregulation was found in injured animals, more pronounced in the severe-injury group. This could not be explained on the basis of intracranial hypertension, hypoxemia, hypercarbia, or brain damage localized to the area of the blood flow electrodes. It is, therefore, concluded that concussive brain injury produces a generalized loss of autoregulation for at least several hours following injury.

Animals↗
PubMed1986

Effects of fluid-percussion brain injury on regional cerebral blood flow and pial arteriolar diameter.

The effects of two levels of fluid-percussion brain injury on cerebral blood flow (CBF) and pial arteriolar diameter were investigated in cats. Regional CBF was measured using the radioactive microsphere technique. Experimental brain injury resulted in changes in arterial blood pressure, CBF, and pial arteriolar diameter that were related to the severity of the injury. Low-level injury (1.88 +/- 0.11 atm, mean +/- standard error of the mean) resulted in a slight transient increase in CBF which had returned to preinjury levels by 30 minutes. High-level injury (2.68 +/- 0.19 atm) resulted in larger, statistically significant (p less than 0.01) increases in whole-brain CBF, decreases in cerebrovascular resistance, and increases in pial arteriolar diameter 1 minute postinjury. One hour after injury, CBF had returned to preinjury levels while cerebral perfusion pressure was significantly (p less than 0.01) reduced. There was no evidence of reduced CBF in any region studied. Pial arterioles dilated during the posttraumatic hypertensive period and then returned to control diameters within 1 hour after injury. Changes in the diameter of pial arterioles were significantly correlated with posttraumatic changes in CBF.

Animals↗
PubMed2000

Effect of initially limited resuscitation in a combined model of fluid-percussion brain injury and severe uncontrolled hemorrhagic shock.

OBJECT: Studies of isolated uncontrolled hemorrhage have indicated that initial limited resuscitation improves survival. Limited resuscitation has not been studied in combined traumatic brain injury and uncontrolled hemorrhage. In this study the authors evaluated the effects of limited resuscitation on outcome in combined fluid-percussion injury (FPI) and uncontrolled hemorrhage. METHODS: Twenty-four swine weighing 17 to 24 kg each underwent FPI (3 atm) and hemorrhage to a mean arterial pressure (MAP) of 30 mm Hg in the presence of a 4-mm aortic tear. Group I (nine animals) was initially resuscitated to a goal MAP of 60 mm Hg; Group II (nine animals) was resuscitated to a goal MAP of 80 mm Hg; and Group III (control; six animals) was not resuscitated. After 60 minutes, the aortic hemorrhage was controlled and the animals were resuscitated to baseline physiological parameters and observed for 150 minutes. Mortality rates were 11%, 50%, and 100% for Groups I, II, and III, respectively (Fisher's exact test; p = 0.002). The total hemorrhage volume was greater in Group II (69+/-32 ml/kg), as compared with Group I (41+/-18 ml/kg) and Group III (37+/-3 ml/kg) according to analysis of variance (p < 0.05). In surviving animals, cerebral perfusion pressure, cerebral blood flow (CBF), cerebral venous O2 saturation (ScvO2), and cerebral metabolic rate of O2 did not differ among groups. Although CBF was approximately 50% of baseline during the period of limited resuscitation in Group I, ScvO2 remained greater than 60%, and arteriovenous O2 differences remained within normal limits. CONCLUSIONS: In this model of FPI and uncontrolled hemorrhage, early aggressive resuscitation, which is currently recommended, resulted in increased hemorrhage and failure to optimize cerebrovascular parameters. In addition, a 60-minute period of moderate hypotension (MAP = 60 mm Hg) was well tolerated and did not compromise cerebrovascular hemodynamics, as evidenced by physiological parameters that remained within the limits of cerebral autoregulation.

Animals↗
PubMed2000

[Physical diagnosis--percussion and palpation of liver].

Percussion and palpation of the liver can produce useful information regarding size, consistency and the surface of the lower liver edge. However, the accuracy of the physical examination of the liver is limited, especially concerning the predictive value of the absence at physical examination of hepatomegaly (> or = 15 cm liver width in the right midclavicular line) for the absence of a truly enlarged liver. Also, the inter-observer variability may be considerable. These limitations of the test may be partly due to a number of pitfalls and misconceptions concerning physical examination of the liver.

Hepatomegaly↗
PubMed1995

[The cardiac examinations in 19c. Poland (development of auscultation and percussion among Cracow and Warsaw physicians)].

The essay is a continuation of the subject touched upon in one of the last year issues. It starts with Józef Dietel's acceptance of a chair in Cracow. The ways of examining and describing of circulatory system by students at his clinic particularly percussion and auscultation are presented. Numerous exerts from descriptions of circulatory system examining methods for students from Antoni Kryszka and Józef K. Rose and Włodzimierz Dybek handbooks are quoted.

Auscultation↗
PubMed1994

[19 c. heart examination in Poland (the beginning of percussion and auscultation)].

Basing on the 19 c literature and health reports, the contemporary views upon the methods of circulatory tract examination were reconstructed. The differences in the choice and propagation of the new methods were pointed out at the most important centres of medicine in Poland: Warsaw, Cracow and Vilnius. It was also established that the methods of percussion and auscultation had reached Poland earlier that the research done so far seemed to have indicated.

Auscultation↗
PubMed2002

High-frequency percussive ventilation as a salvage modality in adult respiratory distress syndrome: a preliminary study.

Despite multiple advances in critical care patients with severe adult respiratory distress syndrome (ARDS) can exhaust the capability of conventional ventilation; this results in respiratory failure and death. High-frequency percussive ventilation (HFPV), which was initially utilized for salvage of burn patients with smoke inhalation injury refractory to conventional ventilation, has evolved as a standard of burn care. Based on our experience with HFPV in burn patients the burn team was consulted to provide salvage ventilation for non-burn surgical intensive care unit patients with refractory respiratory failure. Over a 14-month period ten patients with refractory ARDS from multiple causes were treated. Retrospective chart review was performed. Respiratory parameters were assessed before and 24 hours after initiation of HFPV. Mean values of fraction of inspired oxygen (FiO2), pH, partial pressure of O2 in arterial blood (PaO2), partial pressure of CO2 in arterial blood (PaCO2), HCO3, oxygen saturation in arterial blood (SaO2), PaO2/FiO2, and peak inspiratory pressure were compared. Significant improvement in oxygenation was reflected by increases in SaO2, PaO2, and the PaO2/FiO2 ratio in the first 24 hours of HFPV. No significant increase in peak inspiratory pressure was documented by conversion from conventional ventilation to HFPV. No hemodynamic changes directly associated with HFPV were noted. Seven of ten patients failing conventional ventilation survived to hospital discharge after salvage therapy with HFPV. We advocate further studies of HFPV in non-burn patients with ARDS both as salvage therapy and as replacement for conventional ventilation for the initial treatment for ARDS.

Adult↗
PubMed2002

[The experimental study of expression of intercellular adhesion molecule-1 after fluid percussion brain injury].

OBJECTIVE: To determine the changes of intercellular adhesion molecule-1 after traumatic brain injury. METHODS: Use the fluid-percussion model to inflict rat brain and take the samples at 2, 4, 8, 12, 24 hours after brain injury. The samples were studied by immunohistochemistry method combined with image analysis by MIAS image analysis system. RESULT: The expression of ICAM-1 upregulates at 2 hours, reaches peak at 12 hours and falls down at 24 hours after brain injury. CONCLUSION: The changes of ICAM-1 in brain can provide a backup for estimation of injury time and survival period after brain injury which sustained within 24 hours.

Animals↗
PubMed1992

Percussion after extracorporeal shock wave lithotripsy.

ESWL does not remove the kidney stone, but pulverizes it into tiny particles so that it can be excreted with the urine. Drainage and percussion treatment after ESWL helps excrete particles from the kidney to the ureter much more rapidly and with less trauma, pain, and blood urine, and fewer medications for pain are needed as the particles pass through the urine. Teaching the principles behind this treatment will lead to greater patient compliance and success.

Drainage↗
PubMed1989

Skin accelerometer displacement and relative bone movement of adjacent vertebrae in response to chiropractic percussion thrusts.

The authors studied relative bone movements in response to manipulative light taps to the spine. Piezoelectric accelerometers attached to bone of an anesthetized dog measured transverse, X-Z plane, movements of L2-L3 adjacent vertebrae while percussion thrusts of an instrument used for manipulation made inputs three vertebrae above and five vertebrae below the L2-L3 joint interface. Small, relative 1-mm translations and 0.5 degree rotations occurred during the first 19 msec. When one set of accelerometers were stabilized on the skin surface, half of the skin-bone translation maxima erred less than 2%. However, skin translations averaged 77% (SD = 2%) of bone translations and skin rotations averaged 95% (SD = 26%) of bone rotations. The results suggest the possibility that, with further development, piezoelectric accelerometers can be a noninvasive tool to study dynamic, relative, bone movement.

Animals↗
PubMed1985

[Percussion auscultation of transient ischemic attacks. Role of cerebral evoked potentials].

The auscultatory percussion signs present during so called transitory ischaemic attacks are described. Long experience has revealed the identification of cerebral evoked potentials to be particularly valuable, both in confirming diagnosis and monitoring treatment. "Bed-side" identification of cerebral evoked potentials is an extension of physical symptomatology as applied to diseases of the nervous system. Finally, differential diagnosis with cerebral tumours often associated with enigmatic phenomena is discussed.

Apnea↗
PubMedDate not supplied

[Diagnostic value of percussion of the veins].

Despite the present development of instrument techniques for diagnosis, clinical procedures still remain valid. It is for this reason that, for the past fifteen years, we have continued to use an almost forgotten test: percussion of the veins. Opinions concerning this test and its technical description being contradictory in the literature, we sought to define the exact circumstances under which it should be used, and how to apply it. Our diagnostic results were favorable, the technique simple, and our study was aimed mainly at describing its merits.

Humans↗
PubMed1994

[Percussion-auscultation syndrome of carnitine deficiency].

Up till now it has been possible to demonstrate carnitine deficiency, after separating non esterified carnitine and acyl-carnitines, by some sophisticated assays: photometric methods, enzymatic and radio-enzymatic-methods, gas chromatography, HPLC, mass spectrometry. This diagnostic approach is not easy for the general practitioner; therefore, the diagnosis of carnitine deficiency is often delayed and delegated to the specialist. In this paper signs of the syndrome and how to find them by the aid of auscultatory percussion are fully described for the first time. This knowledge will be helpful to the general practitioner both from technical point of view--diagnosis of carnitine deficiency--and for monitoring the results of therapy.

Adult↗
PubMed1998

EMG study of hand muscle recruitment during hard hammer percussion manufacture of Oldowan tools.

The activity of 17 hand muscles was monitored by electromyography (EMG) in three subjects during hard hammer percussion manufacture of Oldowan tools. Two of the subjects were archaeologists experienced in the replication of prehistoric stone tools. Simultaneous videotapes recorded grips associated with the muscle activities. The purpose of the study was to identify the muscles most likely to have been strongly and repeatedly recruited by early hominids during stone tool-making. This information is fundamental to the identification of skeletal features that may reliably predict tool-making capabilities in early hominids. The muscles most frequently recruited at high force levels for strong precision pinch grips required to control the hammerstone and core are the intrinsic muscles of the fifth finger and the thumb/index finger regions. A productive search for skeletal evidence of habitual Oldowan tool-making behavior will therefore be in the regions of the hand stressed by these intrinsic muscles and in the joint configurations affecting the relative lengths of their moment arms.

Animals↗
PubMed1999

Concurrent loss and proliferation of astrocytes following lateral fluid percussion brain injury in the adult rat.

Astrocyte populations were analyzed over a period of 1 month in the hippocampus following lateral fluid percussion (FP) brain injury. Rats (n = 23) were subjected either to a brain injury of moderate severity, or to anesthesia and surgery without injury (n = 7). At 3 days, 1, 2, or 4 weeks postinjury, subgroups of animals were sacrificed and the brains removed and sectioned for histochemical analysis. The density of astrocytes, identified with gold sublimate staining, decreased significantly in the ipsilateral hippocampus of injured rats 3 days following injury, eventually falling to 64% of the total astrocyte population present in uninjured animals by 1 week postinjury. One month postinjury, the density of hippocampal astrocytes had returned to 85% of the total number of astrocytes observed in the hippocampus of uninjured animals. In order to characterize the post-traumatic formation of new astrocytes, immunohistochemistry was performed using antibodies to proliferating cell nuclear antigen (PCNA) and to glial fibriallary acidic protein (GFAP). Positive immunolabeling for both PCNA and GFAP was most abundant at 3 days following FP brain injury in regions where the blood brain barrier was compromised, and was not detectable by 1 month postinjury. These results indicate that astrocyte proliferation after injury may be evoked by mitogens released from vascular sources, and may be an attempt to compensate for some of the astrocytic cell loss observed after injury.

Age Factors↗