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Results for “POSITIVE-PRESSURE RESPIRATION”

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PubMed1979

PEEP: its use in young patients with apparently normal lungs.

PEEP has been advocated for use in patients with the acute respiratory distress syndrome characterized by a marked reduction in FRC. It has not been advocated for patients with apparently normal lungs requiring prolonged mechanical ventilation. We have done inert gas washouts on five young patients comparing no PEEP to 10 cm H2O PEEP. Four of the five showed a significant improvement in PaO2, a decrease in AaDO2 and Qs/Qt, the fifth a slight improvement on PEEP. Arterial washouts were significantly faster on PEEP in all patients suggesting a decrease in intrapulmonary shunting. Airway washouts in the initial phase were faster off PEEP suggesting an increase in lung volume and FRC with PEEP. Later portions of the curve were faster on PEEP suggesting improved distribution of ventilation. These findings suggest that PEEP might be of significant value in treatment of patients requiring prolonged mechanical ventilation for reasons other than lung abnormalities.

Adolescent↗
PubMed1978

Optimal PEEP.

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Hemodynamics↗
PubMed1978

[Lesional pulmonary edema].

The authors having reported all the possible denominations of syndromes of respiratory distress in the adult mention again the main etiologies, stressing on the last ones. They recall afterwards the different clinical, radiological and biological stages of this syndrome. The hemodynamic profile is defined by normal catheterism data and the presence of a true anatomical shunt. On the other hand several hemodynamic variations are possible. The differential diagnosis is essentially cardiac edema. Finally the authors state that treatment is done only by symptomatic therapies: dehydration and assisted ventilation. They do not make use of membrane oxygenator. Assisted ventilation is essential and is mainly based on a good indication and the optimal use of permanent positive pressure.

Adult↗
PubMed1976

"Aspiration disease".

Aspiration disease, a term used to define both an acute and chronic form of a disease entity, is described. Etiological factors, pathophysiology and therapy are discussed with emphasis on aspiration of gastric juice. A brief mention of a small clinical experience is included.

Acute Disease↗
PubMed1976

Editorial: C.P.A.P.

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Evaluation Studies as Topic↗
PubMed1977

Shock Lung.

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Humans↗
PubMed1976

Pneumothorax in the respiratory distress syndrome: incidence and effect on vital signs, blood gases, and pH.

We determined the incidence of pneumothorax in 295 infants (mean birthweight, 1,917 gm) with the respiratory distress syndrome (RDS) treated according to the same protocol. Fifty-five infants (mean birthweight, 1,594 gm) developed pneumothorax (incidence, 19%); incidence varied with severity of RDS and intensity of respiratory assistance. Pneumothorax occurred in 3.5% (2 of 58) of infants who received no assisted ventilation and in 11% (14 of 124) of infants who received continuous positive airway pressure (CPAP) as the only form of assisted ventilation; the difference between these two groups is not significant. Forty-nine infants initially treated with CPAP later required mechanical ventilation with positive end-expiratory pressure (PEEP). Pneumothorax occurred in 12 of the 49 (24%) and in 21 of 64 (33%) of those infants initially treated with PEEP; the incidence of pneumothorax for both these groups was significantly higher than for those treated with no assisted ventilation or CPAP only. To assess the value of frequent measurement of vital signs, blood gas tensions, and pH in the recognition of pneumothorax, we analyzed these variables by the cumulative sum statistical technique. We noted the following significant changes associated with pneumothorax: arterial blood pressure, heart rate, and respiratory rate decreased in 77% of cases; pulse pressure narrowed in 51% of cases; Po2 decreased in 17 of 20 cases in which ventilatory settings were constant for at least three hours prior to pneumothorax. However, pH and Pco2 showed consistent changes. Frequent measurements of vital signs and Po2 aid in the early diagnosis of pneumothorax.

Blood Pressure↗
PubMed1978

Two early Danish respirators designed for prolonged artificial ventilation.

Two Danish respirators are described. The first one was made by August Krogh in 1931 and was based on the principles of the Drinker tank respirator. The original feature was a motor driven by water from an ordinary water tap. It was never widely used, most likely due to practical problems connected with nursing care, etc. The polio epidemic in Copenhagen in 1952 initiated the era of the IPPV-methods and gave rise to the construction of a great number of new respirators. Among the first of these was the Claus Bang respirator. Although it contained many modern features, it proved technically unreliable and was only used for 3-5 years.

Denmark↗