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[A method of decreasing accidental positive exhalation pressure upon high frequency artificial respiration of newborn infants].

A simple method has been suggested for the reduction of excessive positive end-expiratory pressure (EPEEP) occurring during high-frequency ventilation with positive pressure in the newborn. The method employs a special conntecor with an inner diameter decreasing towards the end of the tube included into the inspiration line. The use of a connector during high-frequency jet ventilation of lung models from newborn with hyaline membrane disease and meconial aspiration reduced effectively EPEEP in the proximal end of the intubation tube. However, the same efficacy of EPEEP reduction in the lungs has been observed only on the model of hyaline membranes. On the models of lungs from newborn with meconial aspiration EPEEP reduced insignificantly. With the increase in gas mixture flow, the efficacy of the device enhanced.

Humans↗
PubMed1989

[Remote artificial respiration and anesthesia in nuclear magnetic resonance imaging].

Ferromagnetic equipment and equipment driven by alternate current cannot be used close to patients undergoing magnetic resonance imaging. Therefore, we tested a ventilator (Siemens Servo 900-D) that was placed more than 7 m away from the patient (outside the magnetic influence of 1.5 teslas) using tubing measuring 9 m in length. Tubing for children above the age of 8 and adults had a width of 22 mm; for neonates and children up to the age of 8 the width was 10 mm. Since the compressed air in such long tubes must be taken into consideration, we plotted nomograms for children and adults that helped to estimate respiratory minute volume including the compressed volume and a table to read the volume of compressed air that has to be added to respiratory volumes already established for ventilated patients from the ICU. In eight patients aged 7 weeks to 56 years (4 to 75 kg body wt.), capnography and blood gases showed that the nomograms were sufficiently accurate to allow safe ventilation. To improve safety, remote monitoring is recommended using long tubing or lines for oscillometric blood pressure measurement, capnography, and pulse oximetry as well as telemetric ECG.

Adult↗
PubMed1989

[Magnetic resonance tomography: a patient-connected system for artificial respiration and monitoring].

Physical phenomena that occur during magnetic resonance imaging (MRI) and the position of the patient inside the scanning tube necessitate adaptations of anesthetic techniques and devices. An anesthesia unit is presented that operates in close proximity to the patient without interfering with the imaging process. This unit enables the anesthesiologist to be close to the patient and his equipment, and minimizes the length of necessary tubing between patient and anesthesia apparatus. The unit consists of commonly used, commercially available devices with only minor modifications.

Anesthesia↗
PubMed1989

[Artificial respiration at home--an exceptional form of intensive care].

A couple with a child suffering from transverse lesion of the spinal cord with respiratory paralysis were greatly interested in taking care of him at home. After making technical and organisational preparations we transferred the child to his home with a respiratory machine. The child has now been at home for 3 years. Although the successful course of this home respirator treatment shows the correctness of our decision, we look upon such a procedure as an exception.

Child↗
PubMed1986

[Acute colectasia in patients on artificial respiration. 10 cases].

Acute colectasia may occur in patients under mechanical ventilation. Causative factors include haemodynamic changes, potassium loss, underlying pathology (chronic respiratory failure, cirrhosis) and especially morphine-like compounds used for sedation. Analysis of the results obtained with various treatments suggests that surgery is not justified: caecal perforation is extremely rare in a previous healthy colon; any surgical procedure is hazardous in this type of patient, and colectasia frequently regresses under appropriate medical treatment, even though mechanical ventilation is pursued.

Acute Disease↗
PubMed1986

[Intraoperative monitoring in artificial respiration of premature and newborn infants. I. Monitoring of respiratory parameters and alveolar ventilation].

Monitoring of ventilation serves to ensure adequate alveolar ventilation and arterial oxygenation, and to avoid pulmonary damage due to mechanical ventilation. Basic clinical monitoring, i.e., inspection, auscultation (including precordial or oesophageal stethoscope) and monitoring of heart rate and blood pressure, is mandatory. Mechanical ventilation is monitored by ventilation pressures (peak pressure, plateau pressure and endexpiratory pressure), ventilation volumes (measured at the in/expiratory valve of the respirator and by hot-wire anemometry at the tube connector), ventilation rate, and inspiratory oxygen concentration (FiO2). Alveolar ventilation should be continuously and indirectly recorded by capnometry (pECO2) and by measurement of transcutaneous pCO2 (tcpCO2), whereas oxygenation is determined via measurement of transcutaneous pO2 (tcpO2). Invasive monitoring of gas exchange is essential in prolonged or intrathoracic interventions as well as in neonates with cardiopulmonary problems. paCO2 may be estimated by capillary or venous blood gas analysis; arterial blood gas analysis is required for exact determination of paCO2 as well as arteriocutaneous pCO2 (atcDCO2) and arterio-end-expiratory (aEDCO2) gradients.

Acid-Base Equilibrium↗