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PubMed1991

A method to maintain normal respiratory and metabolic state in artificially respired rats.

Analysis of arterial blood gases (ABG) in awake, paralyzed, locally anesthetized, and artificially respired rats revealed the development with time of severe hypoxemia associated with metabolic acidosis despite adequate ventilation as assessed by normal PaCO2. These respiratory and metabolic disturbances may underlie the progressive deterioration experienced with this preparation frequently used in neuropharmacological experiments. We report here that the intravascular infusion of bicarbonated artificial plasma, associated with continuous positive pressure ventilation, prevents the deterioration of the respiratory and metabolic state in this preparation, which can be maintained within the range of that of the freely moving animal. This stabilized preparation may thus be highly suitable for neuropharmacological experiments extending for several hours.

Anesthesia↗
PubMed1992

Lack of accumulation of midazolam in plasma and lipoprotein fractions during intravenous lipid infusions in patients on artificial respiration.

Severely ill patients often require total parenteral nutrition including intravenous lipid emulsions concurrently administered with lipophilic drugs. Therefore we investigated whether therapeutic application of a mixed medium chain/long chain triglyceride infusion affects the disposition of midazolam necessary for sedation in patients on artificial respiration. The concentrations of midazolam were measured in unfractionated plasma, and in lipoprotein fractions isolated from ex vivo blood samples, including determination of triglycerides and cholesterol; the albumin level was also analysed. Midazolam in the VLDL fraction was only 0.246 microgram.ml-1, whereas the total plasma concentration averaged 1.101 micrograms.ml-1, and the midazolam content of the LDL plus HDL fractions amounted to 1.771 micrograms.ml-1. Albumin in these lipoprotein fractions was just as unequally distributed. A lipid infusion resulted in a significant elevation of total triglycerides from 157 to 221 mg.dl-1 and VLDL-triglycerides from 77 to 155 mg.dl-1. The triglyceride content of the LDL plus HDL fraction rose from 102 to 139 mg.dl-1. At the same time the midazolam concentration in unfractionated plasma and in the VLDL and the LDL + HDL fractions decreased to 0.899 microgram.ml-1, 0.130 micrograms.ml-1, and 1.265 micrograms.ml-1, respectively. Cholesterol and albumin concentrations were not affected. The data show for the first time that a significant increase in plasma triglycerides during an intravenous lipid infusion does not result in accumulation of midazolam in lipoproteins, probably because albumin binding of the drug is very strong. The lack of midazolam trapping is important with respect to the safety of concurrent use of lipophilic drugs and intravenous lipid infusions.

Adult↗
PubMedDate not supplied

The effect of cimetidine versus ranitidine on the gastric emptying rate of intensive care unit patients sustained on artificial respiration.

OBJECTIVE: To answer the question if their is a difference between cimetidine versus ranitidine on the gastric emptying rate. DESIGN: Prospective, blinded, randomised controlled study. SETTING: A mixed intensive care unit at the University Hospital. PATIENTS: Twenty-four patients sustained on artificial respiration. INTERVENTIONS: Blinded and randomised either cimetidine 200 mg or ranitidine 50 mg were administered IV, after administration of 500 ml of enteral nutrition. MAIN OUTCOME MEASURES: The gastric emptying rate (gastric filling index) was measured over 120 minutes by an ultrasonographic method. In both groups t/2 was very long, there was no statistical difference between the two groups concerning the mean gastric filling index values at successive measurements (time 0 to 120 minutes). Neither was there a difference between the young and the elderly, female and male patients. CONCLUSION: Following administration of either ranitidine or cimetidine in bolus, no difference in the gastric emptying of gastric liquid feeding could be observed in critically ill intubated, ventilated patients.

Adult↗
PubMedDate not supplied

Artificial respiration in the anesthetized horse using bilateral, percutaneous, cervical phrenic-nerve stimulation with needle electrodes: a preliminary report.

In this preliminary study, artificial respiration was produced in four anesthetized horses using trains of stimuli applied to long needle electrodes inserted bilaterally at the base of the neck. The needles were insulated to within 1 cm of the tips. The frequency of the stimuli (0.1 msec) was 35/sec and the train duration (duration of inspiration) was 1 sec. Inspired volume increased with increasing stimulus intensity. In two animals, inspired volumes of 6 liters were achieved. In another animal 4.5 liters was achieved and in another, 2.5 liters. This lower value probably represented less-than-optimal electrode placement. Artificial percutaneous electrophrenic respiration was maintained for half an hour in every animal using a minute volume equivalent to that when breathing spontaneously.

Animals↗
PubMed1993

[The performance of respirator alarms during simulated critical events in CMV/IPPV artificial respiration].

Alarm systems of ventilators enhance detection of possible critical events during artificial ventilation. Due to their significance, in some countries the alarm detection of ventilators is regulated by federal law. Up to now, no recommendations for the adjustment of alarm limits exist and only a few detailed investigations of the accuracy of alarm detection are available. METHODS. The response of four commercially available ventilators (Servoventilator 900C, Siemens, Inc.; Bennett 7200a, Hoyer, Inc.; Veolar, Hamilton, Inc.; EVITA, Dräger, Inc.) to critical events during artificial ventilation of a test lung were evaluated. We measured the alarm time (the time between event creation and alarm response) of ten different simulated critical events including disconnection, differentisized leaks, failure of the gas supply, and obstruction at different places in the artificial airway. DISCUSSION. All respirators were able to recognise severe critical situations such as hose disconnection, failure of gas supply, and total airway obstruction within a short time (< 15 s). The recognition of small airway leaks was more difficult for the ventilators even when the alarm thresholds were close. The alarm detection of the EVITA (software 10.0 or less) under conditions of partial airway obstruction may be a source of risk for the patient as the machine continued supplying inspiration with pressure-limited ventilation even when the pressure threshold was reached.

Emergencies↗
PubMed2006

[From the poliomyelitis epidemic to the founding of artificial respiration centres, intensive care units and centres for home mechanical ventilation].

In 1952, Copenhagen was confronted with a poliomyelitis epidemic that involved the respiratory musculature in large numbers of patients. The anaesthetist B. Ibsen, who established carbon dioxide intoxication due to severe hypoventilation as the cause of death, proposed that the patients be treated by tracheostomy and positive pressure respiration in order to achieve better ventilation than with an iron lung. In the Netherlands, it was decided to organise the control ofthe epidemics on a nationwide basis. Various hospitals were asked to set up artificial respiration centres. In addition, the Beatrix Fund was set up in order to collect money for combating poliomyelitis. The epidemic reached the Netherlands in 1956. In Groningen University Medical Centre, 74 patients were admitted, of whom 36 had to be ventilated. In two cases, the mechanical ventilation could not be stopped and one of these was ultimately discharged home with chronic ventilation in 1960, thus becoming the first patient in the Netherlands to be given mechanical ventilation at home. The mechanical ventilation centres developed into the intensive care units as we know them today. Most of the forms of treatment now in use are based on the techniques thought up and elaborated by the pioneers working in the mechanical ventilation centres. The latest development in this series is the development of centres for home mechanical ventilation.

Critical Care↗
PubMed1997

[Clinical study on action of artificial respiration produced by pressing in massage under anesthesia for lumbar intervertebral disc prolapse].

OBJECTIVE: To observe whether the gas exchange is sufficient for the requirement of body when the patient was prone in position and pressed in the course of massage under intravenous anesthesia with sodium pentothal (SP) for the treatment of lumbar intervertebral disc prolapse. METHODS: The oxygen would not be given to the patients whose heart and lung functions were good during the course of anesthesia and massage, respiratory function and blood gas analysis were studied on 20 patients selected randomly. RESULTS: Tidal volume was smaller and respiratory rate was faster than normal respiration. Saturation pulse oxygen was still normal in all patients. There were no significant changes in blood gas analysis before spinal injection and after massage (P > 0.05). CONCLUSION: The pressing could attain the action of artificial respiration. The respiration pattern was similar to high frequency positive pressure ventilation. The action of vibration and diffusion had normal respiratory effect.

Adult↗
PubMed2002

[Progress of introduction of artificial respirator at home--the knowledge I have gained from a 19 year-old patient requiring a home respiratory management care and through the friendship with his family members].

The patient developed right cerebellar hemorrhage at the age of 15 and spent four years at hospital. The patient and the family members had a strong wish to bring the patient back home and the patient was admitted to the hospital to undergo guidance about home medical care. The patient had paralysis of right upper and lower extremities and generalized strong ataxic motion and was under gastric feeding and had underwent tracheotomy to cope with hypoventilation, which required use of an artificial respirator at night hours. Since the patient was still as young as 19, we want to have the patient "go home" as they wanted. Fortunately, the mother who had to play key roles was still young and the parents worked at home. It didn't take long for them to master the techniques though they had various anxieties. It is considered important in the guidance on home medical care to what degrees the caregivers accept the condition of the patient and can imagine the long lasting care at home. We provided assistance while repeatedly interviewing with the patient and family members considering the significance to confirm their willingness and psychological condition. As a result, the patient was discharged from the hospital in two months. Now, two years have passed, and the patient is still cared at home and the possibility of the patient is sought for. The progress is reported here in this article.

Adult↗
PubMed1997

[Reconstruction of an ancient Egytian mouth-opening device. As early as 5000 years ago artificial respiration was basically possible].

Reproduction of an ancient Egyptian mouth-opening device raises certain technological and historical questions. The most effective variation has proven to be a device made of strip iron built exactly according to the proportions given in the Hunefer papyrus. This device allows quick and safe intubation of intubation dummy CLA 8 without a supplementary light source. Originally, the device was a metal instrument made of meteoric iron, apparently produced only in small numbers. To data, the form of production remains a mystery, since the smelting and processing of iron was totally uncommon in ancient Egypt. Based on the material structure of the device and certain portrayals in graves in Deir el-Medina, mouth-opening as it was actually performed reveals a methodology that can be reconciled with modern pre-clinical polytrauma management. In principle, this indicates that the introduction of artificial respiration thousands of years ago would have been possible.

Egypt, Ancient↗
PubMed1979

Inhibition of platelet aggregation during hypovolemic hypotension by acetylsalicylic acid and artificial respiration.

In vivo measurement of platelet aggregation was performed by a previously described photoelectric method. It is shown that platelet aggregation induced by arterial hypotension can be inhibited by i.v. administration of ASA and by artificial respiration. The inhibition of platelet aggregation following artificial ventilation is significantly more pronounced than by ASA given 24 h prior to the beginning of the experiments. Different sources of platelet aggregation in venous and arterial blood are informative about the canine lung not only as a filter for aggregates but also as a source of aggregating substances.

Adenosine Diphosphate↗
PubMed1994

Management of cobra bite by artificial respiration and supportive therapy.

During the period when the hospital ran out of cobra antivenom, 4 patients bitten by cobra with neuromuscular symptoms and respiratory depression were treated with artificial respiration. Complete recovery was noted within 36 to 72 hours. The data are interpreted to indicate the reversible binding of the venom to receptors. Artificial ventilation appears to be another alternative to specific antivenom treatment and may be used when the antivenom is not available or if there is antivenom hypersensitivity.

Adult↗
PubMedDate not supplied

[Effect of different regimes of the artificial respiration on systemic hemodynamics].

An increase in artificial lung ventilation induced a suppression in arterial and venous portions of the circulation, whereas a limited lung ventilation induced pressor shifts of these parameters. The findings suggest that the value of respiratory volume per a cycle rather than shifts in the minute respiratory volume, affects the values of circulation systemic parameters.

Animals↗
PubMed1979

[The chest roentgenogram during artificial respiration (author's transl)].

Chest roentgenography of artificially ventilated persons not only reveals morphological changes in the lungs but may also provide information regarding their pathogenesis and prognosis. To safeguard against misinterpretation of the findings they should be supplemented by blood gas analyses and function tests (e.g. effective compliance of the respiratory system). The chest roentgenogram also apprises of the development, and consequently of the need for treatment, of such complications as interstital emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum and subcutaneous emphysema.

Humans↗
PubMed1976

[The problems of intubation lesions with long-term artificial respiration (author's transl)].

Necroses of the tracheal wall with esophagotracheal and mediastinal fistulas are a serious complication of modern long-term artificial respiration through inflatable tubes. Different types of cuff, a number of control and monitoring mechanisms against over-pressure in the cuff are described. The intermittent blocking and unblocking method seems to be of importance. A simple and reliable method of intermittent occlusion of the trachea is obtained with the new Abouav and Finley parachute cuff with pressures which never exceed the artificial respiratory pressure of the ventilation system.

Foreign-Body Reaction↗