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Results for “Respiratory Paralysis”

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At least 19 recordsLinked to original sources
PubMed1979

Prolonged respiratory paralysis in wound botulism.

Two patients had wound botulism with longer duration of respiratory paralysis than previously described. Each sustained extensive trauma to soft tissues and grossly contaminated wounds when thrown from a vehicle in a rural area. Progressive muscular weakness and respiratory distress occurred 8 and 13 days after injury, in the presence of infected wounds and clinical and laboratory findings characteristic of botulism. Spontaneous vital capacity and inspiratory effort served as bedside indicators of ventilatory function throughout 11 weeks of ventilatory support in each case and paralleled other clinical assessments of progress and recovery. Wound botulism may result in neuromuscular paralysis for a prolonged period. These cases illustrate the primary role of scrupulous nursing and respiratory care throughout such a period of ventilatory insufficiency.

Adult↗
PubMed1979

Respiratory paralysis to improve oxygenation and mortality in large newborn infants with respiratory distress.

The nonsynchronous respiratory efforts of neonates with surgically correctable disorders may inhibit effective mechanical ventilation. The records of 25 infants treated with metocurine for muscular paralysis to improve mechanical ventilation were reviewed. All patients were greater than 35 (37.6 +/- 2.1) weeks gestation and 2.27 (2.98 +/- .47) kg. All required ventilatory support with an FiO2 of 100%. The mortality rate of this group of infants was 20% as compared with 73% (p < .001) in a similar group of 26 infants managed without paralysis. In 10 of the 25 infants treated with metocurine, pre- and 1 hr postparalysis paO2 values were available. The mean paO2 prior to paralysis was 62 (45--111) mm Hg and the mean post-paralysis paO2 was 144 (75--227) mm Hg, representing at 132% increase in paO2 (p < .001). The mean dosage for metocurine was 3.5 (1.45--6.79) mg/kg/day; however, those requiring paralysis for greater than 7 days showed a dramatically increasing requirement. These preliminary data suggest that respiratory paralysis reduces right-to-left shunting, improves paO2 and decreases mortality in large infants with severe respiratory distress requiring ventilatory support.

Diaphragm↗
PubMed1975

Complete respiratory paralysis caused by a large dose of streptomycin and its treatment with calcium chloride.

Several cases have been reported, in which a rather large dose of streptomycin given intraperitoneally at operation has produced respiratory paralysis. In these cases the treatment has usually consisted of respirator ventilation and administration of atropine and neostigmine. In animal experiments, in which a cessation of breathing has been produced, calcium salts have produced quick recovery. The authors present a case, in which appendicetomy was performed on a 10-year-old girl for a perforated appendix at the end of which, an overdose of intraperitoneal streptomycin was given, followed 10 minutes later by complete cessation of breathing. The patient had to be intubated again and put into a respirator. Neostigmine and atropine were used without noticeable effect. One and a half hours after the breathing had stopped 0.6 g calcium chloride was given intravenously and the girl recovered immediately and completely.

Calcium Chloride↗
PubMed1992

[Diaphragm pacing for the ventilatory support of the quadriplegic patients with respiratory paralysis].

Electrical stimulation of the phrenic nerve to pace the diaphragm in patients with chronic ventilatory insufficiency has been an established therapeutic modality since William W.L. Glenn first described using radiofrequency signals in 1978 to stimulate the phrenic nerves. Before this event, patients who were ventilator-dependent and thus bedridden because of respiratory paralysis associated with quadriplegia usually anticipated little chance for physical or psychosocial rehabilitation. Two cases of C1-C2 subluxtion with cord injury and chronic ventilatory insufficiency were implanted at VGH-Taipei with diaphragm pacemaker in 1988. Postoperative phrenic nerve stimulation was given according to individual training schedule. One case with total phrenic paralysis received bilateral phrenic nerve stimulation and became weaned from the ventilator 6 months later. The other case with partially active ventilatory function received unilateral phrenic nerve stimulation to compensate the ventilation. However, its final outcome still showed the necessity of a bilateral mode to achieve adequate ventilation irrespective of strenuous training for 2 years.

Adult↗
PubMed1976

Respiratory paralysis during treatment of hypertension with trimethaphan camsylate.

Four cases are reported in which respiratory arrest occured coincident with the intravenous administration of large doses of trimethaphan camsylate (Arfonad) to control hypertension. The mechanism of the respiratory depression is unknown, but it may have been related to a direct effect of trimethaphan on the respiratory center or to a curare-like effect of the drug. Close monitoring of ventilatory capacity should be maintained in all patients treated with trimethaphan.

Adult↗
PubMed1975

Artificial hyperventilation during 21 years in three cases of complete respiratory paralysis.

Three patients with paralytic poliomyelitis have been ventilated via tracheostomy with uncuffed silver cannula for 21 years, with high tidal volumes of atmospheric air (8.3, 7.2, and 5.4 ml/kg b.wt.), at a frequency of 20, passive expiration, and without periodic hyperinflation. No pulmonary complications were seen during the whole of this period. The total compliance was significantly decreased. The pulmonary physiological shunt relative to the total pulmonary blood flow (Qs/Qt) was slightly increased. PaO2 was nevertheless normal, probably due to a high alveolar PO2 caused by the hyperventilation. The physiological dead space realtive to the tidal volume (VD/VT) was within the noraml range, but VD was high in one case. Two of the patients disclosed an extremely low CO2 production and a PaCO2 averaging 12 mmHg, with small fluctuations during a 24-hour study. This profound respiratory alkalosis was only partly compensated in the arterial blood (pH: 7.54 and 7.50), suggesting a new state of acid-base equilibrium. The cerebrospinal fluid lactate was significantly increased to about 4 mmol/l, but the patients revealed no signs of impaired cerebral function. A reduction of the degree of hypocapnia by the use of a mechanical dead space is recommended.

Adult↗
PubMed1991

[Phrenic stimulation in respiratory paralysis caused by spinal cord injuries].

Phrenic stimulation is reserved for the rare patients with central neurogenic apnea due to isolated upper spinal cord injuries. Presenting a series of ten cases the authors describe the indications for phrenic stimulation, the technique of implantation and the conditions for diaphragmatic training by the use of stimulation by low frequency trains allowing for an increase in the number of low muscular fibers. The continuation of accompanying neurological rehabilitation and nursing of these severely handicapped patients is not to be neglected because of the length of the training protocole as the aim is their return home. This technique, therefore, seems particularly suitable for application in a few specialized centers where research for material totally implantable and adapted to the physiological requirements of the patient can be conducted parallel to treatment.

Adolescent↗
PubMed1976

Some pharmacological properties of the venom, venom fractions and pure toxin of the yellow-bellied sea snake Pelamis platurus.

The effects of the crude venom, four partially purified venom fractions and pure toxin (Pelamis toxin alpha) from yellow-bellied sea snake, Pelamis platurus, on respiration, blood pressure, heart and skeletal muscle of rabbits have been examined. Results indicated that crude venom, a partially purified toxic fraction and Pelamis toxin alpha caused initial respiratory stimulant effects followed by respiratory paralysis. In most cases, respiratory paralysis occurred before a profound fall in arterial pressure. Depression of the twitch response to nerve stimulation was observed in the tibialis anterior muscle. No significant change in the electrocardiogram was seen. Three partially purified non-toxic fractions of the crude venom induced transient respiratory stimulant effects. It was concluded that the crude venom and Pelamis toxin alpha had an identical mode of action and that they caused respiratory paralysis in rabbits.

Animals↗
PubMed1977

Effect of erabutoxin on respiration of rabbits.

The effect of erabutoxin (ETX) was examined on respiration of rabbits. A single dose of 15 microgram/kg or 25 microgram/kg of ETX did not cause respiratory paralysis, but repeated administration of 15 microgram/kg of ETX at 3 hour intervals (three times) or 25 microgram/kg at 4 hour intervals (twice) caused fatal respiratory paralysis. Furthermore, a single administration of 50 microgram/kg of ETX caused fatal respiratory paralysis within 2 hours after the administration in all animals. This respiratory paralysis caused by ETX was reversible and of long duration (10-20 hour). This respiratory paralysis was not blocked by the administration of anticurare agents (neostigmine, edrophonium) or respiratory stimulants (nikethamide, picrotoxin, dimorpholamine). Since ETX had no influence on the circulatory system, death caused by ETX was prevented with application of artificial respiration.

Animals↗
PubMed1976

ECG changes in benzene, toluene and xylene poisoned rats.

Electrical activity of the heart was studied in acute, subacute and chronic benzene, toluene and xylene poisoning by means of NEK-2 type apparatus in CFY male rats. In the early period of acute intoxication benzene and its methyl derivatives, injected either intraperitoneally or subcutaneously or administered by inhalation did not cause changes in the ECG. Intravenously injected toluene induced a rapid and permanent decrease in blood pressure, in higher doses respiratory paralysis. In acute inhalation toluene and xylene poisoning the anesthesia was followed by respiratory paralysis, bradyarrhythmia and asystole, while inhalation of benzene induced respiratory paralysis followed by ventricular fibrillation. Subacute poisoning with benzene, toluene and xylene caused disorders in repolarization and arrhythmia. The degree, incidence and development of these phenomena depended on the dose and the duration of exposure. The effect of benzene influencing ECG was appreciably more intensive than that of toluene or xylene. Owing to the high number of spontaneous ECG changes due to ageing, it is difficult to evaluate the effect of chronic exposure to the agents under investigation.

Acute Disease↗
PubMed1991

[Effects of diaphragm plication for phrenic nerve paralysis on respiratory mechanics and diaphragm function].

The purpose of this study is to examine the effects of unilateral diaphragm plication for phrenic nerve paralysis on the respiratory mechanics and diaphragm function. Study 1: We performed thoracotomy (BASELINE), left phrenicotomy (INJURY) and left diaphragm plication (PLICATION) in ten dogs. After chest was closed in each condition, measured were the tidal volume (TV), respiratory rate (f), esophageal and gastric pressure swing (delta Pes, delta Pga), dynamic compliance (Cdyn) the ratio of gastric to esophageal pressure swing (delta Pga/delta Pes) and the work of breathing per liter (WOB/L) under stable spontaneous breathing. Study 2: In eight other left-phrenicotomized dogs, Pdi and fractional shortening of the costal diaphragm during contralateral electrophrenic stimulation were measured before and after plication. After plication TV, delta Pga/delta Pes, Cdyn, Pdi and fractional shortening during stimulation increased significantly, whereas Pes and WOB/L decreased significantly compared with INJURY condition. In conclusion unilateral diaphragm plication after paralysis improves the intact hemidiaphragm contractility and diaphragmatic contribution to breathing.

Animals↗