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  • 1990-1994  (3)
  • Controlled mechanical ventilation  (1)
  • Obstruction  (1)
  • Salt wasting  (1)
  • 1
    Electronic Resource
    Electronic Resource
    A new device to remove obstruction from endotracheal tubes during mechanical ventilation in critically ill patients (1994)
    Springer
    Intensive care medicine 20 (1994), S. 573-576 
    Details
    ISSN: 1432-1238
    Keywords: Mechanical ventilation ; Endotracheal tubes ; Obstruction ; Acute respiratory failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate the efficiency of a new device developed to remove obstructions from endotracheal tubes (ETT) in mechanically ventilated patients. Design Open study in mechanically ventilated sedated and paralyzed ICU patients. Setting General ICU and Laboratory of Respiratory Mechanics of the University of Rome “La Sapienza”. Patients 8 consecutive unselected mechanically ventilated, critically ill patients in which a partial obstruction of ETT was suspected on the basis of an increase of the peak inspiratory pressure (〉20%) plus the difficult introduction of a standard suction catheter. Interventions Obstructions to ETT were removed with an experimental “obstruction remover” (OR) Measurements “In vivo” ETT airflow resistance (0.25; 0.5; 0.75; 1l/s) was evaluated before and after use of the OR; the work of breathing necessary to overcome ETT resistance (WOBett) was also evaluated before and after OR use. Results The use of OR significantly reduced in all patients the ETT “in vivo” resistance (From 5.5±2.3 to 2.9±0.5 cmH2O/l/s at 0.25l/s,p〈0.05; from 9±2.4 to 3.8±0.8 cmH2O/l/s at 0.51l/s; from 12.2±3.5 to 5.7±1.2 cmH2O/l/s at 0.75l/s; from 16.9±6 to 9.3±3.8 cmH2O/l/s at 1l/s,p〈0.01 respectively). Also the WOBett was significantly reduced after use of the OR (from 0.66±0.19 to 0.34±0.08 J/l;p〈0.05) Conclusion This experimental device can be safely and successfully used to remove obstructions from the ETT lumen, without suspending mechanical ventilation, reducing the need for rapid ETT substitution in emergency and life-threatening situations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01705724
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Effects of the heat-moisture exchangers on dynamic hyperinflation of mechanically ventilated COPD patients (1990)
    Springer
    Intensive care medicine 16 (1990), S. 441-443 
    Details
    ISSN: 1432-1238
    Keywords: Heat-moisture exchangers ; COPD ; Auto PEEP ; Controlled mechanical ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In recent years the use of devices called Heat and Moisture Exchangers (HME) has become widespread as gas conditioners for ICU patients requiring mechanical ventilation. As an important variation of the resistive properties of the HME, related to flow and duration of use, has recently been pointed out during “in vitro” studies, the use of these devices in COPD patients could increase the levels of auto PEEP and dynamic hyperinflation. In this study we have compared the levels of auto PEEP and difference in functional residual capacity (Δ FRC) in a group of COPD patients, requiring controlled mechanical ventilation (CMV), at basal conditions and after the insertion into the circuit of three HMEs (Dar Hygrobac, Pall Ultipor, Engstrom Edith) at random: the results obtained excluded a significant increase of auto PEEP and Δ (FRC) both with “new” HMEs and after 12 h of continuous use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01711222
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Corticosterone methyl oxidase type II deficiency: a cause of failure to thrive and recurrent dehydration in early infancy (1992)
    Springer
    European journal of pediatrics 151 (1992), S. 170-173 
    Details
    ISSN: 1432-1076
    Keywords: Corticosterone methyl oxidase type II ; Failure to thrive ; Salt wasting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Corticosterone methyl oxidase type II (CMO II) deficiency is an uncommon cause of salt-wasting in infancy. We describe a boy who presented with recurrent dehydration and severe failure to thrive in the first 3 months of life, associated with mild hyponatraemia (serum Na+ 127–132 mEq/l) and hyperkalaemia (serum K+ 5.3–5.9 mEq/l). The diagnosis was suggested by an elevated plasma renin activity (PRA): serum aldosterone ratio, and subsequently confirmed by an elevated serum 18-hydroxycorticosterone: aldosterone ratio. Treatment with 9α-fluorohydroxycortisone normalized growth parameters and PRA levels. CMO II deficiency should be considered in infants with recurrent dehydration and failure to thrive, even when serum sodium and potassium levels are not strikingly abnormal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01954376
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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