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  • 1990-1994  (3)
  • 1994  (3)
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  • 1990-1994  (3)
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  • 1
    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
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical microbiology & infectious diseases 13 (1994), S. 726-731 
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A commercial assay (AmplifiedMycobacterium tuberculosis Direct Test, Gen Probe) which combines transcription-mediated amplification of target rRNA with amplicon detection by a chemiluminescent DNA probe for the rapid detection ofMycobacterium tuberculosis in sputum was evaluated. The test was applied to consecutively collected, NALC/NaOH processed sputum sediments from two laboratories (H and L), each serving a different population of patients with pulmonary tuberculosis. Results were compared to those of fluorochrome staining and culture. A total of 760 specimens obtained from 246 patients were used for the study. The test was positive in 141 of 144 (98 %) specimens that were fluorochrome-positive and culture-positive forMycobacterium tuberculosis. Fifteen of 31 specimens that were fluorochromenegative, culture-positive were also assay-positive. A total of 312 specimens (100 patients) from laboratory H (prevalence = 10 %) and 448 specimens (146 patients) from laboratory L (prevalence = 34 %) were analyzed. Compared to culture, test sensitivity, specificity, positive predictive and negative predictive values were 65 %, 99 %, 94 % and 97 %, respectively, for laboratory H and 93 %, 99 %, 99 % and 97 %, respectively, for laboratory L. If the results were analyzed on the basis of at least one concordant result between the amplification assay and culture in three sputum samples per patient, then the sensitivity, specificity, positive and negative predictive values for identifying infected patients was 70 %, 99 %, 87 % and 97 %, respectively, for laboratory H, and 100 %, 98 %, 96 % and 100 %, respectively, for laboratory L.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-2665
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Magnetic resonance imaging of the brain of a 4-year-old patient with fatty alcohol: NAD+ oxidoreductase deficiency (Sjögren-Larsson syndrome) showed a severe leukodystrophy.
    Type of Medium: Electronic Resource
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