摘要:

Dimethylsulfoxide (DMSO) has been advocated as a central nervous system (CNS) protectant against ischemia and trauma. The present study was performed to evaluate acute cardiovascular effects of DMSO which might complicate the clinical treatment of CNS compromised patients. Intravenously administered DMSO in doses which reportedly provide CNS protection, 2 g/kg, were infused in 6 dogs; hemodynamic variables were measured and compared to infusion of equal volumes of 0.9% sodium chloride. Immediately after infusion, DMSO caused increases in cardiac index, heart rate, pulmonary capillary wedge pressures (WP), and pulmonary arterial (systolic, mean, and diastolic) pressures which were significantly greater than changes induced by saline. DMSO decreased systematic diastolic pressure and systemic vascular resistance at the end of infusion. Most DMSO induced changes returned toward pre-in-fusion values 10 min after the end of infusion.These results suggest transient DMSO effects different from equal volumes of saline, possibly due to hyper-osmotic expansion of plasma volume. A decrease in systemic vascular resistances was also observed. Although neither CNS protection, intracranial pressure or blood flow were studied, these data suggest that DMSO used for CNS protection would not have adverse acute hemodynamic consequences. This may be particularly relevant in traumatized, hypovolemic patients.

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Thromboembolism of abdominal aorta and its branches after umbilical artery catheterization has been previously reported. In the past, total occlusion of the abdominal aorta and its major branches was associated with high mortality. Successful aortic thrombectomy in the neonatal period has been reported only once in English literature. The successful management of 2 infants described here shows the need for early diagnosis and aggressive approach, including surgical thrombectomy when indicated. Thromboembolism of abdominal aorta and iliac arteries can be diagnosed by noninvasive methods, such as 2-dimensional echoaortography and Doppler blood flow measurement.

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

In order to evaluate the relative effectiveness of various commonly used fluids including blood, colloids and crystalloids, the authors measured cardiorespiratory variables before, during, and after 400 therapeutic interventions in a wide variety of critically ill patients including 157 patients with adult respiratory distress syndrome (ARDS), and 54 patients who did not develop ARDS. The responses of ARDS patients were further stratified according to the time of their ARDS, i.e., during the period of their ARDS and either before they developed ARDS, or after they recovered and mechanical ventilation was discontinued.In essence, 500 ml of whole blood, packed red cells, colloids, 5% plasma protein fraction, and dextran-40, and 100 ml of 25% albumin produced significant improvement in hemodynamics and O2transport, while 1000 ml of crystalloids produced small but significant changes in arterial pressure and small statistically insignificant changes in flow, O2delivery, and O2consumption (Vo2).There were similar cardiorespiratory responses to the various agents in: (a) periods during ARDS, (b) not during ARDS, and (c) in non-ARDS patients. In the late or terminal stage, such as the last 48 hours of life, neither colloids nor crystalloids improved hemodynamic and oxygen transport variables; in these circumstances colloids and other fluid therapy may increase pulmonary shunting and worsen lung function.The authors conclude that in early ARDS, i.e., 2–5 days after onset of ARDS from trauma or sepsis, colloids, whole blood and packed cells improve cardiorespiratory function provided wedge pressures >18 mm Hg are not exceeded. Subsequently, an operational or empirical trial of therapy using cardiorespiratory measurements as criteria of efficacy is an appropriate approach.

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The authors determined the correction factor (Ct) for three sizes of commonly available central venous catheters. These catheters are used as the injectate catheter when a 2.5 Fr transthoracic thermistor is used to determine cardiac output by thermodilution.The valves for Ctwere highly reproducible. These determinations can be used conveniently in children to determine cardiac output by thermodilution.

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The measurement of functional residual capacity (FRC) in patients receiving mechanical ventilation may provide valuable data in the assessment and management of acute respiratory failure. Previous descriptions of apparatus and techniques for FRC measurement have either been inapplicable to patients receiving positive end-expiratory pressure (PEEP), or insufficiently detailed to allow convenient duplication in the clinical setting. The authors describe a helium rebreathing method for bedside determination of FRC which can be performed during ventilation with PEEP and which is applicable in patients with prolonged equilibration times. The method is both reproducible in patients (variation from mean FRC: ±2.2%) and accurate (coefficient of variation from in vitro FRC of 3000 ml: ±1.7%). The apparatus and assembly are described in detail and require only components which are readily available commercially, so that they may be applicable to clinical use in a general hospital.

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Twenty-two patients were referred over a 3-year period for endoscopic evaluation of the upper airways. The diagnosis of acute upper airway obstruction was suspected from clinical means, and 8 of the 22 did prove to have critical encroachment of the upper airways requiring tube passage for stabilization. This technique utilizing the fiberoptic bronchoscope for diagnosis and tube placement represents the approach of choice in the adult population with acute upper airway obstruction.

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1981

数据来源: OVID