摘要:

Successful resuscitation from cardiac arrest in the asphyxiated dog model has been ascribed to the use of artificial ventilation, closed chest cardiac massage, and administration of a vasopressor. Controversy remains over whether the most commonly employed vasopressor, epinephrine, exerts its effects primarily by elevating diastolic pressure and reestablishing coronary flow, or by exciting cardiac pacemaker cells and enhancing myocardial contractility. To observe pure α and β adrenergic receptor influences during resuscitation, three groups (α-blocked, β-blocked, unblocked) of dogs were studied. β-blocked dogs resuscitated with phenylephrine and unblocked dogs resuscitated with epinephrine experienced 100% successful resumption of spontaneous circulation after 5 min of asphyxia-induced arrest. Only 27% of α-blocked animals resuscitated with isoproterenol were successfully revived. The appearance of the ECG during cardiac arrest and resuscitation could in no way be used to predict the outcome of resuscitation attempts.Results suggest that, initially, a receptor stimulation with concomitant diastolic pressure elevation is more important to the success of resuscitation than β receptor stimulation.

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Thirteen patients with significant hemorrhage, severe thrombocytopenia, and megaloblastic bone marrows are described. Unusual features of this problem included its acute onset, frequent absence of the typical peripheral blood changes of megaloblastic anemia, normal serum B12 levels, and serum folates which were often not clearly abnormal. Most patients were critically ill and common clinical features included reduced dietary intake, renal failure, renal dialysis, the postoperative state, and sepsis. These clinical features, the laboratory findings, and a platelet increase in most patients after folate therapy lead to the conclusion that this problem is probably due to acute folic acid deficiency. Possible explanations for the atypical laboratory findings include the acuteness of onset, recent blood transfusion therapy, and impaired folate utilization. This problem may be relatively common. Because of its potential clinical importance, rapid onset, and attendant diagnostic difficulties, prophylactic folic acid is recommended in the clinical setting described.

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The use of 100% oxygen to determine intrapulmonary shunting has been widely advocated. This study was performed to determine the clinical application of this technique in critically ill patients on PEEP. Determinations of intrapulmonary shunting using FIO2of 0.45 and 1.0 were performed on 18 patients. Machine error was also calculated. Shunt calculations increased by an average of 52% (29% corrected for machine error) with the use of an FIO2of 1.0 and returned to previous levels when an FIO2of 0.45 was reinstituted.There was no statistical difference in shunt increase between patients on high (≥15 cm H2O) or low (<15 cm H2O) PEEP. The use of 100% oxygen to calculate intrapulmonary shunting in patients on PEEP is misleading in both physiological and methodological terms.

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

We have devised an improved technique for sampling gas from endotracheal airways for mass spectrometer analysis. It is reliable and unobtrusive and is particularly resistant to occlusion of the sampling line by secrections. It has performed well during continuous monitoring of patients in a respiratory ICU.

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Near-drowning represents an insult that can affect all organ systems. A common pathway for injury is hypoxemia, acidosis, and hypoperfusion. Pulmonary insufficiency and CNS dysfunction are major causes of morbidity and mortality. Variations in vascular volume, heart failure, renal failure, coagulation disorders, and electrolyte disturbances may also be present. Patients should be observed for multisystem failure and therapy tailored to the particular needs of each victim.

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1979

数据来源: OVID