Ugeskrift for laeger
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Ugeskrift for laeger · Jul 1996
[Evaluation of trainees' stay in general practice by the young physicians and their tutors].
In 1991 a new reform for postgraduate trainees was introduced in Denmark. Since the reform all young doctors-as a compulsory part of their vocational training-have had to work for six months as general practice trainees, no matter their wishes for future specialization. The reform furthermore led to the general practice trainees being considerably younger than previously-the average length of postgraduate experience before working as a trainee declined from six to seven years to one to two years. ⋯ Ninety-five percent of the questionnaires were returned, thus it was possible to evaluate the new compulsory training in general practice. In conclusion, the main part of the trainees had a positive assessment of the work conditions in general practice. However, a large part of the trainees indicated that their tutor doctors had set aside too short a time for supervision.
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Ugeskrift for laeger · Jul 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Nasal catheters versus Hudson face mask in oxygen therapy].
Thirty-two females, ASA class I, scheduled for termination of pregnancy before the 13th week participated in the study. After induction of anaesthesia, a soft plastic catheter was inserted in the oropharynx and the patients were postoperatively monitored with a capnograph, which sampled in- and expired air from the catheter. In a randomized cross-over design the patients received oxygen therapy by the Hudson face-mask and a nasal cannula. ⋯ The nasal cannula resulted in a significantly higher expired end-tidal O2-fraction (FETO2) compared to the Hudson mask. During the nasal cannula period the respiratory rate was significantly lower than during the face mask period. The end-tidal CO2 pressure (PETCO2) remained constant.
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Ugeskrift for laeger · Jul 1996
[Continuous monitoring of end-tidal CO2-tension in non-intubated patients].
We describe and evaluate a method for continuously monitoring end-tidal CO2 (PETCO2) in non-intubated, spontaneously breathing patients. In 18 ASA I patients scheduled for minor surgery a 3.3 mm (10 CH) soft plastic catheter was preoperatively inserted through one nostril placing the tip at the level of the epiglottis. In the recovery room a capnograph was connected to the catheter for monitoring PETCO2. ⋯ We tested the possibility of mixing expired air with supplementary oxygen via the other nostril at a flowrate of 15 litres min-1, and found no significant difference in PETCO2 with or without flow (0.0 +/- 0.9 mmHg). Values are mean +/- SD. In conclusion we find that this method allows accurate monitoring of PETCO2 in non-intubated, spontaneously breathing patients even at supplementary oxygen flow-rates of up to 15 litres min-1.
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Ugeskrift for laeger · Jun 1996
Review[Acute respiratory distress syndrome. Pathogenesis and therapy of acute pulmonary failure].
Adult respiratory distress syndrome (ARDS) is the pulmonary response to systemic inflammation precipitated by local or systemic tissue hypoxia, or ischaemia and reperfusion. ARDS is a dynamic, pathological process with a multifactorial etiology. The main clinical manifestations of ARDS are dyspnoea, non-cardiogenic pulmonary oedema, and hypoxia due to increased pulmonary capillary permeability, pulmonary vasoconstriction and diminished pulmonary vascular reactivity. ⋯ For treatment of pulmonary hypertension nitric oxide is useful. Change of position and inhalation with beta2-agonists are therapeutic possibilities. Steroids may be of benefit in the late proliferative phase of ARDS.
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Ugeskrift for laeger · Jun 1996
Case Reports[Caffeine antagonizes the neuromuscular blockade of vecuronium].
It is known that theophylline antagonizes the neuromuscular blockade in animals and case reports, where the same phenomenon has been observed in man, are described. One patient is described where another methylxantine-caffeine-caused resistance to neuromuscular blockade by vecuronium, but successful blockade was achieved by pancuronium.