Ugeskrift for laeger
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Multiple endocrine neoplasia type 2a and 2b (MEN 2a and 2b) are rare diseases, inherited as autosomal dominant traits. The neoplasias in MEN 2a are medullary thyroid carcinoma, pheochromocytoma and hyperparathyroidism. ⋯ This is important as the diseases are inherited and occur in young individuals. In this review, epidemiology, clinical features, diagnosis and treatment are discussed.
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Following infusion of hypertonic saline, interstitial and intracellular fluids are within minutes drawn into the vascular compartment as a result of osmotic gradients. Administration of 5 ml/kg body weight hypertonic saline leads to a degree of plasma expansion corresponding to 8-12 ml/kg. Results from major randomized studies on treatment of acute hypotension demonstrate that infusion of hypertonic saline leads to improved survival. ⋯ I illustrates the rapid plasma expanding properties of hypertonic saline and no. II the effect on central haemodynamics with increased stroke volume and cardiac index. Consequently, hypertonic saline is considered an important supplement in the treatment of severe hypovolaemic or septic shock.
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Ugeskrift for laeger · Jan 1996
Review[Invasive ventilation. Classification, technique and clinical experiences with BiPAP/APRV (Biphasic Positive Airway Pressure/Airway Pressure Release Ventilation)].
BiPAP (bilevel or biphasic positive airway pressure) and APRV (airway pressure release ventilation) are new, and from a technical viewpoint closely related techniques recently introduced to the field of invasive ventilatory support. BiPAP/APRV can be described as a pressure controlled continuous high flow positive airway pressure system with a time-cycled change between a high inspiratory pressure level and a lower expiratory pressure level. ⋯ APRV has primarily been investigated in conditions of moderate to severe acute lung injury and it seems that APRV is associated with less detrimental effects on the cardiopulmonary system compared to conventional ventilatory strategies. Apart from a review of the literature the article gives a classification and a technical description of the systems and focuses on the practical approach to BiPAP/APRV, e.g. the initiation and adjustment of respiratory support and the weaning from ventilatory support when applying these techniques.
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Ugeskrift for laeger · Jan 1996
[BiPAP (Biphasic Positive Airway Pressure)--an apparatus for non-invasive respiratory support].
Ventilatory support to patients suffering from respiratory insufficiency using a non-invasive technique has gained increasing popularity during the last few years. BiPAP (biphasic positive airway pressure) (Respiconics) offers inspiratory support and expiratory resistance to this group of patients both in the hospital and, in particular, in the home. The apparatus has proven to be effective as for instance a long term support device for patients suffering from neuromuscular diseases, sleep apnoeas and during the postoperative period. It works without pressurized air and is portable.