The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Jun 1995
Randomized Controlled Trial Comparative Study Clinical TrialEffects of different intermittent mandatory ventilation rates on oxygen consumption in premature infants recovering from respiratory distress syndrome.
Oxygen consumption at intermittent mandatory ventilation (IMV) rates of 10 and 20 breaths per minute was evaluated to determine whether a higher IMV rate in mechanically ventilated premature infants with apnea and respiratory insufficiency would reduce metabolic expenditure. Ten studies were performed in seven infants, with three infants studied twice after a trial of failed elective extubation. The mean birth weight was 952 +/- 183 kg (SD), and the mean postnatal age was 12 +/- 8 days (SD). ⋯ The oxygen consumption difference at the two IMV rates was not significantly related to dynamic lung compliance, resistance, or work of breathing. These results demonstrate that mechanically dependent premature infants without bronchopulmonary dysplasia do not have significant alteration in oxygen consumption with changes in IMV. This finding suggests that there is no potential metabolic energy balance benefit in use of moderately higher IMV rates to achieve improved growth rates in this population of infants.
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J Am Osteopath Assoc · Jun 1995
Case ReportsAccidental epinephrine auto-injector-induced digital ischemia reversed by phentolamine digital block.
The use of epinephrine-containing auto-injectors as a prescription medication for treating routine to severe anaphylactic reactions is now widely accepted. Associated with this trend is an increasing number of accidental injections of epinephrine into digits, causing severe vasoconstriction and the risk of ischemic necrosis. ⋯ The alpha-adrenergic blocking characteristics of phentolamine administered by a variety of methods have proved effective in reversing the effects of epinephrine in these cases. The authors urge that the described treatment protocol become more widely disseminated among primary care and emergency physicians.