The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialComparison of thoracic manipulation with incentive spirometry in preventing postoperative atelectasis.
Atelectasis is a preventable complication that often occurs after upper abdominal surgery. In our 1-year randomized, researcher-blinded trial, low-risk cholecystectomy patients were subjected to either the thoracic lymphatic pump (n = 21) or incentive spirometry (n = 21) to prevent atelectasis. ⋯ Atelectasis occurred in 2 (5%) of 21 patients regardless of whether incentive spirometry or thoracic lymphatic pump treatment was used. Study patients treated with the thoracic lymphatic pump technique had an earlier recovery and quicker return toward preoperative values for FVC and FEV1 than patients treated with incentive spirometry.
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J Am Osteopath Assoc · Jun 1993
Case ReportsUnexpected adverse effects of Freon 11 and Freon 12 as medication propellants.
Metered-dose inhalers are frequently used in treating pulmonary diseases associated with bronchoconstriction, chiefly asthma and chronic bronchitis. These aerosolized medications are not without the potential for adverse effects. The author describes two patients who likely had adverse reactions to the Freon propellants used in the inhalers. These reactions are reported in order to alert physicians to their possible occurrence and to suggest a rational treatment approach.
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J Am Osteopath Assoc · Dec 1992
Invasive hemodynamic monitoring during cardiopulmonary resuscitation in a community hospital emergency department.
Monitoring the effects of resuscitation efforts in a community emergency department are limited primarily to noninvasive techniques. Coronary perfusion pressure (CCP) has been used as a predictor for successful resuscitation. The authors investigated the feasibility of measuring the CPP in a community emergency department and incorporating the CPP into decisions for managing the resuscitation effort. ⋯ There was no significant difference in return of spontaneous circulation between patients in the invasively monitored and the noninvasively monitored group. Coronary perfusion pressure monitoring had a positive influence on the management of three patients. This study showed that CPP monitoring is feasible in a community hospital, but further studies are needed to better define the effects of CPP in resuscitation effort outcome.