Intensive care medicine
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Intensive care medicine · Jan 1988
Case ReportsIntermittent positive pressure ventilation by nasal mask: technique and applications.
Intermittent positive pressure ventilation delivered non-invasively through a well-fitting nasal mask has been used to control nocturnal hypoventilation in three patients with severe, combined cardiorespiratory and skeletal disease. The advantages of this approach to domiciliary ventilation are described and the requirements of the ventilator are defined.
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Intensive care medicine · Jan 1988
Case ReportsExtracorporeal lung assist for patient with hypercapnia due to status asthmaticus.
A 62-year-old female was brought to our emergency room in status asthmatics. She needed mechanical ventilation because of hypercapnia. However, effective mechanical ventilation was difficult because of severe airflow obstruction. Instead of conventional mechanical ventilation, we used extracorporeal lung assist (ECLA) to prevent barotrauma and lung tissue damage, and to reduce the doses of sedatives and muscle relaxants needed.
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Intensive care medicine · Jan 1988
Case ReportsPulmonary edema due to partial upper airway obstruction in a child.
The case of an 8-year-old boy is reported, who developed acute pulmonary edema associated with acute subglottic swelling and subsequent partial upper airway obstruction after extubation and recovery from anaesthesia. The main factors responsible for the formation of pulmonary edema presumably are a large subatmospheric transpulmonary pressure gradient and hypoxia leading to translocation of circulating blood volume into the pulmonary vasculature and fluid shift across the alveolar-capillary membrane. Application of oxygen and CPAP or PEEP plus diuretic therapy will promote rapid clearance of the pulmonary edema.
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Intensive care medicine · Jan 1988
Case ReportsParacetamol-associated coma, metabolic acidosis, renal and hepatic failure.
A case of metabolic acidosis, acute renal failure and hepatic failure following paracetamol ingestion is presented. The diagnostic difficulty at presentation is highlighted. Continuous arteriovenous haemofiltration proved a valuable means of maintaining fluid and electrolyte balance. The patient recovered.
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Intensive care medicine · Jan 1988
Case ReportsCorynebacterium JK: surgical infections in non-immunosuppressed patients.
Infection caused by Corynebacterium JK (CJK) has been recently described in immunocompromised patients. To evaluate the frequency of CJK infection among surgical and trauma intensive care patients, all patients with CJK isolations at clinical sites were reviewed. ⋯ Eight patients were studied; 3 of them were considered infected, while 5 were judged only colonized. It is concluded that CJK infections can be a clinical problem in surgical trauma patients.