Anaesthesia and intensive care
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Carbon monoxide is a common domestic and industrial poison which may be lethal. Survivors can develop permanent neuropsychiatric disability. ⋯ Oxygen is the recommended antidote to carbon monoxide, but it appears that oxygen under hyperbaric conditions repeated either daily or as indicated by the patient's condition may be required to provide an effective dose. A reliable marker of the severity of carbon monoxide poisoning is urgently needed so that trials of alternative regimens can proceed.
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Anaesth Intensive Care · Nov 1991
Shoulder manipulation to facilitate central vein catheterization from the external jugular vein.
Manipulation of the shoulder to facilitate passage of J-wires past the clavicle during external jugular vein catheterization was tested prospectively in 111 adult patients undergoing cardiac surgery. On 10 of 25 occasions when the wire would not pass into the thorax, manipulation of the shoulder then allowed the wire to pass.
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Anaesth Intensive Care · Nov 1991
CPAP, effective respiratory support in patients with AIDS-related Pneumocystis carinii pneumonia.
Human Immunodeficiency Virus (HIV) related Pneumocystis carinii pneumonia (PCP) associated with severe respiratory failure is an increasingly common problem in major centres and is associated with a high mortality in previous and recent studies. Early in the epidemic, alternatives to invasive intensive care treatment were utilized in our institution and found to be successful. When respiratory failure developed, mask CPAP was used instead of intubation and ventilation. ⋯ Only two patients were admitted to the intensive care unit for respiratory support after failure of CPAP. Both patients were intubated and received intermittent positive pressure ventilation (IPPV). Both patients died.