Critical care medicine
-
Critical care medicine · Jul 1981
Prophylactic intubation and continuous positive airway pressure in the management of inhalation injury in burn victims.
Burn mortality statistics are influenced by age and degree of total surface body burn. The addition of an inhalation injury to a cutaneous burn results in a significant increase in mortality rate. Nine hundred fourteen patients with acute thermal injury were screened for positive history of burn in a closed space, facial or oropharyngeal burn, singed nasal vibrisae, carbonacious sputum, and clinical signs of upper airway involvement. ⋯ In patients with inhalation injury, burn wound sepsis (21.7%) was the main cause of death. These data suggest that prophylactic intubation and CPAP therapy in burn patients with suspected inhalation injury prevent pulmonary related death in early stage of burn. Irrespective of presence of inhalation injury, sepsis originating from the wound or respiratory tract is the main cause of death in the late stage of burn.
-
Critical care medicine · Jul 1981
Comparative StudyPerformance of neonatal ventilators: the effects of changes in resistance and compliance.
The authors tested the ability of 6 neonatal ventilators (Baby bird, Bourns BP-200, Veriflo, Bourns LS, ServoVent, SI-75) to deliver a preset tidal volume with minimal pressures when the compliance and resistance of test lung were altered. The authors also studied the effects of gas leaks from the system and the effects of PEEP. ⋯ Under these same conditions (normal compliance, elevated resistance), only 24-46% of the preset tidal volume was delivered. The different ventilators caused the pressure within the test lung to exceed 5, 10, and 15 cm H2O for differing amounts of time (sec)/min.
-
critically ill infants receiving supplemental oxygen for their hypoxemia may become significantly compromised by hypoxemia and bradycardia when supplemental oxygenation is interrupted to carry out laryngoscopy and tracheal intubation. It would, therefore, be desirable to devise a means of maintaining supplemental oxygenation during the procedure. A modified laryngoscope blade achieved this objective simply and efficiently. ⋯ The procedure of intubation was less stressful both to the patient and to the operator. It would seem appropriate to use the modified laryngoscope blade in all situations where hypoxemia threatens. It would seem to have a particular place in intubation of the difficult airway.