Critical care medicine
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Critical care medicine · Aug 1982
Comparative StudyFailure of one method of simultaneous chest compression, ventilation, and abdominal binding during CPR.
Some modified methods of CPR improve carotid blood flow, but there are no studies to show that these modified techniques improve survival, Accordingly, an experimental CPR technique using simultaneous chest compression, ventilation (SCV-CPR), and abdominal binding was compared to standard CPR in beagle dogs. The modified technique utilized a broad-based bellows device that was mechanically compressed, producing chest compression, delivering a volume of air to the endotracheal tube, and pressurizing an abdominal binder. The duration of ventricular fibrillation and CPR was 5 min. ⋯ The aortic diastolic pressure and the diastolic gradient between the aorta and right atrium was significantly different between the 2 groups. Because these pressures relate to the coronary perfusion pressure, they may explain the discrepancy in the survival rate. This study suggests increasing carotid blood flow during CPR will not necessarily improve survival.
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Critical care medicine · Aug 1982
Measurement of esophageal pressure in newborn infants using an esophageal balloon gastric catheter.
This report describes a new standard technique for the measurement of esophageal pressure (Pes) in mechanically ventilated neonates. A neonatal esophageal balloon was positioned in the distal esophagus and inflated with a volume of air determined by static pressure volume curves. ⋯ Measurements made in the supine position were higher than those made in either the right or left lateral position (p less than 0.005). Pes measurements increased notably with barotrauma (p less than 0.025).
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Critical care medicine · Aug 1982
Assessment of pediatric intensive care--application of the Therapeutic Intervention Scoring System.
There are few reports analyzing the results of intensive care for children. We evaluated quantitatively the amount of care required in our multidisciplinary pediatric ICU using the Therapeutic Intervention Scoring System (TISS) and assessed qualitatively the severity of illness using the Clinical Classification System (CCS). Over a 6-month period, there were 323 patients (99 CCS Class II, 83 Class III, 141 Class IV) whose overall mortality at 1-month follow-up was 10% (Class II, 0%; Class III 2%; Class IV, 23%). ⋯ The mortality of our Class IV patients was lower than a comparable adult population with similar TISS scores; however, the TISS regression slopes for Class IV patients were similar. We conclude that CCS and TISS are both useful for describing the pediatric intensive care patient population. TISS is particularly helpful in assessing the amount of care received as well as providing a means of evaluating severity of illness.
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Critical care medicine · Aug 1982
Comparative StudyEffects of conventional and high frequency jet ventilation on lung parenchyma.
Despite the increasing acceptance of high frequency jet ventilation (HFJV), very little work has been done to determine if lung damage results from its use. We performed an experimental study to compare the effects of conventional ventilation with those of HFJV on the lung parenchyma of anesthetized dogs. Thirteen animals were studied for periods ranging from 2-24 h. ⋯ In no case did the jet ventilated side show more damage than the control. We concluded that it is possible to use HFJV for 24 h without apparent parenchymal lung damage. Reduced hyperaeration is identified as a possible advantage of HFJV over conventional methods.