Anaesthesia
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A patient received an hypoxic anaesthetic gas mixture and made an uneventful recovery. The fault was traced to an air-oxygen mixer valve in the Intensive Care Unit. An oxygen monitor in theatre would have detected the fault before the patient was anaesthetised.
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Cardiopulmonary bypass and complement activation. Involvement of classical and alternative pathways.
Complement is activated during cardiopulmonary bypass with consumption of the complement components C3, C4 and factor B. This takes place when either a bubble or membrane oxygenator is used and is not affected by steroid therapy. Complement activation is predominantly by the classical pathway and may be related to the aggregation of IgM found in bypass sera.
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Biography Historical Article
Eugen Bogdan Aburel (1899-1975). The pioneer of regional analgesia for pain relief in childbirth.
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Case Reports Comparative Study
High frequency venturi jet ventilation. Adult respiratory distress syndrome--a case report.
A Penlon Nuffield Series 200 Ventilator, adapted for use as a high frequency jet ventilator, was used to treat a patient with adult respiratory distress syndrome. Adequate alveolar ventilation with this method was achieved with lower mean intrapulmonary pressure (5.4 cmH2O) than with conventional intermittent positive pressure ventilation (IPPV) (6 cmH2O). An improved cardiac output was also apparent, as judged by a better systemic blood pressure [105/50 mmHg for high frequency jet ventilation (HFJV) compared to 90/40 mmHg for IPPV] and a lower central venous pressure 6 cmH2O for HFJV as compared to 9.5 cmH2O with conventional IPPV. ⋯ This allowed an assessment to be made of any potential neurological damage caused by the cervical fracture. An assessment had not been possible during conventional ventilation due to the heavy narcotic and sedative regime required to settle the patient. This case report provides further evidence that HFJV is a useful adjunct in the management of patients requiring mechanical ventilation and also that the Penlon Nuffield Series 200 Ventilator is capable of high frequency jet ventilation.