Anaesthesia
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Case Reports
Treatment of a flail injury of the chest. A case report with consideration of the evolution of therapy.
A patient with flail-chest injury, and associated abdominal and musculo-skeletal trauma, required several modes of mechanical ventilation in the Surgical Intensive Care Unit Ventilator modalities included mechanical ventilation with positive end-expiratory pressure (PEEP) and intermittent mandatory ventilation (IMV) with continuous positive airway pressure (CPAP) during 12 days of intensive respiratory care. This treatment has resulted from an evolution of ideas about pathophysiology and treatment of the flail-chest injury. Future developments portend a shorter duration of ventilatory support; alternatively, a radically new mode of therapy may simplify the care of the flail-chest injured patient.
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An electronic trigger for the Philips AV1 ventilator is described.
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Randomized Controlled Trial Clinical Trial
The value of topical lignocaine for bronchoscopy under general anaesthesia.
Patients for bronchoscopy were randomly allocated to two groups, one receiving 4 ml 4% lignocaine spray and a control group which was not sprayed. There were no significant differences in the incidence of cough and spasm on recovery between the groups. The findings of a double-blind study comparing patients sprayed with 0-9% saline or lignocaine showed a significantly higher incidence of spasm in the saline group.