British journal of anaesthesia
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Traumatic haemopericardium is an uncommon but life threatening condition. It is usually caused by penetrating cardiac injuries or cardiac rupture from blunt chest trauma. We report haemopericardium and cardiac tamponade in a young girl after blunt abdominal trauma. ⋯ No damage was found at laparotomy and she remained haemodynamically unstable. Further investigation found cardiac tamponade and haemopericardium. This was managed by insertion of a pericardial drain using transthoracic echocardiogram guidance, with later drainage in the operating theatre using guidance with a transoesophageal echocardiogram.
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We have compared the effects of inhalation of aerosolized surfactant on experimental acute respiratory distress syndrome. Escherichia coli endotoxin (55 (SD 20) mg kg(-1)) was injected into the tracheas of 36 adult rats anaesthetized and mechanically ventilated with pure oxygen. When the Pa(O(2)) decreased to 11.3 (3.3) kPa, the animals were randomly subjected to inhalation of aerosolized modified natural surfactant (MNS) for 0 min (control group), 30, 60, and 120 min. ⋯ In the groups receiving inhalation of surfactant for 30 and 60 min, Pa(O(2)) increased but decreased soon after termination of the inhalation. In contrast, Pa(O(2)) of the group receiving inhalation of surfactant for 120 min continued to increase, reaching 52.1 (12.5) kPa at 180 min (P<0.05 vs control). Thus, we conclude that improvement in gas exchange as a result of inhalation of MNS depends on the duration of inhalation.