Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1984
Volume limited ventilation for treatment of severe respiratory distress in neonates.
Ventilatory treatment of the very small infant with severe respiratory distress remains controversial. At several occasions pressure limited ventilators have shown not to provide adequate alveolar ventilation in these newborn babies. On the other hand, until now few data are found concerning the ventilation of newborns with volume limited ventilators. The authors report two cases with successful ventilation using a servo controlled volume limited machine and they stress the possibilities and advantages of such a type of ventilator in a neonatal intensive care unit.
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Emergency Medical Aid (AMU) has existed on an organized basis in France for ten years. Considering that every call for medical assistance requires an answer the SAMU (Emergency Medical Aid Service) acts as a switchboard. Its implantation in a hospital and its powerful centralized telecommunications make it possible to adapt responses to the type of case: serious ones require sophisticated equipment, whereas non-serious ones come under a General Practitioner. ⋯ The SAMU also have other missions such as: teaching, prevention, disasters. The French system is aimed at reducing inequality in emergency situations and guaranteeing the whole population permanent medical care. Its cost to the public, however, is only +1 per inhabitant per year.
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Despite of controversial findings, High-Dose-Barbiturate Therapy is advocated by many authors for treatment of postischemic/anoxic encephalopathy and head trauma with elevated intracranial pressure. The adverse effects to thiopentone are analyzed in a retrospective study including 30 patients treated by high-dose thiopentone for raised intracranial pressure after severe head injury. ⋯ The specific prevention measures and the extended monitoring of barbiturate-treated patients are described. Considering the high incidence of clinical complications the indication for HDBT has to be reevaluated.
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The use of computers in the practice of anesthesiology appears to be very promising--therefore the time has come to reflect on ways to utilize the possibilities of computers in this field. The anesthesiologist is faced with an existing "medical information science" and system developments and must now address these questions: How do computers fit in these systems? What is the kind of support and help one can expect from the use of computers? Next one attempts to define the needs for computer support, taking into account the specific working conditions of various anesthesia teams. A description is made of how a system for medical information is automatized--and by way of an example--how such a computer system for anesthesiologists is linked to a larger regional facility. Advantages and disadvantages of such a system are discussed.