Acta anaesthesiologica Scandinavica. Supplementum
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Acta Anaesthesiol Scand Suppl · Jan 1996
Case ReportsHigh frequency ventilation techniques in ARDS.
High frequency ventilation techniques are not applied as routine measures but are still regarded as lastditch efforts in treating patients with severe ARDS or with extensive bronchoplural fistula when conventional mechanical ventilation is not capable in providing sufficient gas exchange. High frequency ventilation techniques can be used in patients with septicemia or recent cerebral bleeding, which is a contraindication for ECMO, or in patients with increased ICP. We believe that high frequency ventilation techniques provide an important therapeutic tool in the treatment of pulmonary insufficiency since the hardware requirement is minimal and, after a brief explanation, the application is easy.
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Acta Anaesthesiol Scand Suppl · Jan 1996
Thermoregulatory vasoconstriction and perianesthetic heat transfer.
Heat transfer between the core and its environment in normothermic and slightly hypothermic situations is determined largely by the influence of vasomotion on convection. Tonic vasoconstriction, the normal barrier to heat loss from the core, is impaired upon induction of anesthesia. The resulting dilation of the arteriovenous shunts leads to redistribution of heat from the core to the periphery, diminishing the temperature gradient between the two compartments. ⋯ Under normal conditions of mild thermal stress, thermoregulatory vasoconstriction is thus able to protect core temperature by reducing cutaneous heat transfer and functionally isolating the peripheral and core thermal compartments. Consequently, anesthetic-induced alterations in vasomotor tone is one of the major factors influencing core temperature in patients who are not actively cooled or warmed. In contrast, thermoregulatory tone is insufficient to prevent core temperature perturbations in patients undergoing vigorous cutaneous cooling or warming.
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Statistical analyses show, that the factor of human error is by far a more frequent cause of helicopter accidents than is technical failure. The Crew Coordination Concept is an attempt to improve safety conditions. The particularly difficult conditions encountered on EMS flights in mountain terrain call for special training programs. Smaller helicopter models have a limited altitude range for operation.