La Revue du praticien
-
La Revue du praticien · Nov 1990
[Current modalities of mechanical ventilation for acute respiratory failure in chronic respiratory insufficiency].
Acute respiratory failure in patients with chronic obstructive lung disease is a frequent and serious complication, with a mortality rate of 20 p. 100 and 57 p. 100 of the patients kept under mechanical ventilation for more than two weeks. The main problem with mechanical ventilation is an unavoidable intrinsic positive expiratory pressure and a hyperinflation that can be increased by the different modes of ventilation. ⋯ At the moment, there is no way of predicting the outcome of weaning in each individual subjects, and none of the various ventilation procedures has proved superior to the others. Nasal ventilation has recently been introduced in intensive care where it constitutes a major step forward being less invasive; it avoids intubation in 60 p. 100 of the patients but is more exacting for the physicians and nursing staff; finally, it makes it possible to treat acute respiratory failure at an earlier stage than previously.
-
La Revue du praticien · Nov 1990
[Tissue oxygenation during recovery from anesthesia. Value and measurement].
The measurement of tissue oxygen concentrations in the intensive care unit is important for the management of patients, especially those in shock. In daily practice, right heart catheterization with continuous monitoring of the oxygen saturation of mixed venous blood provided means of evaluating the principal parameters of oxygenation (transport, consumption and extraction), and of analyzing therapeutic interventions. The finding of an oxygen debt implies an appropriate therapeutic response designed to balance oxygen supplies with peripheral oxygen demand.