Clinical intensive care : international journal of critical & coronary care medicine
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The principles and problems of extracorporeal respiratory support (extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal) are reviewed. The recent development of intravenous oxygenation (IVOX) is noted and compared with existing forms of extracorporeal support.
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Clin Intensive Care · Jan 1991
Case ReportsSuccessful extracorporeal lung assist (ECLA) for a patient with severe asthma and cardiac arrest.
A 20-year-old male had a severe asthma attack complicated by a cardiac arrest despite maximal conventional therapy including mechanical ventilation. He was treated successfully with emergency veno-arterial Extra-corporeal Lung Assist started after 30 minutes of cardiopulmonary resuscitation. We believe that ECLA is a life-saving measure for intractable asthma and cardiac arrest.
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Clin Intensive Care · Jan 1991
Physiological responses to endotracheal and oral suctioning in paediatric patients: the influence of endotracheal tube sizes and suction pressures.
To study the influence of varying outer suction catheter (SC) diameter (OD) to inner endotracheal tube (ETT) diameter (ID) and suction pressures (SP) on heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), arterial oxygen saturation (SaO 2) and intracranial pressure (ICP) during ETT and oral suctioning. An additional aim was to define an optimal suction catheter size that would prove easy to introduce and be rapidly effective in clearing secretions with the least physiological alteration. ⋯ Our study suggests that: 1. Tracheal toilet using variations in OD/ID ratios and SP within limits tested resulted in similar significant adverse changes in HR, ICP and SaO 2 and similar trends in RR and MAP. 2. Based on the ease of introduction and the effectiveness of clearing secretions, a medium SC (OD/ID = 0.7) is most appropriate for infants and children. 3. Oral suctioning also results in adverse physiological changes, therefore similar precautions to those taken during tracheal suctioning should be followed for oral suctioning.