Kokyu to junkan. Respiration & circulation
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Comparative Study
[Comparison of standard-dose epinephrine and high-dose epinephrine in cardiopulmonary arrest outside the hospital].
We compared high-dose epinephrine (HDE) with standard-dose epinephrine (SDE) in improving the outcome of resuscitation after out-of-hospital cardiopulmonary arrest. The SDE group received epinephrine 1mg, and the HDE group received epinephrine 5mg respectively every 5 minutes until the return of spontaneous circulation. ⋯ However, the rate of successful resuscitation tended to be higher in the SDE group. The ineffectiveness of HDE was considered to be due to the existence coronary artery diseases in the majority of patients, or increase in myocardial oxygen demand by the beta 1-adrenergic effects of epinephrine.
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External high frequency oscillation (EHFO) around a negative pressure using a thoracoabdominal chamber without an artificial airway has been shown to be an effective form of ventilation in a quadriplegic patient. The patient was an 18 year old male, suffering from high-level cervical cord tumor (lipoma). His respiratory distress was severe, respiration was diaphragmatic only. ⋯ It is remarkable that the patient expelled sputum whenever he was connected to the Hayek Oscillator, far beyond that achievable by physiotherapy. EHFO avoids the need for endotracheal intubation, thus reducing the hazards of mechanical ventilation attributable to intubation. We conclude that EHFO produces gas exchange significantly and that this technique may have potential clinical application.