Swiss medical weekly
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Swiss medical weekly · Mar 1985
Randomized Controlled Trial Comparative Study Clinical Trial[Objectivation of the effect of antitussive agents using tussometry in patients with chronic cough].
The antitussive effect of several antitussive agents has been objectively evaluated in patients with chronic stable cough due to bronchial carcinoma, pulmonary tuberculosis or chronic obstructive lung disease. The patients received the active antitussive drugs or placebo in a double-blind, randomized crossover design. The preparations were administered at 10 p.m. and 2 a.m. on 7 consecutive nights and no antitussive was given for the following 20 hours. ⋯ The duration of action of low-dose codeine (6 hours) was unsatisfactory. Subjective preference for dextromethorphan indicates a psychotropic central nervous action of this drug not assessed by the measuring device. Noscapine was equally well tolerated but more neutral psychologically.
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Removal of catheter tip or guide wire emboli is needed for most cases with this complication. An alternative to surgery is transvenous retrieval. ⋯ No further complications were caused by this procedure. Due to the serious hazards of embolized foreign bodies there is a need to remove them, and the authors believe that the transluminal route, preferably with the loop catheter, should be the primary approach to this iatrogenic complication.
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Swiss medical weekly · Feb 1985
[Injury to the larynx and trachea following artificial respiration].
A general interdisciplinary survey of trends within intensive care units is necessary in order to further reduce the risk of laryngo-tracheal injury requiring treatment after prolonged intubation. Endoscopic controls of the larynx and cervical trachea should be recommended as urgent during long intubations, to ensure that a secondary tracheotomy does not ultimately occur too late. Only a perfectly performed tracheotomy minimises complications (stenoses). Repeated laryngoscopy and endoscopy of the trachea with a fibreoptic system (a few days after extubation) is recommended after every prolonged intubation.
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Swiss medical weekly · Feb 1985
Comparative Study[Determination of extravascular lung water in critical patients: comparison with radiological, hemodynamic and functional lung findings].
Measurement of extravascular lung water (EVLW) was performed by the thermal-dye technique in 55 critically ill patients. The EVLW values were compared with the corresponding radiographic, hemodynamic and functional pulmonary data. ⋯ Though different positive correlations between EVLW values and these parameters were found, they cannot replace EVLW measurement. Rather, EVLW measurement provides additional information on the degree of pulmonary edema which is useful in differentiating between cardiac and non-cardiac pulmonary edema and in states of radiologic over- or underestimation of EVLW.
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Swiss medical weekly · Feb 1985
[Mechanical ventilation in acute decompensation in chronic obstructive bronchopneumopathy].
Acute respiratory failure in chronic obstructive lung disease (COPD) is characterized by abnormal gas exchange and respiratory muscle fatigue; mechanical ventilation would appear to be particularly well suited to the management of COPD patients, because the respirator is a reliable oxygenator and a mechanical power supplier. However, many clinicians are reluctant to prescribe this therapy. ⋯ Data are presented which show no correlation between the duration of mechanical ventilation, the age of the patients and pulmonary function tests. During acute respiratory failure, COPD patients require active management in an intensive care unit.