Articles: function.
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Journal of anesthesia · Jun 1997
Effect of external high-frequency oscillation on severe cardiogenic pulmonary edema.
Effective gas exchange can be maintained in animals without endotracheal intubation using external high-frequency oscillation (EHFO). The aim of this study was to evaluate the effect of EHFO in patients with respiratory failure due to severe cardiogenic pulmonary edema. Seven patients were ventilated with EHFO for 2h at 60 oscillations·min(-1), with a cuiras pressure of 36 cmH2O (-26 to +10) and an inspiratory to expiratory ratio of 1:1, with EHFO. ⋯ Arterial CO2 pressure (Paco2) did not, however, decrease. Increased stroke volume without a change in pulmonary artery wedge pressure (preload) suggests either improved inotropic function of the left ventricle or reduced left ventricular afterload with EHFO. The use of EHFO may be effective not only for gas exchange but also for left ventricular function in patients with severe cardiogenic pulmonary edema.
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Studies using a multimodal approach in order to prognose therapeutic success in patients suffering from back pain were seen to have highly diverse results. However, in spite of various independent health care systems, a common interest prevails in identifying determinants of therapeutic success in order to improve therapy. ⋯ Predicting successful treatment is hardly possible without analyzing individual circumstances, focusing on sociodemographic variables, workplace-related conditions, and aspects of individual motivation. With regard to objective therapeutic success, subjective perceptions proved highly influential. Treatment proved successful only when the patient's perception of functional disability was minimized. Hence, individual perceptions and experiences were more important than physical capabilities.
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Restor Neurol Neuros · Jan 1997
Cervical spinal cord injury in the adult rat: assessment of forelimb dysfunction.
Traumatic injury to the adult human spinal cord most frequently occurs at the mid-to-low cervical segments and produces tetraplegia. To investigate treatments for improving upper extremity function after cervical spinal cord injury (SCI), three behavioral tests were examined for their potential usefulness in evaluating forelimb function in an adult rat model that mimics human low cervical SCI. Testing was conducted pre- and up to 4 weeks post-operation in adult female rats subjected to either contusion injury at the C7 spinal cord segment or sham-surgery. ⋯ The Forelimb Grip Strength Test showed a significant decrease in forelimb grip strength of lesion rats throughout the 4 weeks post-cervical SCI. Significant deficits in reach and pellet retrieval by lesion rats were measured at l-to-4 weeks post-cervical SCI with the conditioned pellet retrieval Staircase Test. The results demonstrate that these qualitative and quantitative forelimb behavioral tests can be used to evaluate forelimb function following low cervical SCI and may be useful to investigate treatments for improving forelimb function in these lesions.
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The purpose of this study was to evaluate the effect of altering the use of the protocol for brain death determination in traumatically injured patients, on time to brain death determination, medical complication rates, organ procurement rates and charges for care rendered during brain death determination. A retrospective chart review of trauma patients with lethal brain injuries at an urban tertiary care trauma center was performed. Two groups of trauma patients with lethal head injuries were compared. Group I consisted of patients pronounced brain dead using a protocol requiring two brain examinations, and group II contained patients evaluated using a protocol requiring one brain examination in conjunction with a nuclear medicine brain flow scan. ⋯ Medical complications are universal in the traumatized patient awaiting the determination of brain death. These complications necessitate aggressive and costly care in the intensive care unit in order to optimize organ function in preparation for possible transplantation. In our institution, the determination of brain death using a single clinical examination and a nuclear medicine flow study significantly shortened the brain death stay and reduced associated charges accrued during this period. The complication and organ procurement rates were not affected in this small, preliminary report sample.