0000000000114954
AUTHOR
D. Elich
Successful treatment of a patient with ARDS after pneumonectomy using high-frequency oscillatory ventilation.
High frequency oscillatory ventilation (HFOV) was used in a patient who developed the acute respiratory distress syndrome 5 days following a right pneumonectomy for bronchogenic carcinoma. When conventional pressure-controlled ventilation failed to maintain adequate oxygenation, HFOV dramatically improved oxygenation within the first few hours of therapy. Pulmonary function and gas exchange recovered during a 10-day period of HFOV. No negative side effects were observed. Early use of HFOV may be a beneficial ventilation strategy for adults with acute pulmonary failure, even in the postoperative period after lung resection.
Active compression-decompression resuscitation: a prospective, randomized study in a two-tiered EMS system with physicians in the field.
Improved cardiopulmonary circulation with active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been demonstrated in studies using different animal models and a small number of humans in cardiac arrest (CA). However, prehospital studies have shown both positive and no extra benefit of ACD-CPR on return of spontaneous circulation (ROSC), hospital admission and discharge rates. The aim of our prospective study was to compare standard manual CPR (S-CPR) with ACD-CPR as the initial technique of resuscitating patients with out-of-hospital CA, with respect to survival rates and neurological outcome. Patients with out-of-hospital CA treated by emergency medical services (EMS…
Kontinuierlicher exspiratorischer Alkoholnachweis
The absorption of large volumes of irrigation fluid is a major problem in transurethral prostatic surgery (TUR-P). Various indicators have been tested to monitor fluid absorption with regard to continuous registration and sufficient accuracy. The volumetric fluid balance is not suitable as a routine method because of its inaccuracy. Easily accessible parameters are unspecific because of surgical bleeding (haematocrit [Hct]), or are interfered with by physiological counter-regulatory actions (serum sodium [Na] concentration). In 1986 Hulten et al. suggested adding 2% ethanol to the irrigation fluid as a marker and investigated it intermittently in the expired air with an alcohol-test applian…
Aktive Kompressions-Dekompressions-Reanimation (ACD-CPR)
□ Hintergrund Aktive Kompression, kombiniert mit aktiver Dekompression (ACD-CPR) mit Hilfe einer Druck-Saugglocke (Cardio Pump®, Ambu Int.), fuhrt zu einer verbesserten Organdurchblutung wahrend der kardiopulmonalen Reanimation im Vergleich zur Standardreanimationstechnik. Die Ergebnisse praklinischer Studien differieren in den verschiedenen Zentren und sind von den logistischen Gegebenheiten des jeweiligen Rettungssystems abhangig: Die Einfuhrung der ACD-CPR fuhrte in einigen Zentren zu einer signifikanten Erhohung der Uberlebensrate, wahrend sie in anderen, Zentren das Reanimationsresultat nicht beeinfluste.
Carbon dioxide levels during pre-hospital active compression–decompression versus standard cardiopulmonary resuscitation
Abstract In a prospective randomised study we investigated end-tidal carbon dioxide levels during standard versus active compression–decompression (ACD) cardiopulmonary resuscitation (CPR) assuming that the end-tital carbon dioxide reflects cardiac output during resuscitation. In each group 60 patients with out-of-hospital cardiac arrest were treated either with the standard or the ACD method. End-tidal CO 2 ( p et CO 2 , mmHg) was assessed with a side-stream capnometer following intubation and then every 2 min up to 10 min or restoration of spontaneous circulation (ROSC). There was no difference in p et CO 2 between both patient groups. However, CO 2 was significantly higher in patients wh…
Struktur- und Ergebnisqualit�t eines Rettungssystems
Ziel dieser Untersuchung war es zu klaren, ob die Struktur des Mainzer Rettungssystems eine flachendeckende und fristgerechte Versorgung von Notfallpatienten gewahrleistet. Daruber hinaus wurde der Einflus infrastruktureller Faktoren des Stadtgebietes sowie der Reanimation durch Ersthelfer auf Struktur- und Ergebnisqualitat untersucht. Das zu untersuchende System versorgt 190 000 Einwohner auf einer Flache von 80 km2 mit Hilfe von 4 Rettungs- (RTW) und 1 Notarztwagen (NAW), die in einem gestaffelten System mit den Moglichkeiten eines Fruhdefibrillationsprogramms fur Rettungsassistenten eingesetzt werden.