Study of pulmonary function tests in insulin dependent diabetes mellitus

Thirty patients complaining from insulin dependent diabetes mellitus were selected for the present study. A set of ventilatory lung function parameters was measured in each patient [N=30] and control subjects [N=10] using an electronic spirometer. The studied group showed a highly significant [p<0.001] reduction in SVC, FEV1, FEV1 / FVC, FEF 25-75% and PEFR when compared with control group. The present study showed insignificant difference in the spirometric parameters when diabetic group with duration of diabetes more than 5 years compared with diabetic group with duration of diabetes 5 years or less. Also, insignificant difference were observed in patients with blood glucose level above 200 mg/dl and those with blood glucose below 200 mg/dl. From the present study we concluded that both restrictive and obstructive ventilatory defect were observed in insulin dependent diabetes mellitus. These ventilatory disorders had no relation to both the duration and glycemic control of diabetes We recommend the periodic evaluation of pulmonary function using spirometer in insulin dependent diabetic patients even though not symptomatized and to remember that the base line is not the same as for healthy subjects

Verification of the laryngeal mask position using the fiberoptic laryngoscope

Fifty patients were studied by fiberoptic laryngoscopy through the LMA and after its insertion. Respiratory obstruction was seen in 6 patients [12%]. Five patients with obstruction were due to down- folding of the epiglottis [one complete and four partial]. One patient with partial obstruction was due to forward displacement of the posterior cricoid area with in-folding of large aryepiglottic folds. Strangely enough, in the patient with complete obstruction, the epiglottis obstructed the fenestrated end of the LMA itself and not the laryngeal inlet. The vocal cords could be visualized in 90% of patients. The epiglottis was seen within the cuff in 62% of cases and still the device functioned satisfactorily. It is no longer recommended to remove and reinsert the LMA if the epiglottis lies within the cuff, provided that the respiratory parameters are within normal. The esophagus was seen within the cuff in 6% of cases, so the device does not protect against aspiration of gastric contents

Experience in a new percutaneous approach to the axillary vein for central venous catheterization

The new infraclavicular approach to the axillary vein was tried in 60 patients scheduled for central venous catheterization. It was successful in 55 patients. There was a low incidence of complications: Catheter malposition [6.7%], arterial puncture [5%], transient parasthesia [5%] and hematoma [1.6%]. Apart from difficulty in locating the vein in markedly obese patients, the results of this study confirmed the reliability, safety and effectiveness of this approach