Primary epineural repair of the ulnar nerve in children.

Transectional nerve injuries are uncommon in children. We report the outcome of 19 children aged < or = 13 years with acute transectional injuries to the ulnar nerves who were treated by primary epineural repair. There were 13 boys and 6 girls with a mean age at the time of injury of 6.7 years (range, 2-12 years). The site of injury was the palm in 4 children, wrist in 10, forearm in 4, and above the elbow in 1. Associated injuries to other structures occurred in 13 children. The mean recovery (Medical Research Council scale) of the first dorsal interosseous muscle was grade 4.0 (range, grade 3-5) and the mean outcome for the abductor digiti minimi was grade 3.9 (range, grade 2-5). The mean static 2-point discrimination was 6 mm (range, 2-20 mm). The mean follow-up period was 50 months (range, 12-103 months). Although proximal injuries (at or above the elbow) had a poorer outcome, satisfactory function of the intrinsic hand muscles still occurred; this finding contrasts to results reported in adults. Similarly, associated injuries to adjacent structures had no impact on ulnar nerve recovery. Primary epineural repair of the acutely transected ulnar nerve leads to a satisfactory recovery in both motor and sensory function in children younger than 13 years.

A multipatient mass spectrometer based system for the measurement of metabolic gas exchange in artificially ventilated intensive care patients.

A commercially available multi-patient mass spectrometer based system [MPMS] has been evaluated for the measurement of metabolic gas exchange in artificially ventilated patients. The system automatically measures and displays oxygen uptake, (VO2) carbon dioxide output, (VCO2) respiratory quotient (RQ) expired minute volume, (Ve) and the percentage concentration of inspired gases. Measurements of VO2, VCO2, RQ and Ve, obtained using this system were compared with those determined by simultaneous Douglas bag collections. The measurement of carbon dioxide and oxygen concentrations was assessed separately by direct comparison with infra-red and paramagnetic analysis respectively. The MPMS measurements of metabolic gas exchange were found to have insignificant systematic errors with precisions of +/- 12 ml/min VO2, +/- 7 ml/min VCO2, +/- 0.03 RQ and +/- 0.1 l/min Ve; (2SD).