ABSTRACT
OBJECTIVE: To evaluate computed tomography quantification of injured pulmonary volume after thoracic trauma and its relevance for severity grade of patients with lung contusion. STUDY DESIGN: Retrospective study in a major French Level I university trauma center. PATIENTS AND METHODS: Clinical and biological data including oxygenation index (PaO2/FIO2) and therapeutics modalities during the first 5 days: positive end expiratory pressure (Peep) and nitric oxide (NO), were collected on 49 patients with lung contusion resulting from thoracic trauma. Injured pulmonary volume was evaluated on initial thoracic tomodensitometry by 2 senior radiologists. The correlation between oxygenation index, therapeutics modalities and initial injured pulmonary volume was assessed for signification. RESULTS: Injured pulmonary volume larger than 37.75% of total lung volume is associated with both hypoxemia at the twenty-fourth hour (PaO2/FIO2 <300), and need for Peep >6 cm H2O and /or ongoing NO administration on day 5. CONCLUSION: Injured parenchymal pulmonary volume evaluation on initial tomodensitometry seems to be an important indicator of lung contusion severity. Thoracic computed tomography provides additional prognostic information in the initial evaluation of thoracic trauma with parenchymal injury.
Subject(s)
Lung Injury , Lung Volume Measurements , Lung/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Female , France , Humans , Hypoxia/blood , Hypoxia/complications , Male , Middle Aged , Nitric Oxide/blood , Oxygen/blood , Positive-Pressure Respiration , Retrospective Studies , Thoracic Injuries/diagnostic imaging , Tomography, X-Ray Computed , Trauma CentersABSTRACT
Subcutaneous emphysema associated with impossible tracheobronchial aspiration occurred in a patient several hours after percutaneous tracheostomy. Misplacement of tracheal cannula was diagnosed and a tube exchanger was used to replace the cannula in a normal position. Twenty hours later a tracheal tear was recognized. This paper considers the pathophysiology and prevention of such a complication.
Subject(s)
Trachea/injuries , Tracheotomy/adverse effects , Aged , Dilatation/adverse effects , Dilatation/instrumentation , Humans , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/instrumentation , Male , Mediastinal Emphysema/etiology , Subcutaneous Emphysema/etiology , Suction , Tracheotomy/instrumentationABSTRACT
Before organ harvesting, previous information of the donor's family is mandatory in France. However information's content and consequences are not specified and may vary widely between hospitals. In some institutions, relatives are only informed of harvesting intent; in others, some teams require family's authorization before harvesting. To make easier and more efficient this information some improvements are suggested.
Subject(s)
Ethics, Medical , Professional-Family Relations , Tissue Donors , Tissue and Organ Procurement/legislation & jurisprudence , Brain Death/legislation & jurisprudence , Communication , France , HumansABSTRACT
In the recovery room, a ventilated patient suddenly developed bradycardia and severe cardiovascular collapse due to increased airway pressure. The cause of this life-threatening complication was continuous occlusion of the expiratory valve by a ruptured diaphragm in a Bennett's valve. When the rupture is located within the circular contact area with the expiratory port, the valve occludes normally during insufflation. On expiration, the expiratory gas under pressure penetrates the ruptured capsule, maintaining the valve occluded. A small part of the expired gas escapes through the small-bore connecting tube of the diaphragm.
Subject(s)
Ventilators, Mechanical/adverse effects , Equipment Failure , Female , Humans , Middle Aged , Postoperative PeriodABSTRACT
The ABT 4000 ventilator is aimed at being used in operating theatres, as it can be used in an open or a closed circuit, as well as for short periods of artificial ventilation with room air with or without added oxygen. This paper gives a description of the apparatus easy to understand, as well as an analysis of the workings of this constant volume ventilator controlled by microprocessor.
Subject(s)
Ventilators, Mechanical , Equipment Design , Evaluation Studies as Topic , Humans , Respiration, Artificial/methodsABSTRACT
Canton-S Drosophila melanogaster males were exposed to electrostatic and magnetic fields for 24 h to determine the influence of low energy fields on the production of sex-linked recessive lethal mutations in the mature, motile sperm. To detect sex-linked recessive lethal production in mature sperm the standard Muller-5 test was done. Exposure of the males to the magnetic field or the electrostatic field did not significantly affect the mutation frequency in mature sperm.
