ABSTRACT
The case of an 8-month-old boy with bilateral diaphragmatic paralysis after surgical reoperation for congenital heart disease is presented. In order to avoid repeated intubation and long-term mechanical ventilation or tracheotomy, we used nasal mask continuous positive airway pressure (CPAP) as an alternative method for assisted ventilation. Within 24 hours the boy accepted the nasal mask and symptoms such as dyspnea and sweating disappeared. Respiratory movements became regular and oxygen saturation increased. Nasal mask CPAP may serve as an alternative treatment of bilateral diaphragmatic paralysis in infants, thereby avoiding tracheotomy or long-term mechanical ventilation.
Subject(s)
Heart Defects, Congenital/surgery , Laryngeal Masks , Positive-Pressure Respiration , Postoperative Complications/therapy , Respiratory Paralysis/therapy , Diaphragm/physiopathology , Humans , Infant , Intubation , Male , Phrenic Nerve/injuries , Postoperative Period , Respiration, Artificial , Respiratory Paralysis/etiology , TracheotomyABSTRACT
Triglyceride lipase and diglyceride kinase can be used in a sensitive stereospecific analysis of the separate fatty acid compositions at the 1, 2 and 3 positions of a triglyceride.Diglyceride kinase fromEscherichia coli selectively catalyzes the phosphorylation of 1,2-diglycerides but not the 2,3-diglycerides.The composition of the 3-position in rat liver triglycerides is clearly different from that at the 1-position.
