Effectiveness and haemodynamic tolerance of M.A.V. in conscious patients with a severe respiratory insufficiency is mainly due to the proper adaptation to ventilator with low frequency and adequate V.T. Thus M.A.V. is an eventual complement to directed ventilation exercises which in addition reduce the "rebound" of hypoxia and hypercapnia after a M.A.V. session. A proper adaptation ensures haemodynamic tolerance. Expiratory time should be sufficient in such obstructive patients. A post inspiratory pause can improve V.C.O2. Nevertheless, it should not shorten inspiratory time to less than one second and for each patient the best ventilatory profile should be properly established taking into account blood gases, circulatory, expired CO2 and clinical monitoring.

Carbon Dioxide↗

PubMedDate not supplied

[Clinical and bacteriological evaluation of sisomicin in sixteen cases of severe bronchopulmonary infection (author's transl)].

Sisomicin, an aminoglycoside antibiotic, was used as sole bactericidal therapy in sixteen cases of severe bronchopulmonary infection for an average of 11,5 days (range 7 to 14) with a dose of 3,5 mg/kg per day in three intramuscular injections. Fifteen of these hospitalized patients presented with chronic airway obstruction which resulted in lowered O2 saturation (SaO2 congruent to 86,1%, range 74 to 93) and, in twelve patients, hypercapnia (PaCO2 = 55,7 torr, range 33--73). Two of these patients were under continuous assisted ventilation. Two patients had a lower lobe infiltrate and a lung abscess respectively. Proteus (n = 3), Pseudomonas (n = 9), K. pneumoniae (n = 2), E. Coli (n = 1), Enterobacter (n = 1), S. aureus (n = 1) and D. pneumoniae (n = 1) were the dominant organisms in the bronchial secretions isolated by Mulder's method; P. aeruginosa was associated with K. pneumoniae, P. rettgeri and E. coli respectively in three cases. In thirteen cases, either a clinical cure (n = 2) or a definite improvement was observed (sputum volume and purulence, auscultatory signs, temperature). However, among these patients were three cases of superinfection/colonization and two cases of persistent organisms. In addition, in two of the three cases showing no improvement colonization occured. The favorable results of this study appear to be due to vigorous antibiotic therapy combined with intensive adjunct therapy. No adverse local or systemic reactions clearly attributable to the drug were observed.

Adult↗

PubMedDate not supplied

[Preliminary report and indications of assisted ventilation at home (author's transl)].

Two uses of intermittent positive pressure can be distinguished: one supports inhalotherapy and the other longterm assisted ventilation. The apparatus can be connected to the patient either through mouth-piece or by tracheostomy. The main factors involved in the indication of assisted ventilation are the number of acute failures, hypoxemia, hypercapnia, cor pulmonale. In our department, 53 patients were kept under prolonged supervision before a decision was made to use assisted ventilation or not. This attitude seems absolutely necessary. An oxygen test of several hours provides very useful information. Finally, the authors review the indication of various ventilation methods (tracheostomy, oral) in relation to different chronic respiratory insufficiency etiologies (ie., chronic obstructive broncho-pneumonia, restrictive syndrome).

Home Nursing↗

PubMedDate not supplied

[Long-term results of intermittent ventilatory assistance for 74 severe obstructive chronic respiratory insufficient patients (PaCO2 greater than 50 Torr) ventilated for more than a year (author's transl)].

From 1967 to 1978, home assisted ventilation (HAD) was applied to 74 severe chronic respiratory insufficient patients (67 COPD-7 restrictive). These patients used volume generators through mouth piece, except 3 of them who had a tracheostomy. The main results of this study are a highly statistically significant decrement (P less than 0,001) of the hospitalization durations and of the frequency of ARF, as well as an improvement of the survival duration in front of a non-tested group, and a significant decrease of haematocrit (less than 0,05) and P.V.R. (P less than 0,01). But blood gases and functional tests are not statistically different. Age (greater than 55 years) and delay after first ARF (greater than 2 years) when starting HAD are considered as pejorative factors.

Blood Gas Analysis↗

PubMedDate not supplied

[Muscular syndrome after exertion revealing the onset of endo- genous lactic acid intoxication following the administration of phenformin].

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Acidosis↗

PubMedDate not supplied

[Myocardial and muscular damage during drug poisoning].

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Alanine Transaminase↗