Biomedical subjects
Publications and source records attributed to M D Bexton.
A high frequency oscillator and its interface with the Siemens 900C ventilator form a combined high frequency oscillator and intermittent positive pressure ventilator. This combined high frequency ventilator is designed for use in selected cases of refractory hypoxaemia.
A double-blind, randomised, controlled study was undertaken to investigate the effects on injection pain and excitatory phenomena of adding thiopentone to methohexitone. One hundred and twenty unpremedicated, day-case patients received one of four induction regimens: unmodified 1% methohexitone, or a mixture of 2.5% thiopentone and 1% methohexitone in ratios of 1:1, 1:3 or 1:9 by volume. The addition of one part of thiopentone to three parts of methohexitone produced a mixture which significantly reduced the occurrence of pain and discomfort compared with methohexitone alone from 67% to 13% (p < 0.01) and reduced the occurrence of excitatory effects from 50% to 13% (p < 0.01).
We describe a pregnant patient with respiratory failure due to an atypical pneumonia and asthma that was successfully treated with the combination of high frequency oscillatory ventilation and intermittent positive pressure ventilation. This combined high frequency ventilatory technique is not commonly used in adults with respiratory failure and is largely contraindicated in patients with prolonged respiratory time constants such as occurs in asthma because of the risk of gas trapping. We suggest that this technique be considered in cases of respiratory failure refractory to conventional intermittent positive pressure ventilation and, that with appropriate monitoring of airways pressure, is worthy of a trial in patients with prolonged respiratory time constants.
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