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Pascal Stucki

Publications and source records attributed to Pascal Stucki.

4 recordsLinked to original sources

Measuring end-expiratory lung volume and pulmonary mechanics to detect early lung function impairment in rabbits.

We investigated whether end-expiratory lung volume (EELV) or lung mechanical parameters are more sensitive for the detection of a compromised gas exchange during bronchoconstriction and after surfactant depletion. EELV was determined via SF(6) multiple breath wash-outs in mechanically ventilated rabbits while a positive end-expiratory pressure (PEEP) of 1, 3 or 7 cm H(2)O was maintained. Airway resistance (R(aw)) and parenchymal elastance (H) were estimated from the pulmonary input impedance measured at each PEEP level by means of forced oscillations. Measurements were repeated during i.v. methacholine (MCh) infusions and following lung injury induced by saline lavage. MCh induced marked elevations in R(aw), with no significant change in EELV or H at any PEEP. After lavage, the severity of hypoxia was reflected systematically in significant decreases in EELV at all PEEP levels (-42+/-13%, -26+/-4%, and -18+/-5% at 1, 3 and 7 cm H(2)O, respectively), whereas compromised gas exchange was not associated with consistent changes in the mechanical parameters at a PEEP of 7 cm H(2)O (20+/-9% and 14+/-9% in R(aw) and H, respectively; p=0.2). We conclude that R(aw) is the only sensitive indicator for the detection of a compromised lung function during MCh infusions, whereas the estimation of EELV is necessary to follow the progression of a lung injury when a high PEEP level is applied.

Airway Resistance↗

Severe methemoglobinemia due to food intoxication in infants.

The purpose of this case report is to illustrate food intoxication in infants as a consequence of fennel ingestion. Four cases of methemoglobinemia (MetHb) are presented here. Each patient ate homemade fennel purée a few hours prior to arriving to the emergency department with cyanosis unresponsive to oxygen, in the absence of suspected cyanotic heart disease. All 4 patients received treatment with methylene blue and fully recovered. Our cases emphasize that improper handling and storing of vegetables can lead to life-threatening MetHb.

Cyanosis↗

Successful management of severe respiratory failure combining heliox with noninvasive high-frequency percussive ventilation.

Heliox has been shown to be beneficial in the management of different obstructive pulmonary disorders. High-frequency percussive ventilation has recently been advocated to treat lung injury in children with reduced lung compliance. We report our experience of combining heliox with noninvasive high-frequency percussive ventilation in a 5-yr-old boy with severe acute respiratory failure resulting from advanced cystic fibrosis lung disease. The dramatic improvement allowed stabilization and withholding of endotracheal intubation. We hypothesize that this approach improved gas exchange by enhancing molecular diffusion and by favoring laminar flow throughout the upper and lower airways. Further investigations should study the mechanisms of this noninvasive bimodal therapy.

Child, Preschool↗

[Heliox in pediatrics].

Heliox is composed of oxygen and helium and its low specific gravity allows a modification of the gas flow within the airway. Breathing heliox favors a laminar flow and therefore decreases the work of breathing. Its usefulness in the child is established in croup or in post-extubation stridor. It can be considered if conventional treatment fails to improve the child's breathing pattern. Its major goal is to avoid invasive manoeuvers as much as possible.

Airway Obstruction↗