PubMed Health⌕ Search

Biomedical subjects

R M Kacmarek

Publications and source records attributed to R M Kacmarek.

85 records · Page 5Linked to original sources
PubMed1991

Portable airway-suction systems: a comparison of performance.

UNLABELLED: A number of portable suction systems (powered either manually, pneumatically, or electrically) are available. We compared the performance of three electric systems (Laerdal Medical LSU, Laerdal Medical CSU, and Matrx Medical) and two manual systems (Vitalograph Emergency Aspirator and California Medical V-VAC) to wall suction set at maximum pressure of 300 torr [39.9 kPa]. METHODS: We determined the maximum pressure each system was capable of generating, and we measured the volume of imitation maple syrup each system at maximum pressure could suction within 5 seconds and the time required by each system at maximum pressure to suction 150 mL of syrup. In addition, we evaluated the life of each electric system's internal battery. RESULTS: All the electric systems were capable of generating suction pressure greater than 300 torr [39.9 kPa]. The amount of time required by the electric systems to suction 150 mL of syrup was not significantly different from that required by wall suction. In 5 seconds, wall suction suctioned a significantly greater volume of syrup than did the Matrx Medical system (p less than 0.05, ANOVA), but a significantly smaller volume of syrup than did the Laerdal Medical CSU system (p less than 0.05, ANOVA). The manual Vitalograph Emergency Aspirator was capable of generating 300 torr [39.9 kPa] pressure, but the California Medical V-VAC was not. Wall suction significantly outperformed both of the manual systems when volume of syrup suctioned in 5 seconds and time required to suction 150 mL of syrup were compared (P less than 0.05 ANOVA). All electric systems were capable of maintaining maximum suction greater than 15 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1990

The new generation of mechanical ventilators.

The newest generation of mechanical ventilators has allowed increased flexibility and enhanced mechanical performance. Primary advantages of these units are improved interfacing during spontaneous breathing, improved monitoring capabilities, and increased safety by the addition of apnea/back-up ventilation during all spontaneous breathing modes. The major drawbacks of these units are their operational complexity and the inclusion of a large number of highly sensitive alarms. Finally, in spite of the scope and capabilities of these ventilators, the vast majority of patients can be very capably managed with the "mid-range" ventilators discussed as well as the majority of well maintained older generation ventilators. All the bells and whistles available on top-of-the-line units do not necessarily constitute an improvement in patient care.

Humans↗
PubMed1990

Ventilatory strategies in the management of the adult respiratory distress syndrome.

This article review available strategies for mechanically ventilating patients with the adult respiratory distress syndrome. The authors first present the conventional strategies of mechanical ventilation: volume-limited mechanical ventilation with positive end-expiratory pressure (PEEP) at normal inspiratory-expiratory ratios, the approach that has been the mainstay of ventilatory support since the initial description of PEEP. This discussion attempts to summarize the rationale and goals of treatment in a practical, clinically useful manner. The second section of the article reviews less conventional ventilatory approaches, including inverse ratio ventilation, extracorporeal techniques, high-frequency ventilation, prone position, and fluctuating PEEP, and attempts to review critically the available literature regarding their application.

Extracorporeal Membrane Oxygenation↗
PubMed1989

Sonomicrometric regional diaphragmatic shortening in awake sheep after thoracic surgery.

Through a right thoracotomy in seven sheep we chronically implanted sonomicrometry crystals and electromyographic electrodes in the costal and crural diaphragmatic regions. Awake sheep were studied during recovery for 4-6 wk, both during quiet breathing (QB) and during CO2 rebreathing. Tidal volume, respiratory frequency, and esophageal and gastric pressures were studied before and after surgery. Normalized resting length (LFRC) was significantly decreased for the costal segment on postoperative day 1 compared with postoperative day 28. Fractional costal shortening both during QB and at 10% end-tidal CO2 (ETCO2) increased significantly from postoperative days 1 to 28, whereas crural shortening did not change during QB but progressively increased at 10% ETCO2. Maximal costal shortening during electrophrenic stimulation was constant at 40% LFRC during recovery, although maximal crural shortening increased from 23 to 32% LFRC. Minute ventilation, tidal volume, and transdiaphragmatic pressure at 10% ETCO2 increased progressively after thoracotomy until postoperative day 28. Our results suggest there is profound diaphragmatic inhibition after thoracotomy and crystal implantation in sheep that requires at least 3-4 wk for stable recovery.

Animals↗