PubMed · 7359023
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P W Head. 1980. Decompression injuries in the temporal bone.. https://doi.org/10.1017/s002221510008854x
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UNLABELLED: We wished to retrospectively evaluate the effects of permissive hypercapnia (PHY) on barotrauma, mortality and length of stay when applied to ventilated infants with respiratory syncytial virus (RSV) bronchiolitis. Nineteen control infants with RSV induced respiratory failure were treated with conventional ventilation (April 1991-January 1994), after which time PHY was adopted as unit policy. A further 28 infants were then treated with PHY (January 1994 April 1996). Demographic and physiological data were collected from admission, and outcome variables including length of stay, barotrauma and mortality were recorded. The PHY group showed a significantly higher mean pCO2 (7.6 vs 5.2 kPa), a lower mean pH (7.34 vs 7.40), and a reduction in maximal peak inspiratory pressures (25 vs 30 cmH2O). Mortality, barotrauma, use of neuromuscular blockade and nosocomial infection did not differ between groups. There was a trend towards increased length of ventilation in the PHY group (median 7 vs 5 days). CONCLUSION: Based on this retrospective data we can show no benefit for the use of permissive hypercapnia as a ventilatory strategy in this patient group. A prospective randomised controlled trial is warranted to accurately assess the outcome variables and cost implications of this strategy.
We have observed 3 cases of ocular trauma in children that were caused by an atypical, hypobaric mechanism induced by a toy called a Popper. When we initially notified the United States Consumer Product Safety Commission in 1990, Poppers disappeared from store shelves. We are concerned that this potentially harmful toy is making a comeback in 1998 (Smilemakers Inc, Spartanburg, SC; June-July 1998 catalog, p. 57). In 1990, packaged poppers cautioned against applying to face or skin; we are not sure that such warnings accompany current Poppers.
An infant with pneumomediastinum due to mechanical ventilation was successfully treated using high frequency oscillatory ventilation (HFOV). The 3-month-old male had undergone ligation of a patent ductus arteriosus and suffered from barotraumatic pneumomediastinum in the postoperative period. Computed tomography of the chest confirmed the diagnosis. While using conventional mechanical ventilation the respiratory failure worsened. HFOV was instituted and the patient improved. A lower airway pressure by this mode of ventilation provided significant advantages in the patient with an air leak. He was subsequently extubated and discharged home.