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PubMed1979

Induced hypotension for orthognathic surgery.

Achieving satisfactory hemostasis during orthognathic surgery may be difficult because of the extensive vascularity of facial structures. Hypotensive anesthetic techniques provide clear operative fields by altering regional tissue perfusion through the use of systemic vasodilators, ganglionic blocking agents, and positioning of the patient. Thorough monitoring during surgery, careful selection of patients, and close communication between the surgeon and anesthesiologist permit safe anesthesia, can decrease operating time, and usually obviate the need for transfusions.

Adult↗
PubMed1979

[Effect of chest physiotherapy on pO2 and pCO2 in premature and mature babies with respiratory distress syndrome (author's transl)].

pH, pCO2, pO2 and where possible DAaO2 determinations were done before, immediately after and 30 minutes after chest physiotherapy in 4 groups (respiratory adaptation disturbance, pneumonia, hyaline membrane disease--controlled ventilation and RDS--nasal-CPAP) of mature and premature infants and in a group of healthy infants. The most striking alterations of the parameters investigated were found in infants treated with nasal-CPAP and controlled ventilation where especially a decrease of pH and increase of pCO2 was observed. After small increases of paO2 immediately after physiotherapy the paO2 values and concomitantly DAaO2 values 30 minutes after chest physiotherapy fell below the levels before physiotherapy. There was no significant change from pretreatment values in any group of infants. A physiotherapist experienced in the care of infants with respiratory diseases is most important for achieving satisfactory results.

Carbon Dioxide↗
PubMed1976

"Aspiration disease".

Aspiration disease, a term used to define both an acute and chronic form of a disease entity, is described. Etiological factors, pathophysiology and therapy are discussed with emphasis on aspiration of gastric juice. A brief mention of a small clinical experience is included.

Acute Disease↗
PubMed1976

Editorial: C.P.A.P.

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Evaluation Studies as Topic↗
PubMed1977

Shock Lung.

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Humans↗
PubMed1976

Pneumothorax in the respiratory distress syndrome: incidence and effect on vital signs, blood gases, and pH.

We determined the incidence of pneumothorax in 295 infants (mean birthweight, 1,917 gm) with the respiratory distress syndrome (RDS) treated according to the same protocol. Fifty-five infants (mean birthweight, 1,594 gm) developed pneumothorax (incidence, 19%); incidence varied with severity of RDS and intensity of respiratory assistance. Pneumothorax occurred in 3.5% (2 of 58) of infants who received no assisted ventilation and in 11% (14 of 124) of infants who received continuous positive airway pressure (CPAP) as the only form of assisted ventilation; the difference between these two groups is not significant. Forty-nine infants initially treated with CPAP later required mechanical ventilation with positive end-expiratory pressure (PEEP). Pneumothorax occurred in 12 of the 49 (24%) and in 21 of 64 (33%) of those infants initially treated with PEEP; the incidence of pneumothorax for both these groups was significantly higher than for those treated with no assisted ventilation or CPAP only. To assess the value of frequent measurement of vital signs, blood gas tensions, and pH in the recognition of pneumothorax, we analyzed these variables by the cumulative sum statistical technique. We noted the following significant changes associated with pneumothorax: arterial blood pressure, heart rate, and respiratory rate decreased in 77% of cases; pulse pressure narrowed in 51% of cases; Po2 decreased in 17 of 20 cases in which ventilatory settings were constant for at least three hours prior to pneumothorax. However, pH and Pco2 showed consistent changes. Frequent measurements of vital signs and Po2 aid in the early diagnosis of pneumothorax.

Blood Pressure↗
PubMed1976

Renal function in experimental chronic hydronephrosis. V. Net acid excretion capacity in relation to renal pelvic volume after maximal loading with NH4Cl.

In 12 mongrel dogs intravenous loading with ammonium chloride (4 mmol NH4+/kg body weight) was performed before and 2-9 weeks after unilateral hydronephrosis had been produced by ligation of the ureter over an indwelling catheter. In an attempt to satisfy the demand for adequate, constant, alveolar ventilation a special respirator of the high-frequency positive-pressure ventilation (HFPPV) type was used. The acid-base status of the blood was determined before and after the loading and the acidification capacity of each kidney was assessed by measuring the amount of titratable acid and ammonium ions excreted in the urine. In the hydronephrotic kidney the excretion of both titratable acid and ammonium ions was statistically significantly reduced, both compared with the initial values in session I and compared with the healthy kidney in session II. After additional loading with ammonium chloride in session II, however, both kidneys increased their excretions to approximately similar extents. When the excretion was calculated per ml glomerular filtrate, no statistically significant changes were found between sessions I and II, either for the intact or the hydronephrotic kidney. The renal pelvic volume on the hydronephrotic side was measured and related to the reduction of the capacity of the kidney to excrete titratable acid and ammonium ions. No statistically significant correlation was obtained.

Acid-Base Equilibrium↗