Mechanical Complications of Artificial Ventilation in the Newborn

Neonatology ◽  
1970 ◽  
Vol 16 (1-3) ◽  
pp. 122-132 ◽  
Author(s):  
J.P. Relier
Keyword(s):  
Artificial Ventilation ◽  
Mechanical Complications

ADRENOCORTICAL FUNCTION IN PATIENTS WITH ACUTE SEVERE BRAIN AND PITUITARY LESION

1962 ◽  
Vol 40 (2) ◽  
pp. 254-262 ◽  
Author(s):  
H. H. Bassøe ◽  
R. Emberland ◽  
E. Glück ◽  
K. F. Støa
Keyword(s):  
Pituitary Gland ◽  
Adrenal Cortex ◽  
Artificial Ventilation ◽  
Practical Significance ◽  
Adrenocortical Function ◽  
The Third ◽  
Low Levels ◽  
Pituitary Lesion ◽  
Steroid Excretion ◽  
The Brain

ABSTRACT The steroid excretion and the plasma corticosteroids were investigated in three patients with necrosis of the brain and of the pituitary gland. The patients were kept alive by artificial ventilation. In two of the patients the neutral 17-ketosteroids and the 17-hydrocorticosteroids fell to extremely low levels. At the same time, the number of eosinophil cells showed a tendency to increase. Corticotrophin administered intravenously twice to the third patient had a stimulating effect on the adrenal cortex. The theoretical and practical significance of these findings is discussed.

scholarly journals Challenges in Clinical Nutrition during the COVID-19 Pandemic

2020 ◽  
Vol 1 (1) ◽  
pp. 13-15
Author(s):  
Christina N.  Katsagoni
Keyword(s):  
Artificial Ventilation ◽  
Clinical Nutrition ◽  
Tube Insertion ◽  
Nutritional Screening ◽  
Nutrition Management ◽  
Muscle Catabolism ◽  
Key Aspects ◽  
Inflammatory Syndrome ◽  
Nutrition Practice ◽  
Nasogastric Tube Insertion

The viral epidemic caused by the new Coronavirus SARS-CoV-2 is responsible for the new Coronavirus disease-2019 (Covid-19). Fifteen percent of the Covid-19 patients will require hospital stay, and 10% of them will need urgent respiratory and hemodynamic support in the intensive care unit (ICU). Covid-19 is an infectious disease characterized by inflammatory syndrome, itself leading to reduced food intake and increased muscle catabolism. Therefore Covid-19 patients are at high risk of being malnourished, making the prevention of malnutrition and the nutritional management key aspects of care. Urgent, brutal and massive arrivals of patients needing urgent respiratory care and artificial ventilation lead to the necessity to reorganize hospital care, wards and staff. In that context, nutritional screening and care may not be considered a priority. Moreover, at the start of the epidemic, due to mask and other protecting material shortage, the risk of healthcare givers contamination have led to not using enteral nutrition, although indicated, because nasogastric tube insertion is an aerosol-generating procedure. Clinical nutrition practice based on the international guidelines should therefore adapt and the use of degraded procedures could unfortunately be the only way. Based on the experience from the first weeks of the epidemic in France, we emphasize ten challenges for clinical nutrition practice. The objective is to bring objective answers to the most frequently met issues to help the clinical nutrition caregivers to promote nutritional care in the hospitalized Covid-19 patient. We propose a flow chart for optimizing the nutrition management of the Covid-19 patients in the non-ICU wards.

Mechanical complications of cerebrospinal fluid shunt. Differences between adult and pediatric populations: myths or reality?

2021 ◽  
Author(s):  
Guillaume Coll ◽  
Francis Abed Rabbo ◽  
Emmanuel de Schlichting ◽  
Aurélien Coste ◽  
Jean Chazal ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Shunt ◽  
Mechanical Complications ◽  
Pediatric Populations

scholarly journals Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jean-François Timsit ◽  
Julien Baleine ◽  
Louis Bernard ◽  
Silvia Calvino-Gunther ◽  
Michael Darmon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Expert Opinion ◽  
Therapeutic Strategies ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Improvement Program ◽  
Femoral Access ◽  
Mechanical Complications ◽  
French Speaking

Abstract The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections’ prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Antiseptic- or antibiotic-impregnated CVC should likely not be used (GRADE 2, for children and adults). Catheter dressings should likely not be changed before the 7th day, except when the dressing gets detached, soiled or impregnated with blood (GRADE 2− adults). CHG dressings should likely be used (GRADE 2+). For adults and children, ultrasound guidance should be used to reduce mechanical complications in case of internal jugular access (GRADE 1), subclavian access (Grade 2) and femoral venous, arterial radial and femoral access (Expert opinion). For children, an ultrasound-guided supraclavicular approach of the brachiocephalic vein was recommended to reduce the number of attempts for cannulation and mechanical complications. Based on scarce publications on diagnostic and therapeutic strategies and on their experience (expert opinion), the panel proposed definitions, and therapeutic strategies.

Medullary lateral tegmental field: control of respiratory rate and vagal lung inflation afferent influences on sympathetic nerve discharge

2005 ◽  
Vol 288 (5) ◽  
pp. R1396-R1410 ◽  
Author(s):  
Shaun W. Phillips ◽  
Gerard L. Gebber ◽  
Susan M. Barman
Keyword(s):  
Respiratory Rate ◽  
Sympathetic Nerve ◽  
Artificial Ventilation ◽  
Critical Role ◽  
Lung Inflation ◽  
Chemical Inactivation ◽  
A Value ◽  
Relationship Of ◽  
The Relationship ◽  
Nerve Discharge

We used spectral analysis and event-triggered averaging to determine the effects of chemical inactivation of the medullary lateral tegmental field (LTF) on 1) the relationship of intratracheal pressure (ITP, an index of vagal lung inflation afferent activity) to sympathetic nerve discharge (SND) and phrenic nerve activity (PNA) and 2) central respiratory rate in paralyzed, artificially ventilated dial-urethane-anesthetized cats. ITP-SND coherence value at the frequency of artificial ventilation was significantly ( P < 0.05; n = 18) reduced from 0.73 ± 0.04 (mean ± SE) to 0.24 ± 0.04 after bilateral microinjection of muscimol into the LTF. Central respiratory rate was unexpectedly increased in 12 of these experiments (0.28 ± 0.03 vs. 0.95 ± 0.25 Hz). The ITP-PNA coherence value was variably affected by chemical inactivation of the LTF. It was unchanged when central respiratory rate was also not altered, decreased when respiratory rate was increased above the rate of artificial ventilation, and increased when respiratory rate was raised from a value below the rate of artificial ventilation to the same frequency as the ventilator. Chemical inactivation of the LTF increased central respiratory rate in four of six vagotomized cats but did not significantly affect the PNA-SND coherence value. These data demonstrate that the LTF 1) plays a critical role in mediating the effects of vagal lung inflation afferents on SND but not PNA, 2) helps maintain central respiratory rate in the physiological range, but 3) is not involved in the coupling of central respiratory and sympathetic circuits.

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