Archive for December, 2008

ScienceDaily (2008-12-19) — For the first time in the world, transplant surgeons in Canada used a new technique to repair an injured donor lung that was unsuitable for transplant, and then successfully transplanted it into a patient. The use of this technique could significantly expand the lung donor organ pool and improve outcomes after transplantation.

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GlaxoSmithKline Plc’s widely prescribed drug Advair is safe enough for treating asthma but two lesser-used medicines are too risky, a U.S. advisory panel ruled on Thursday. Evidence of asthma-related deaths and serious complications led the panel of experts to warn against continued use of Glaxo’s Serevent and Novartis AG’s Foradil for adults, adolescents and children with asthma.

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  • Pulmonary embolism is a life-threatening condition that occurs when a clot of blood or other material blocks an artery in your lungs.
  • This is an extremely common and highly lethal condition that is a leading cause of death in all age groups.
  • One of the most prevalent disease processes responsible for  in-patient mortality (30%)
  • Overlooked diagnosis.

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Assisted Cough

Assisted Cough
(Quad Cough)

By having someone assist you in coughing, your cough will be more forceful and productive and you will be able to both prevent and treat some respiratory complications by bringing up secretions normally present in the lung. Indications for an assisted cough are:

* Weak or ineffective cough, and/or
* Excessive secretions

Reasons to avoid an assisted cough are:

* Pain
* Internal problems, such as abdominal complications, where pushing on the abdomen could cause more complications
* Chest injury ( broken ribs)
* Flail chest, where the chest has excessive mobility, usually due to paralysis of the muscles which control it.

Method:

Assisted Cough

The Institute for Rehabilitation Research and Development (IRRD)

at The Rehabilitation Centre (Ottawa)

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VIEW PDF

The oxygen dissociation curve

300px-Oxyhaemoglobin_dissociation_curve

Oxygen saturation

Oxygen delivery depends on:

Cardiac output
Haemoglobin concentration
Arterial oxygen saturation
Arterial oxygen saturation (SaO2) depends on arterial oxygen tension (PaO2)

saturation

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Pneumothorax

• Definition

Air accumulation in the pleural space with secondary lung

collapse

• Sources

–Visceral pleura

–Ruptured esophagus

–Chest wall defect

–Gas-forming organisms

• Factors determining gasreabsorption

–Diffusion properties of the gases

–Pressure gradients

–Area of contact

–Permeability of pleural surface

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Read Further:

Pneumothorax and Chest Tubes PDF

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From NEJM:

micro6ABSTRACT

Background The combination of complete diaphragm inactivity and mechanical ventilation (for more than 18 hours) elicits disuse atrophy of myofibers in animals. We hypothesized that the same may also occur in the human diaphragm.

Conclusions The combination of 18 to 69 hours of complete diaphragmatic inactivity and mechanical ventilation results in marked atrophy of human diaphragm myofibers. These findings are consistent with increased diaphragmatic proteolysis during inactivity.

Read Full article NEJM

coverAbstract

Background: Pneumonia viruses such as influenza may potentially spread by airborne transmission. We studied the dispersion of exhaled air through a simple oxygen mask applied to a human patient simulator (HPS) during the delivery of different oxygen flow in a room free of air currents.

 

 

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Original CHEST article

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