(CBC):An eight-year-old Edmonton boy will get to enjoy the “amazing gift” of a typical childhood after becoming Alberta’s youngest double-lung transplant recipient
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The routine management of mechanical ventilation in the ICU includes monitoring of peak airway pressures, plateau pressures and determining airway resistance.
When volume or pressure is pushed through an airway, a peak pressure is generated. This peak pressure is the sum of the amount of pressure necessary to get through the airways, inflate the alveoli and displace the chest wall and diaphragm. An inspiratory hold is performed on the ventilator to measure how much this pressure (plateau pressure) is actually being sensed in the alveoli once the lungs are inflated. By subtracting the plateau pressure from the peak pressure, we can calculate the resistance from the airways.
In managing mechanical ventilation, we routinely look at the plateau pressure to determine the limits to which we can increase our ventilating volumes. For the majority of patients, the chest wall and diaphragm are relatively compliant so are not a major factor in ability to ventilate patients. In cases of stiff chest wall or distended abdomens, the plateau pressure may be misleading as the pressure sensed within the alveoli is in part due to the pressures from the stiff chest wall or diaphragm.
Recently, esophageal catheters have been used to help optimize ventilation of patients with concerns re. stiff chest walls or diaphragms (distended abdomens). A catheter inserted in the esophagus is in close proximity to the pleural space. Esophageal pressures can be used as a surrogate to pleural pressures. Use of esophageal pressure monitoring can then help to differentiate between:
o pressure in the pleural space, attributable to chest wall and diaphragm and
o pressure distending the lungs (transpulmonary pressure) which might result in barotraumaPtpt (transpulmonary) = Paw (plateau) – Pes (esophageal)
October 12, 2009 — H1N1 critical illness mostly affects young patients and is often fatal, according to the results of a Canadian and Mexican study and an editorial published online October 12 in the Journal of the American Medical Association(JAMA).
“Of 215 patients with critical illness, 162 had confirmed, 6 had probable, and 47 had suspected community-acquired 2009 influenza A (H1N1) infection. Mean age was 32.3 ± 21.4 years in the 168 patients with confirmed or probable 2009 influenza A (H1N1); 113 patients (67.3%) were women and girls, 50 patients (29.8%) were children, and 43 patients (25.6%) were aboriginal Canadians…”
H1N1 Critical Illness Mostly Affects Young Patients and Is Often Fatal
Google.org has an interesting site devoted to following flu trends. You can chart by “National” or by “Province.
Google Flu Trends uses aggregated Google search data to estimate current flu activity around the world in near real-time.
Check out the site below:
Learn more about the research behind Google Flu Trends:
Read the article published by Nature, Detecting influenza epidemics using search engine query data.
The KidO’s Bear has a friendly, non-threatening appearance and has successfully provided aerosol and oxygen therapy for tens of thousands of patients.
Since it calms the anxious or agitated patient, the Bear’s design insures maximum compliance with breathing treatments for asthma and other respiratory illnesses. The Bear also incorporates direct delivery technology that focuses the administration of medication or oxygen thereby insuring that the patient receives maximum effectiveness and benefit from the treatment or therapy.
