Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study compared percutaneous transtracheal jet ventilation (PTJV) at a frequency (f) of 20/min, with high-frequency positive-pressure ventilation (HFPPV) at f of 60/min, and endotracheal intubation and intermittent positive-pressure ventilation (ET IPPV) at f of 10/min in apneic dogs. Fifty-four emergency medicine trainees (EMTs) attempted PTJV via a 14-gauge Angiocath attached to a hand-held jet ventilator, f of 20/min, and ET IPPV using an Ambu bag, f of 10/min. Twenty-nine other EMTs attempted cricothyrotomy using a prototype nonkinkable catheter (Arrow) and a new jet ventilator, Bronchovent, f of 60/min, equipped with a pressure sensor which stops ventilation at pressures greater than 20 cm H2O. Adequate oxygenation was achieved by all 3 groups, but only the HFPPV group avoided respiratory alkalosis. There was a higher equipment failure rate (catheter kinking and dislodgment) in the PTJV group. In the HFPPV group, the Bronchovent's pressure-limiting sensor stopped ventilation when the catheter was kinked or out of position, reducing the extent of subcutaneous emphysema and barotrauma. With further catheter improvements, HFPPV Bronchovent may offer a safe and reliable method of ventilating patients during CPR in the field.
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PMID:Percutaneous transtracheal jet ventilation for cardiopulmonary resuscitation: evaluation of a new jet ventilator. 636 May 35

Two term and one post-term newborn infants with pneumomediastinum associated with the use of an Elder CPR (cardiopulmonary resuscitation)/demand valve during resuscitation are described. Because of apnea or irregular gasping respiration after vaginal delivery, they received repetitive positive-pressure ventilation with this resuscitator, which is designed to provide 100% oxygen with a limited pressure of up to 40 cmH2O. Following resuscitation, the infants had tachypnea and diminished breath sounds. Roentgenograms and computed tomography of the chest revealed pneumomediastinum in all three and cervical subcutaneous emphysema in one. They required 25-30% oxygen for 3-14 days until they recovered spontaneously. Thus, pressures as low as 40 cmH2O can cause barotrauma, and the Elder resuscitator, even when functioning properly, may injure the lungs of newborn infants.
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PMID:Pneumomediastinum in newborns induced by the Elder CPR/demand valve during resuscitation. 912 62

Occasionally, individuals accused of inflicting fatal injuries on infants and young children will claim some variant of the "CPR defense," that is, they attribute the cause of injuries found at autopsy to their "untrained" resuscitative efforts. A 10-year (1994-2003) historical fixed cohort study of all pediatric forensic autopsies at the Miami-Dade County Medical Examiner Department was undertaken. To be eligible for inclusion in the study, children had to have died of atraumatic causes, with or without resuscitative efforts (N(atraumatic) = 546). Of these, 382 had a history of cardiopulmonary resuscitation (CPR; average age of 4.17 years); 248 had CPR provided by trained individuals only; 133 had CPR provided by both trained and untrained individuals; 1 had CPR provided by untrained individuals only. There was no overlap between these 3 distinct groups. Twenty-two findings potentially attributable to CPR were identified in 19:15 cases of orofacial injuries compatible with attempted endotracheal intubation; 4 cases with focal pulmonary parenchymal hemorrhage; 1 case with prominent anterior mediastinal emphysema; and 2 cases with anterior chest abrasions. There were no significant hollow or solid thoracoabdominal organ injuries. There were no rib fractures. The estimated relative risk of injury subsequent to resuscitation was not statistically different between the subset of decedents whose resuscitative attempts were made by trained individuals only, and the subset who received CPR from both trained and untrained individuals. In the single case of CPR application by an untrained individual only, no injuries resulted. The remaining 164 children dying from nontraumatic causes and who did not undergo resuscitative efforts served as a control group; no injuries were identified. This study indicates that in the pediatric population, injuries secondary to resuscitative efforts are infrequent or rare, pathophysiologically inconsequential, and predominantly orofacial in location. In our population, CPR did not result in any rib fractures or significant visceral injuries. Participation of nonmedical or untrained individuals in resuscitation did not increase the likelihood of injury.
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PMID:Do resuscitation-related injuries kill infants and children? 2103 Aug 46