IPPB and hypercapnia in respiratory failure: The effect of different concentrations of inspired oxygen on arterial blood gas tensions

Fourteen patients with acute exacerbations of chronic bronchitis and hypercapnia received two treatment periods with Intermittent Positive Pressure Breathing, the ventilator being driven by gas containing about 24% or about 45% oxygen. Arterial PO2 and PCO2 were measured before, during and after each treatment. The results demonstrated that increasing hypercapnia did not, as a rule, occur when 45% oxygen was used as the driving gas. When hypercapnia did occur it appeared to be independent of the inspired oxygen concentration. The importance of short treatment periods, correct ventilator settings and supervision of the patient during and after treatment is emphasised.     

Therapeutic Exercise for Spinal Segmental Stabilization in Low Back Pain: Scientific Basis and Clinical Approach

Abstract

Co-activation of agonist and antagonist muscles in healthy people is considered a normal strategy that aids movement efficiency during the performance of functional activities. In some cases, however, it is an abnormal strategy that aids stability and/or precision but not efficiency of movement. Co-activation varies not only between agonist and antagonist pairs, but within a pair from time to time, and depending on a range of factors. Muscle co-activation strategies are used when uncertainty in relation to execution of a specific task occurs, during the learning of a new skill or as compensation. Movement dysfunction in neurological conditions may coincide with abnormal levels of co-activation. It is unclear at what level co-activation assists or impedes functional ability, and to what extent reduced agonist excitation and antagonist co-activation combine to cause significant weakness. A major limitation in understanding the mechanisms of co-activation in neurologically impaired individuals is the wide range of methods that are used to determine levels of antagonist activation and hence co-activation levels. The muscle action, joint position, contraction type and testing conditions may influence the antagonist EMG recorded. This review investigates the methods routinely used to quantify co-activation, and relevant findings, particularly with respect to neurologically impaired individuals. Inconsistencies in methods used limit comparison between studies, but it is clear that whilst co-activation may occur alongside clinical features in neurological conditions, it is often viewed as a task-related strategy used to cope with the complexity of a task. This review highlights whether the use of co-activation strategies should be considered useful contributions to successful rehabilitation.     

Continuous positive pressure ventilation in children with bronchopneumonia

The application of a small end-expiratory pressure of 5 cmH2O to the assisted ventilation of nineteen children (mean age 19 months) with bronchopneumonia was compared with intermittent positive pressure ventilation. Within 1 h of introducing continuous positive pressure ventilation the alveolar-to-arterial oxygen gradient was reduced in most patients, with an increase in functional residual capacity and a decrease in total pulmonary blood shunt. Physiological dead space was also reduced, a feature not observed in other studies, and the significance of this finding is discussed. The use of continuous positive pressure ventilation in broncho-pulmonary infection was shown to be effective even at small pressures, and can be recommended especially for patients requiring long-term ventilation.     

Ventilatory pattern following diazepam and lorazepam

The effect of intravenous diazepam (10 mg) or lorazepam (2 mg) on the ventilatory pattern has been studied in two groups of ten patients prior to elective surgery. Injection of lorazepam was followed by a periodic pattern of ventilation in nine patients.     

银连含漱液在机械通气患者口腔护理中的应用研究

【目的】探讨银连含漱液对预防和减少呼吸机相关性肺炎(VAP)的临床效果。【方法】将符合纳入标准的60例患者随机分为试验组和对照组各30例。对照组采用生理盐水进行常规的口腔护理,试验组采用银连含漱液进行口腔护理。比较2组VAP发生率、体温、白细胞数、中性粒细胞数、肺部浸润情况、痰培养结果及口腔并发症(口腔粘膜糜烂、口腔溃疡、口臭)情况。【结果】试验后试验组的VAP发生率、体温、白细胞数、中性粒细胞数、X线检查心肺见感染灶、痰培养见致病菌生长和口腔糜烂、口腔溃疡、口臭等口腔并发症的发生率均显著低于对照组,2组比较差异均有统计学意义(P<0.05或P<0.01)。【结论】银连含漱液能够有效预防和减少呼吸机相关性肺炎的发生。     

针刺肺俞穴改善肺功能时效关系研究

通过针刺肺俞穴，观察不同留针时间对呼吸系统疾病患者肺功能改善情况。结果表明，针刺肺俞穴能明显改善肺功能，在留针２０分钟时可见针刺效应，４０分钟时针刺效应最明显，６０分钟时针刺效应有所降低。提示不同留针时间对肺功能的改善效应是不同的。