Resuscitation

Intrauterine gene therapy (IUGT) potentially enables the treatment and possible cure of monogenic -diseases that cause severe fetal damage. The main benefits of this approach will be the ability to correct the disorder before the onset of irreversible pathology and inducing central immune tolerance to the vector and transgene if treatment is instituted in early gestation.

Burn pain can cause psychologic and functional difficulties, and is difficult to predict from wound depth. The initial painful stimulation of nerve endings by the burn with continued painful stimuli result in peripheral and central mechanisms causing amplification of painful stimuli, and the development of chronic pain syndromes that can be difficult to treat. In order to assess the effect of analgesic interventions it is essential to measure the patient's pain in a simple and reproducible manner.

The diagnosis and treatment of psychiatric disorders in intensive care patients have been for a long time neglected. They are nowadays better recognized and managed. These disorders are mainly: delirium; anxiety disorders, from simple anxiety to panic disorder with agitation; adaptation disorders with depressive mood; brief psychotic disorders with persecution ideas. The manifestations of psychiatric disorders occur not only during the stay in intensive care unit (ICU) but also after transfer from ICU and several months after discharge from hospital.

The purpose of this study was to compare the Oxylator EM-100, a ventilator with a fixed flow and working pressure of 25 to 50 cm H(2)O, with a bag-valve device with respect to safety, efficiency, and efficacy when used by professionals. We conducted a prospective, controlled, caregiver-blind single center study. Induction was followed by ventilation with a bag-valve device oxylator in manual and automatic modes. Steps were repeated under hypnosis, after muscle relaxation with mask, and with an endotracheal tube. Forty patients, aged 48.8 +/- 13.5 years weighing 50 to 111 kg were studied.

The beneficial effect of a beta-blocking agent (pindolol), given as an adjuvant to DC-shock and lidocaine therapy in a case of heart resuscitation is reported. A 65-year-old female patient was operated for an abdominal aortic aneurysm. At the conclusion of the operation, which was prolonged and difficult, the patient developed alternating ventricular tachycardia and fibrillation. Within a time interval of 50 min electrical defibrillation was performed 20 to 25 times, and as much as 1100 mg of lidocaine was administered.

Reports of successful attempts at resuscitation have been published for more than 200 years, but systematic analysis of an optimal technique has been undertaken for only the last 20 years. As a result of these experiments and of the many years of experience of resuscitation teams, extensive recommendations were formulated by a conference on cardiopulmonary resuscitation of the "American Heart Association" in May 1973.

Endotoxin shock was induced in Labrador retriever dogs by intravenous infusion of a lethal dose of Escherichia coli endotoxin (2 mg/kg body weight) over a three-hour period in order to study plasma hypoxanthine concentrations. The animals succumbed within 14 hours after start of the infusion. Terminally when aortic blood pressure dropped below 30 mm Hg and bradycardia had developed, the animals were resuscitated by external cardiac massage, artificial ventilation, and volume therapy. During shock no significant alteration of plasma hypoxanthine concentrations occurred.

Restoration of adequate spontaneous circulation after "arrest" and cardiopulmonary resuscitation (CPR) of 546 patients before and 460 patients after initiation of a CPR training course in a 500-bed city hospital is reported. Between January 1972 and June 1976, adequate circulation after CPR was present in 38.6% of patients before and 50.4% after training ICU nurses and house physicians in modern resuscitation techniques.