Oxygen Tent Research Articles

Perioperative Management of Obstructive Sleep Apnea in Patients With Syndromic Craniosynostosis Undergoing LeFort III Osteotomy With Distraction: A Case Series.

Retrospective observational study. The purpose of this publication is to address the absence of literature detailing respiratory management in patients with syndromic craniosynostosis and obstructive sleep apnea during the immediate postoperative interval following LeFort III advancement with placement of distraction hardware but prior to sufficient midface advancement. After IRB approval, the investigators retrospectively selected candidates for inclusion in this case series. The sample was composed of four patients ranging from 10 to 19 years of age undergoing LeFort III midface advancement during a one-year span at a single tertiary care center. All operations were performed by a single surgeon. Three of the selected patients suffered significant obstructive sleep apnea necessitating the operation, as determined by polysomnography. One patient experienced persistent apnea postoperatively requiring prolonged ICU level care. Three of the four patients had severe OSA diagnosed by polysomnography with a median AHI of 28.3. Two of the three patients with preoperative OSA experienced no untoward respiratory compromise in the immediate postoperative period; one required nightly oxygen tent and the other required no supplemental oxygen. Patient 1 experienced significant postoperative respiratory distress with nightly apneic episodes and desaturations requiring supplemental oxygen and frequent stimulation. The present study suggests that early involvement of sleep medicine and management of patient expectations is vital. Extremely close postoperative monitoring in the ICU is necessary. Future studies are needed to protocolize perioperative management of obstructive sleep apnea in patients undergoing LeFort III osteotomy prior to initiation and completion of midface advancement.

Oxygen chambers and tents.

Oxygen chambers and tents.

Simulating effect of neonate body position on carbon dioxide tension in oxygen tent

Oxygen therapy is a common method of respiratory support, but its use involves the risk of carbon dioxide recycling and the development of hypercapnia in the patient.The aim of the study. Assess the carbon dioxide tension in the oxygen tent depending on the patient's body position in the experimental newborn Model.Materials and Methods. The study was performed on the phantom of the newborn. Influence of 3 patient positions at fresh mixture feed rate 2.5, 5, 7 and 10 l/min is evaluated. Monitoring of the carbon dioxide tension was carried out using Testo 480, measurements were carried out for 60 minutes.Results of the study. A clear relationship was established between the position of the newborn's body and the tension of carbon dioxide in the oxygen tent. The minimum tension of carbon dioxide is noted in the patient's position ≪on the back≪ at a fresh mixture feed rate of 7.5 l/minute and is 527 ± 64 ppm, and the maximum ‒ in the child's position ≪on the stomach≪ at the same oxygen-air mixture feed rate: 1180 ± 63 ppm.Conclusion. The position of the newborn baby's body is the main factor affecting the carbon dioxide stress in the oxygen tent.

The McKesson Oxygen Tent: The Role of the Rubber Sheet

The McKesson Oxygen Tent: The Role of the Rubber Sheet

Social, economic, environmental and political constraints on municipal fiscal policy: Do tough national sanctions act as a fire blanket or an oxygen tent?

The impact of local social, economic, environmental and political constraints (SEEP) on local government policy has long been a central theme of the decentralization and local government literature. How do local SEEP factors affect the fiscal management of Danish municipalities after a major structural reform in 2007? Does a tough sanction-based expenditure limitation regime affect the relationship between local external constraints and municipal fiscal policy? The fiscal management of Danish municipalities has improved significantly after the economic crisis and a sanction regime implemented by the national government in 2011. This empirical analysis shows that economic constraints and especially changes in economic constraints significantly affect the fiscal policy but that also environmental instability in terms of population changes make it harder to balance the budget. In addition, a sanction regime seems to place constraints on local authorities’ fiscal management policy, which reduces the importance of environmental factors.

Relationship between oxygen concentration and temperature in an exothermic warming device

IntroductionActively warming hypothermic patients or preventing hypothermia is critical in optimising outcomes in patients with traumatic injuries. Our aim was to investigate the effect of ambient oxygen concentration on the...

Three poems and reflections

In the poem, I am a five-year-old child in the midst of a polio epidemic. I lie alone in an oxygen tent, Encased in a clear plastic shield / Like a piece of meat in the butcher’s case. Although it ...

Apnoea, dyspnoea and wheezing in primary lower respiratory infections due to human rhinovirus in Japanese infants

Human rhinovirus (HRV) is generally recognized as a common cold agent, but it can be associated with severe acute respiratory infection and result in illnesses such as pneumonia. Here, we report on manifestations of severe respiratory infection, including apnoea, dyspnoea and wheezing, that might have been due to primary HRV infection, in two Japanese infants. Although both cases had a good outcome, the infants, a 40‐day‐old male and 2‐month‐old male, displayed the aforementioned symptoms with life‐threatening bronchitis and hyperinflation, and received aggressive respiratory care (intubation or oxygen tent). HRV alone was detected in respiratory specimens. Genetic and phylogenetic analysis of the detected HRV revealed strains that are prevalent in various countries (HRV‐A, genotype HRV‐96 and HRV‐C, genotype HRV‐C46). The results suggest that, besides respiratory syncytial virus, primary HRV infection in infants can be associated with severe respiratory symptoms such as apnoea, dyspnoea and wheezing in lower respiratory infections, although these cases may be rare.

Learning the Code

Learning the Code Leonard Kriegel (bio) COMMIT ACTS OF KINDNESS! —a bumper sticker IN late July 1944 life for me was suddenly framed by a sense of ending. I had just turned eleven that May, an age at which most boys are old enough to realize that death is inevitable. Yet all eleven-year-olds measure life through the mysteries of impending adolescence—which meant that it wasn’t the death of my legs or the fear that the sudden onset of illness was yet another punishment inflicted by the mysterious metaphysics of the body that I found difficult to accept. Eleven-year-olds willingly grant death its prerogatives, if only because the only indisputable fact of life at eleven is how painfully quixotic it can be. As terrified as I was of this sudden inability to move my legs it somehow seemed curiously natural to wake and find one’s body suddenly reduced to a burning slab of pain. I don’t remember having heard the word polio before the virus took me down. Yet it struck me from the onset as appropriately onomatopoeic. Simply to sound the word out gloved fear from the beginning. That illness had established its kingship over my body was one more unexplainable aspect of a world at war. Sixty-three years later that war remains the counterimage of my embattled body. Long before I read Heraclitus’s line “Death is everywhere, in the voices of all men,” I was acquainted with its accuracy. Because of the war death’s inevitability seemed almost reassuring—not that I had any desire to die at the onset of illness. I passionately wanted to live. Only, as I wondered whether I would soon embrace that farthest shore, I didn’t feel any greater fear of death than I do today as a man in his seventies. In 1944 eleven-year-olds were on curiously intimate terms with the idea of death. American life was rooted to those sudden endings that had become a staple of the radio and newspapers. Calamity invariably seemed just around the corner in a nation barraged by daily renditions of the barbarism of the Nazis and Japs (who didn’t become Japanese until the war’s [End Page 232] end). Death hovered in the air, and one didn’t need Professor McLuhan to understand that brutal naked catastrophe could seek one out at any moment. And when catastrophe came it would inevitably be personal. I myself was somehow responsible for lying flat on my back and board-stiff in a small country hospital in Cold Spring, New York, just as I was somehow responsible for the fact that in that same room Jerry, one of the four boys with whom I shared a bunk, lay choking to death in an oxygen tent that loomed over us like a giant yellow balloon. Had I not begged my parents to send me to camp until I finally succeeded in wearing down their immigrant fear? Eastern European Jews who had never mastered America, they desperately wanted their sons to be part of a nation where even a workingman’s children could escape the city’s summer heat. Two weeks in “the country” would be “healthy.” How could fresh air and green grass and chirping crickets possibly harm an eleven-year-old? I breathed that air and I ran through that grass and I swam in a dark lake far beyond their fearful immigrant eyes—until I awoke one morning to discover I could run no more. Long before Milton Friedman made it a conservative mantra, any New York child could have testified to his statement, “There’s no such thing as a free lunch.” It was cataclysmic but not altogether surprising to wake in the middle of the night two days before I was to return home and find that my legs no longer held me up. I reacted to that discovery in typical eleven-year-old fashion—by crawling back to bed and going back to sleep. Morning would prove it all a bad dream. But morning brought only the ambulance that would take me to the Julia Butterfield Memorial Hospital in Cold Spring. Jerry...

Respiratory Health Survey of Respiratory Therapists

The purpose of this study was to determine whether respiratory therapists (RTs) had an elevated risk of respiratory symptoms and to determine the association of work exposures with symptoms. Mailed questionnaire responses from 275 RTs working in British Columbia, Canada, were compared to those of 628 physiotherapists who had been surveyed previously. Analyses incorporated logistic regression analysis with adjustment for age, sex, smoking status, and childhood asthma. Compared to physiotherapists, RTs had over twice the risk of being woken by dyspnea, having wheeze, asthma attacks, and asthma diagnosed after entering the profession. Among RTs, two work factors associated with asthma were sterilizing instruments with glutaraldehyde-based solutions and the use of aerosolized ribavirin. RTs who used an oxygen tent or hood had the highest risk of asthma diagnosed after entering the profession (odds ratio [OR], 8.3; 95% confidence interval [CI], 12.6 to 26.0) and of asthma attacks in the last 12 months (OR, 3.6; 95% CI, 1.2 to 10.9). Our data suggest that RTs may be at an increased risk for asthma-like symptoms and for receiving a diagnosis of asthma since starting to work in their profession, possibly related to exposure to glutaraldehyde and aerosolized ribavirin.

Developing a specialty: J.S. Lundy's three major contributions to anesthesiology

John S. Lundy was able to accomplish three major goals during the early years of his stewardship of the section on anesthesia of the Mayo Clinic. In 1925, Lundy established the first anatomy lab at the Mayo Clinic. He believed that the lab would serve as a useful tool for teaching residents as well as research into regional anesthetic techniques. Second, Lundy desired to advance the science of anesthesiology. Lundy developed the concept of balanced anesthesia, pioneered the introduction of barbiturates to the practice of anesthesia, developed anesthesia section services for the use of ventilators, ventilator vests, oxygen tents, and nasal oxygen supplementation. Lastly, in 1935, he established the nation's first blood bank. Lundy and Ralph Tovell had the opportunity to do pioneering work in transfusion medicine, which led to an improvement in the quality of service, and patient safety. These three major accomplishments provided Lundy with abundant scientific material to present to the American Medical Association (AMA) in Chicago. These trips to Chicago allowed him to gain the ear of Olin West, Morris Fishbien, and James E. Pallin. Lundy was able to successfully lobby in 1939 for the creation of a section of anesthesia within the AMA. In 1940, Lundy′s dream came true with the recognition of anesthesia as a specialty by the AMA.

Characterization of a Hooded Human Exposure Apparatus for Inhalation of Gases and Aerosols

A human exposure apparatus was designed to administer a gas and/or aerosol directly to the subject's face. This apparatus utilized a hood associated with a powered air-purifying respirator. The design criteria included the need to maximize subject comfort, maintain consistent atmospheres of a gas or dust within the hood, and the accurate use of direct-reading instruments to monitor exposure levels. An 83-L drum was used to pre-mix the gas or aerosol with the main dilution air prior to entering the hood worn by the subject. A clear plastic oxygen tent, ventilated with room exhaust air, was used to contain contaminants exiting the hood. Bypass valves were added to allow for a startup period during which contaminant concentration levels were allowed to stabilize prior to exposing the human subject. Results from characterization studies demonstrated that the system adequately contained contaminants within the oxygen tent, provided adequate mixing of contaminant and dilution air, produced stable contaminant concentrations over time, and was responsive to sudden changes in contaminant generation rate.

Oxygen Tent Fire Ignited by Sparking Toy

Oxygen Tent Fire Ignited by Sparking Toy

Environmental exposure of primary care personnel to ribavirin aerosol when supervising treatment of infants with respiratory syncytial virus infections.

The potential exposure to ribavirin aerosol in the environment was assessed in nurses caring for infants and children with severe lower respiratory tract infections due to respiratory syncytial virus. Ribavirin aerosol was administered via a ventilator, oxygen tent, or oxygen hood. Participants worked directly with infants receiving ribavirin for 20.0 to 35.0 h over a 3-day period. No toxic or adverse effects of ribavirin aerosol were observed in any of the 19 nurses studied, and ribavirin was not detected in erythrocytes, plasma, or urine collected after the potential exposure period.

A simple way of administering oxygen to the pediatric patient with upper airway obstruction.

An open-top oxygen tent has been developed for supplying humidified oxygen to the pediatric patient while allowing easy access to the child's head, neck, and upper thoracic region with limited impairment of either observations or movement of the child. This tent is easily and economically fabricated from 0.002-in clear plastic sheeting and 3/4-in polyvinyl chloride pipe available from a local hardware store.

Some Personal Notes on Adapting Folk-Fairy Tales to Film

Some Personal Notes on Adapting Folk-Fairy Tales to Film Tom Davenport I have made two films of traditional folktales. Hansel and Gretel: An Appalachian Version and Rapunzel, Rapunzel are both live-action adaptations of the Grimm stories. Because of my limited budgets, I had to choose relatively simple tales with few sets or special effects and very small casts. For the same reason, I used American settings for both: a 1930s Depression version of "Hansel and Gretel" and a turn-of-the-century Victorian version of "Rapunzel." I like to think that, in the end, my budget limitations proved advantageous; both films follow the Grimm stories faithfully, and both have stimulated lively positive and negative reactions from critics of children's film. I began my film career making documentaries. My first major film, The Shakers, about a small American religious community, was broadcast as a PBS special and was generally considered a very successful television documentary. I learned while making it that a television documentary that depends on interviews and narration is, as one would expect, carried by the soundtrack. Without the picture, one could follow most of the content of the film, but without sound the film was virtually meaningless. The film took several years to complete, and by the time it was finished I was tired of the documentary format. Just before it was completed, my oldest boy, who was about four, got a severe case of croup. My wife and I took him to the hospital, and the doctor put him in an oxygen tent. The hospital policy limited parents' visiting hours to two short periods each day and none at all during the night. He was in the hospital for two days and two nights. Shortly after he returned home, I began to read him "Hansel [End Page 107] and Gretel." I had loved the folk-fairy tales as a child, and I wanted to share with him this story of abandonment so that he would not feel so alone in his experience. The story was an instant success, and I read it over and over. Suddenly one evening it struck me that the story could be made into a film. This film could be done realistically and could be set in the Blue Ridge Mountains where I lived. It was practical because I could use the documentary techniques I already knew, and working close to home would make it less expensive. It was exciting to discover this old tale in the faces of friends and neighbors and in the scenery and houses near home; the county dogcatcher became Hansel's and Gretel's father, and the ginger-bread house was one built and still lived in by a local hippy. A. student once asked the famous photographer Edward Weston what he should photograph: "Walk around the block," Weston replied. Even in dramatizing fairy tales, it turned out that the challenge lay in imagining the possible significance of the everyday and the close at hand. Rapunzel, Rapunzel was made several years later, after I had made several more documentaries on American folk subjects and was eager to return to the dramatic format. By this time, the libraries were purchasing Hansel and Gretel, and I thought another folktale adaptation would be popular. Like Hansel and Gretel, Rapunzel, Rapunzel required only a few sets and actors, which could all be found close to home; the local waitress became the pregnant mother of Rapunzel, and the garden of the witch belonged to a turn-of-the-century Virginia estate. According to Marilyn Iarusso, children's film specialist at the New York Public Library, there have been few adaptations of traditional folktales, and most of these are animations or puppet films; I know of only a handful of folk-fairy tales done in live-action. Few of these have been successful. (Cocteau's Beauty and the Beast is a notable exception.) Other than my two films, there are no live-action fairy tales in the New York Public Library collection that are both faithful to the original tale and successful with children. My own live-action adaptations have been controversial, partly because of my choice of live-action treatment...

Safety in oxygen atmospheres

A practical way to illustrate the influence of concentration on the rate of a chemical reaction is to show a simulated oxygen tent.

Oxygen Therapy for Pneumatosis Coli: A Report of Two Cases and a Review

Two patients with incapacitating symptoms from pneumatosis coli were successfully treated with high concentration oxygen (55-70%) inhalation via a Hudson face mask for five days. Symptoms improved dramatically starting on the third treatment day. Continuous restriction in an oxygen tent is unnecessary. This is an effective, simple and safe therapy for pneumatosis coli.

The effect of treatment environments

Although environmental psychology is a relatively recent field of study, the impact of environment on psychological health is a subject already dear to the heart of the media and the public. Hospitals as stressful environments have evoked less clamour than council estates, high rise building, traffic congestion, pollution and disaster zones, but the early studies by sociologists have influenced hospital planning and design. In the past 15 years, psychiatrists have expressed increasing awareness of the effect of hospital and treatment environments though published observations from surgical and medical colleagues remains sparse. Hospital staff soon develop defences to protect themselves in their work environment and become less perceptive of its potential effects on others. Technological advances and the increased use of apparative techniques have accentuated stress and revealed more clearly that clinical reactions to hospital environments do occur. Studies of treatment environments have aimed at identifying either the potentially stressful aspects of the physical and emotional environment or the psychological characteristics of patients which influence adaptation in specific treatment procedures. Mendelsohn in 1956 described acute psychotic reactions in poliomyelitis patients, during artificial respiration in the tank respirator. He ascribed the acute confusional state with hallucinations and delusions to the sensory deprivation of the environment. Improved design has rendered the tank respirator therapeutically obsolete though it is still used experimentally to create conditions of sensory monotony. The advance of open heart surgery was followed by reports of a high incidence of post operative delirium which linked with aspects of the treatment environment. Patients were nursed post operatively in open, well lit recovery areas, immobilised by pain and tubing, encased in a plastic oxygen tent with its monotonous hiss and deprived of sleep by discomfort and observations. Removal from this environment,which combined sensory monotony with sleep deprivation,to the conventional ward setting usually resolved delirium in 1-2 days. Heller's replication study in 1970 revealed a marked decrease in the incidence of delirium which now related to organic features such as severity of cardiac illness, time on cardiac by pass and age. He ascribed this decreasing incidence to modifications in both the physical environment and the psychological atmosphere in recovery units - too late to prevent the emergence of a new

Acoustical environments in incubators and infant oxygen tents

The present article reports the detailed findings of our study of the acoustical conditions in incubators and infant oxygen tents. This elaboration of our original brief report (published in Lancet, in Great Britain) is presented in order to further alert the medical and health-related professional community against the potential dangers to physical, cognitive, linguistic, and emotional development that may result from the noise levels in these environments. We strongly urge that these phenomena relating to the environment of the hospitalized infant be investigated more widely and with little delay. Initiative should be taken, not only by clinicians and research workers in the treatment centers, but also by engineers and manufacturers involved in the design and production of hospital equipment.