Positive Pressure Devices Research Articles

An intraoral positive pressure device in the treatment of trismus

An intraoral positive pressure device in the treatment of trismus

An intraoral positive-pressure device for treatment of trismus

Trismus is a challenging clinical problem that may result from several different causes. The dentist may choose from a wide spectrum of treatment modalities, depending on the severity of the individual case and the health and cooperation of the patient. An individual course of treatment must be planned for each patient. It is important to monitor the treatment closely for effectiveness of the therapy and to ensure the patient's compliance. Treatment should be modified as necessary, according to the patient's progress. We have described an intraoral dynamic device that may be used as part of a treatment program and that enhances patient compliance as compared to traditional extraoral devices.

Aerosol therapy of asthma: principles and applications.

Aerosols are the mainstay of therapy of reversible airflow obstruction. Currently available aerosols include bronchodilators such as beta-adrenoceptor agonists and anticholinergic agents which may be used alone or together with prophylactic, anti-inflammatory medications such as sodium cromoglycate and steroids. These agents are characterized by primarily topical activity and thus result in minimal systemic effects. By combining these medications in optimum doses, most patients can be readily managed. In patients with severe airway hyperreactivity, aerosols may need to be combined with oral sustained-release theophylline compounds and/or systemic steroids, the latter being used in minimum doses and if possible on alternate days to minimize adrenal suppression and steroid-related systemic complications. In recent years, an improved understanding of aerosol physics, pharmacology and airway physiology has led to greatly improved aerosol therapy with increasing emphasis on metered dose inhalers as the delivery system of choice while nebulizers are used less frequently except in hospital and pediatric applications. The use of intermittent positive-pressure devices for aerosol delivery has decreased considerably as physicians recognize that simpler delivery methods work equally well at much lower cost. While aerosol therapy techniques are now well worked out, research is continuing on methods of improving the efficiency of aerosol delivery and in the development of newer pharmacological agents such as longer-acting adrenoceptor agonists, calcium channel blockers, antagonists of mediators derived from arachidonic acid as well as higher dose aerosolized steroids.

High frequency ventilation and gas diffusion.

The efficiency of CO2 removal was studied using a simple lung model with a high frequency positive pressure device (up to 100 b.p.m.) with and without an anatomical deadspace. At a constant minute ventilation without an anatomical dead space, the efficiency of CO2 elimination increased with increasing frequency. However, when a dead space was introduced, the efficiency of CO2 elimination decreased with increasing frequency. Using a high frequency oscillation technique (360 to 900 b.p.m.), it was not possible to maintain a reasonable CO2 elimination with tidal volumes less than the anatomical dead space. In this model there was no evidence that accelerated diffusion was a factor in CO2 removal during high frequency ventilation or oscillation.

Monitoring of Respiratory Function in Critical Care Patients

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled "Surgical Care of the Respiratory Patient." The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.

Endotracheal Intubation and Tracheostomy: Indications, Techniques, and Complications

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled Surgical Care of the Respiratory Patient. The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.

Ventilation: External Regulation of the Environment of the Lung

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled “Surgical Care of the Respiratory Patient.” The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.

Surgical Management of Complications of Respiratory Failure

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled "Surgical Care of the Respiratory Patient." The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.

Bronchoscopy in Respiratory Care

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled Surgical Care of the Respiratory Patient. The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.

Thoracotomy and Pulmonary Resection

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled "Surgical Care of the Respiratory Patient." The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.

Chest Radiology in the Surgical Patient

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled Surgical Care of the Respiratory Patient. The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.

Prolonged alteration of lung mechanics in kyphoscoliosis by positive pressure hyperinflation.

The effects of a short period of large inflation pressures, delivered by intermittent positive pressure devices, on the abnormal lung mechanics of patients with kyphoscoliosis were studied. Their chronically decreased lung compliance was, on the average, increased by 70 per cent by this procedure and this increase was maintained for as long as 3 hours. Lung tissue resistance, but not the Plethysmographic airway resistance, also decreased after the hyperinflation. The large increases in lung compliance, without correspondingly large increases in functional residual capacity, suggested that a reorientation of alveolar surface forces might have been responsible for this phenomenon, although expansion of collapsed air spaces could not be excluded. The accompanying decreases in work of breathing after the brief period of hyperinflation suggest that this procedure might be of clinical use in the patient with kyphoscoliosis.

An opener for radioisotope bottles of the British pattern.

Solutions of radioisotopes are supplied by the Radiochemical Centre in glass bottles sealed by a pressed metal cap and rubber bung. The necessary secure fastening of these caps often makes removal of the radioactive solution a difficult process. There are two approaches to the removal of the solution from these bottles. Either the cap and bung can be extracted or a syringe used. The former technique is usually desirable but difficult: the latter complicated but safe. The “beer bottle” type opener, though rapid, can be hazardous, and in our experience with the re-entrant type of stopper opening inevitably “sprays” some of the contents and on occasions the bottle neck itself has been removed. The method is therefore to be avoided without extra precautions. The syringe, or alternatively a double needle and positive pressure device, results in two or three contaminated parts and these must be cleaned fairly quickly. If the bottle seal can be removed easily then this is most often the method of choice and enables simple subsequent techniques to be employed. The device illustrated in Fig. 1A and 1B is designed to remove the sealed cap and rubber bung with the minimum of risk and in a short time. The operation takes about one and a half minutes. For re-entrant bungs extraction is a two-stage process: first the metal cap is cut away, then discarded and the bung extracted vertically.

Expansion of the lungs of newborn infants.

The normal newborn infant is able to expand his lungs so easily that he seems not to struggle at all, and in a few minutes the oxygen saturation of his blood is over 90%. In the operating room, the anesthesiologist can maintain pulmonary ventilation during chest operations on newborn infants with ease. In the delivery room, however, one encounters, fortunately rather rarely, infants who cannot breathe adequately, and in such infants, artificial positive-pressure respiration is much less successful than in the operating room where normal lungs are dealt with. The difficulty seems to arise from three possible causes: 1. The lungs may be obstructed by debris. 2. The lungs may be too immature to expand well. 3. The normal neonatal lung may require more than the 15 cm. H 2 O (11.5 mm. Hg) permitted on most positive-pressure resuscitation devices. Since the first two difficulties are discussed by others (see

A PNEUMATIC SHIELD FOR OPERATIONS ON THE LUNG

In thoracic surgery in man, positive or negative pressure devices are rarely essential. Either pleural cavity or even the anterior mediastinum may be invaded without, as a rule, a fatality from operation pneumothorax. It is a source of satisfaction, however, to have available an apparatus capable of almost instantly removing the condition of pneumothorax. In 1908¹I devised an aspirating shield to be applied over the wound under such conditions. The present shield is modified by omitting the metal rim and glass window which interfered with accurate coaptation to the chest wall and substituting a simple inflated rubber rim in which is held a flexible celluloid window. The apparatus may be sterilized in the autoclave or in boiling water. A simple two-way cock connects the cavity of the shield at will with either the external air or a suitable vacuum tank. To overcome pneumothorax the shield is applied over the wound and the lever turned connecting the vacuum tank with the eavity of the shield until the lung