1/7. Rigid spine syndrome with respiratory failure.The pathogenesis and therapy of respiratory failure in the rigid spine syndrome are discussed in two cases who improved with respiratory assistance. In both cases, the partial pressures of oxygen and carbon dioxide were reversed in arterial blood gas analysis and %VC was less than 30%. Remission from respiratory failure has been obtained by the use of a ventilator during the night. The cause of the respiratory failure in both cases was severe restrictive respiratory dysfunction due to extreme flattening of the chest and fixation of the thorax during respiration as a result of contracture of costovertebral joints. All the previously reported cases of the rigid spine syndrome with respiratory failure died. Appropriate use of the ventilator can improve the prognosis.- - - - - - - - - - ranking = 1keywords = respiration (Clic here for more details about this article) |
2/7. Nasal continuous positive airway pressure in the treatment of whooping cough.A 3-week-old baby, suffering from whooping cough with severe attacks of apnoea and hypoxia, was treated by nasal CPAP with a positive airway pressure of about 5 cm H2O. The respiration improved rapidly and the transcutaneous oxygen tension increased to a normal level. The treatment was carried on for 7 days and discontinued gradually in the course of 3 days. The child was also treated with pertussis immunoglobulin and erythromycin. The CPAP system employed is easily and rapidly applied and allows normal nursing of the child during the treatment and manual lung physiotherapy in upright position. The treatment probably proved lifesaving.- - - - - - - - - - ranking = 1keywords = respiration (Clic here for more details about this article) |
3/7. Delayed encephalopathy following cardiac arrest.A 46 year old woman suffered a post-operative cardiac arrest associated with prolonged depression of oxygenation and respiration. She made a good initial recovery but one year later insidiously developed symptoms of widespread central nervous system damage compatible with a delayed post-hypoxic encephalopathy. This case is unusual in the length of time between the hypoxic insult and the later deterioration and also illustrates other atypical features of a delayed post-hypoxic syndrome.- - - - - - - - - - ranking = 1keywords = respiration (Clic here for more details about this article) |
4/7. Cyclic EEG changes in subacute spongiform and anoxic encephalopathy.Polygraphic recordings of EEG, EMG, EKG and respiration were made on three patients with histologically verified subacute spongiform encephalopathy and one patient with anoxic encephalopathy both before and after intravenous diazepam. The records showed cyclical activity occurring about every half minute in which the EEG changes were correlated with myoclonus and cardio-respiratory changes. It is suggested that these cycles represent spontaneous cycles of arousal to which the 1/sec sharp waves are related wnd which result from the same mechanisms that produce other cyclical autonomic phenomena.- - - - - - - - - - ranking = 1keywords = respiration (Clic here for more details about this article) |
5/7. Cardiac asystole during an hypoxic drive study in a normal subject.A healthy 31-year-old man who had previously sojourned to an altitude of 5,000 meters with no detrimental effect developed sudden cardiac asystole during a progressive hypoxic ventilatory response ( HVR ) test. At the moment of asystole, his alveolar PO2 (PAO2) was 41 mm Hg and his arterial oxygen saturation (SaO2) was 81 percent. cardiopulmonary resuscitation was initiated, and after 20 seconds of asystole and apnea, he recovered normal sinus rhythm and spontaneous respiration. A subsequent ECG and cardiac enzyme levels were normal. During testing, he demonstrated depressed ventilation in response to hypoxia and a slowing of the heart rate. Careful observation of heart rate and breath-by-breath ventilation during HVR tests may predict this potentially fatal complication.- - - - - - - - - - ranking = 1keywords = respiration (Clic here for more details about this article) |
6/7. Near-drowning: an unusual case.This paper reports the case of a 2 1/2-year-old male who appeared to have drowned in the family swimming pool. Immediate continuous cardiopulmonary resuscitation eventually restored circulation and respiration. Subsequently, in the intensive care unit, he appeared to "cone" and suffer brain "death". Prompt and continuous use of measures to support cerebral resuscitation were successful and the child subsequently was completely normal. A reevaluation of current information seems indicated in regard to the prognosis of the near-drowned child.- - - - - - - - - - ranking = 1keywords = respiration (Clic here for more details about this article) |
7/7. heart rate and respiratory rhythm dynamics on ascent to high altitude.OBJECTIVE--To investigate the alterations in autonomic control of heart rate at high altitude and to test the hypothesis that hypoxaemic stress during exposure to high altitude induces non-linear, periodic heart rate oscillations, similar to those seen in heart failure and the sleep apnoea syndrome. SUBJECTS--11 healthy subjects aged 24-64. MAIN OUTCOME MEASURES--24 hour ambulatory electrocardiogram records obtained at baseline (1524 m) and at 4700 m. Simultaneous heart rate and respiratory dynamics during 2.5 hours of sleep by fast Fourier transform analysis of beat to beat heart rate and of an electrocardiographically derived respiration signal. RESULTS--All subjects had resting hypoxaemia at high altitude, with an average oxyhaemoglobin saturation of 81% (5%). There was no significant change in mean heart rate, but low frequency (0.01-0.05 Hz) spectral power was increased (P < 0.01) at high altitude. time series analysis showed a complex range of non-linear sinus rhythm dynamics. Striking low frequency (0.04-0.06 Hz) heart rate oscillations were observed during sleep in eight subjects at high altitude. Analysis of the electrocardiographically derived respiration signal indicated that these heart rate oscillations correlated with low frequency respiratory oscillations. CONCLUSIONS--These data suggest (a) that increased low frequency power during high altitude exposure is not simply attributable to increased sympathetic modulation of heart rate, but relates to distinctive cardiopulmonary oscillations at approximately 0.05 Hz and (b) that the emergence of periodic heart rate oscillations at high altitude is consistent with an unstable cardiopulmonary control system that may develop on acute exposure to hypoxaemic stress.- - - - - - - - - - ranking = 2keywords = respiration (Clic here for more details about this article) |