Chest
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Comparative Study
Comparison of transcutaneous and alveolar partial pressure of carbon dioxide during carbon dioxide breathing in healthy children.
In 18 healthy children three to 13 years of age, the transcutaneous partial pressure of carbon dioxide (PtcCO2) (Radiometer electrode) and the alveolar partial pressure of carbon dioxide (PACO2) (Beckman analyzer) were measured simultaneously during the breathing of room air and 5 percent carbon dioxide. The PtcCO2 electrode was placed on the anterior thorax and heated to 42 degrees C. The PACO2 was calculated on the 4/5 part of the carbon dioxide expired trace. ⋯ These results suggest that breathing carbon dioxide modified the factors acting on PtcCO2, possibly by changes in the vasomotor tone of cutaneous blood vessels. These modifications appeared to be variable from subject to subject. Therefore, we conclude that PtcCO2 does not appear to be an accurate quantitative index to assess ventilatory response to carbon dioxide.
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Descriptions of adventitious lung sounds in the case reports of eight authoritative medical journals from 1978 through 1982 were tabulated in an effort to identify recent changes in terminology. Adventitious lung sounds were described in 590 case reports. ⋯ British journals predominantly use the terms, "crackles" and "wheezes," to describe adventitious lung sounds. Although American journals most often use the terms, "rales," "wheezes," and "rhonchi," the term, "crackles," is increasing in usage.
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The effects of increasing oxygen delivery (DO2) on oxygen consumption (VO2) in eight patients with septic shock and five patients with hypovolemic shock were studied during fluid resuscitation. In the septic shock group, DO2 increased from 315 +/- 29 to 424 +/- 25 ml/min/m2 (p less than 0.01) and VO2 increased from 134 +/- 8 to 151 +/- 7 ml/min/m2 (p less than 0.01). ⋯ There was no significant difference in either the increase in DO2 or VO2 between the septic shock and hypovolemic shock patients. We conclude that increasing DO2 by fluid resuscitation increases VO2 during both hypovolemic and septic shock.