Hiroshima journal of medical sciences
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Hiroshima J. Med. Sci. · Dec 2008
Early induction of PMX-DHP improves oxygenation in severe sepsis patients with acute lung injury.
Direct hemoperfusion with polymyxin B-immobilized fibers (PMX-DHP) has been widely regarded as a treatment modality for septic shock in Japan. Recently, it was reported that PMX significantly improved the P/F (PaO2/FiO2) ratio in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). The aim of this study was to examine whether the phase of sepsis is related to the effects of PMX-DHP treatment on oxygenation in patients with ALI and ARDS. ⋯ In the H-R group, P/F ratio increased from 194 +/- 83 to 262 +/- 113 after PMX-DHP treatment, with a statistical significance, whereas no difference was found in the S-S group. There was no difference in the 28 days survival rate between the groups. It was suggested that early introduction of PMX-DHP for severe sepsis may improve oxygenation.
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Hiroshima J. Med. Sci. · Dec 2008
Airway Scope for emergency intubations: usefulness of a new video-laryngoscope.
The Airway Scope (AWS-S100, Pentax, Tokyo, Japan) is a new video-laryngoscope, which has a specially designed blade and a portable, battery-powered, 2.4-inch built-in liquid crystal device (LCD) full-color video screen at the top of the handle. In this study, we tested the usefulness of the AWS for tracheal intubation in acute, urgent situations. Patients admitted to the Advanced Emergency and Critical Care Center at Hiroshima University Hospital and who required orotracheal intubations were prospectively enrolled. ⋯ The durations from inserting the blade via the oral cavity until observing the glottis (T1), inserting the tube into the trachea (T2), and confirming the chest rise (T3) were 22 +/- 15, 34 +/- 21 and 49 +/- 27 sec, respectively. When the results were classified into t experienced and novice groups, T1, T2 and T3 were 17 +/- 10 vs. 26 +/- 17, 32 +/- 23 vs. 36 +/- 20, and 45 +/- 25 vs. 53 +/- 27 sec, respectively (the experienced vs. the novice group, n.s.). These results suggested that the AWS may be a suitable device particularly for less experienced personnel, such as novice Advanced Life Support providers.