[Thrombelastographic pattern in chronic bronchopneumonia patients placed on oxygen therapy]

The thromboelastographic pattern in chronic obstructive lung disease as compared to normal group during O2 administration was evaluated. The results stressed that the basal hypocoagulability of pathological subjects had become normal after O2 administration. No significant change in the group of normal subjects was observed.

Adenovirus type 21 bronchopneumonia in infants and young children

An epidemic of bronchopneumonia in infants and young children, with adenovirus type 21 infection, was observed in Auckland, New Zealand, in 1977. Eighteen children, four to 44 months of age, with clinical and radiologic evidence of bronchopneumonia are described. Several of the children were seriously ill but there were no deaths. When reviewed six to 12 months after diagnosis, six children had clinical signs and 13 had radiologic signs of residual pulmonary disease. There were no detectable pulmonary sequelae in two children. Three children were lost to follow-up and could not be evaluated. Adenovirus type 21 bronchopneumonia is a serious illness and an important cause of chronic bronchopneumopathy in infants and young children.

Continuous positive pressure ventilation in children with bronchopneumonia

The application of a small end-expiratory pressure of 5 cmH2O to the assisted ventilation of nineteen children (mean age 19 months) with bronchopneumonia was compared with intermittent positive pressure ventilation. Within 1 h of introducing continuous positive pressure ventilation the alveolar-to-arterial oxygen gradient was reduced in most patients, with an increase in functional residual capacity and a decrease in total pulmonary blood shunt. Physiological dead space was also reduced, a feature not observed in other studies, and the significance of this finding is discussed. The use of continuous positive pressure ventilation in broncho-pulmonary infection was shown to be effective even at small pressures, and can be recommended especially for patients requiring long-term ventilation.

[The therapeutic significance of bronchial suction-drainage in infants]

Bronchial suction-drainage in infants--according to our observations--is a life-saving procedure in cases of aspiration, severe bronchitis and retention of bronchial secretion. It can also be very effective in atelectasis, bronchopneumonia and pulmonary abscess. The earlier the drainage the quicker the clearing up of the atelectasis. An additional indication for performing bronchial suction in severe lower respiratory tract infections is to gagain secretion for bacterial culture. This is especially important in the Gram negative and Staphylococcus infections of young infants. The right upper pulmonary lobe is the most common localisation for atelectasis and pneumonia in this age group. One possible explanation for this could be that malformed bronchi are more frequently found in the right than in the left upper lobe. It is such a characteristical phenomenon in infancy that we called it "the right upper lobe syndrome".

Trauma of the central nervous system in children

In summary, the care of the patient with head trauma is not dissimilar to any other acutely ill individuals. Careful, systematic observation and recording of changing factors and physical signs is necessary. Proper application and appropriate treatment in response to dynamic changes will provide a satisfactory result as in any other form of illness or trauma. The patient with multiple injuries may call for compromise in treatment, however with the exception of gross hemorrhage, the head injury should take precedence in the early period following injury for there are other factors that may prove fatal. Do not accept unnecessary delay in the treatment of other injuries on the grounds that the patient has had a head injury. The orthopedic surgeon can treat the fractured femur, the plastic surgeon-the face, and the general surgeon-the abdomen, without jeopardizing brain recovery. The treatment of the patient with head trauma, as treatment of any other individual in present day medical practice, has become more of a team effort, not only involving the neurosurgeon, but the pediatrician, the specialist in pulmonary physiology, and other expert groups.