Guidelines for weaning from positive end-expiratory pressure in ventilated patients.

Positive end-expiratory pressure is helpful in avoiding hypoxemia but can cause barotrauma to the lungs and heart. Reducing positive end-expiratory pressure as quickly as possible without sacrificing oxygenation is desirable. Weaning from positive end-expiratory pressure is an integral part of removing mechanical ventilation, but the selection of patients for positive end-expiratory pressure reduction and appropriate monitoring after this has not been established.

Cholecystectomy after tube cholecystostomy.

Seventy-nine patients with cholecystostomy tubes underwent cholecystectomies. Twenty-nine had cholecystectomies and common bile duct exploration and 50 had cholecystectomies only. The 50 who had cholecystectomies alone were compared with 50 patients who had elective cholecystectomies.

Stomahesive as a tracheostomy dressing.

Seven patients had occlusive stomahesive dressings placed on their tracheostomies. These patients were compared with four patients managed with standard tracheostomy care. Stomahesive was applied using a defined technique and all seven patients were followed until tracheostomy closure.

Treatment priorities in combined blunt abdominal and aortic trauma.

Sixteen patients with blunt thoracic aortic transections also had intraabdominal injuries. Eleven patients had laparotomies first, and 5 patients had thoracotomies first. Records for the 16 patients were reviewed to identify successful treatment priorities.

Management of asymptomatic patients following stab wounds to the chest.

A patient with stab wounds to the chest may have negative physical findings, and normal radiologic examinations and still develop delayed pneumothorax or hemothorax. The frequency and time intervals of these complications have not been established. One hundred ten asymptomatic patients with chest stab wounds were prospectively studied.