Oxygen transport during extracorporeal oxygenation for the treatment of adult respiratory distress syndrome

An inventory of hemodynamic and respiratory measurements was obtained in two patients with acute respiratory failure syndrome prior to and during venoarterial extracorporeal membrane oxygenation for study of oxygen transport. As the inspired oxygen concentration fraction was reduced from 1.0 to 0.5 and paO2 was increased from less than 50 to physiologic ranges during extracorporeal membrane oxygenation, tachycardia and pulmonary hypertension were reversed. Total oxygen transport was reduced rather than increased. Oxygen consumption and oxygen extraction were not altered during extracorporeal membrane oxygenation. However, a striking reduction was observed in cardiac output. After reversal of anoxemia, the total of the cardiac output of the patient and the extracorporeal membrane oxygenation flow were less than the cardiac output of the patient prior to extracorporeal membrane oxygenation. These observations provide evidence that the beneficial effects of extracorporeal membrane oxygenation stem, at least in part, from a reduction of the work load on the heart. Since high cardiac output failure is observed during progression of adult respiratory distress syndrome, mechanical support of circulation during extracorporeal membrane oxygenation may be of primary therapeutic benefit.     

Atopic eczema: a clinical psychiatric study

The method of Deutsch and Weeks was modified to provide a reliable and reasonably quick method for assaying the L-ascorbic acid content of culture medium. The modified method was used to determine the decay of L-ascorbic acid under various conditions of culture and the concentration of the vitamin in commercially prepared media. The half-life of L-ascorbic acid in a modified New circulator gassed with 95% O2 + 5% CO2 was 1.5 hr.; and when gassed with 20% O2 + 5% CO2 + 75% N2, about 2 hr. In Petri dishes gassed with 20% O2 + 5% CO2 + 75% N2, the half-life of L-ascorbic acid was 0.9 hr. About 4% of the L-ascorbic acid was lost per day when medium was stored at 0 degrees C and about 9% per day when stored at 5 degrees C. When medium with an initial content of 300 microng per ml was stored at room temperature, the half-life was found to be 15.5 hr. The L-ascorbic acid in five commercially available media, which contain the vitamin in their formulations, was assayed immediately after their delivery to the laboratory. The values of L-ascorbic acid measured in these media were in all cases far lower than prescribed. A continuous-flow organ culture system has been designed which allows the provision of a relatively constant level of L-ascorbic acid to explant by taking advantage of the slow oxidation of L-ascorbic acid at 0 degrees C.