Maciej Guć

Development of an electronic manometer for intrapleural pressure monitoring.

Background: Measurement of intrapleural pressure is useful during various pleural procedures. However, a pleural manometer is rarely available. Objectives: The aim of this study was to (1) construct an electronic pleural manometer, (2) assess the accuracy of the measurements done with the new device, (3) calculate the costs of the manometer construction and (4) perform an initial evaluation of the device in a clinical setting. Methods: Only widely accessible elements were used to construct the device. A vascular pressure transducer was used to transform pressure into an electronic signal. Reliability of the measurements was evaluated in a laboratory setting in a prospective, single-blind manner by comparing the results with those measured by a water manometer. Functionality of the device was assessed during therapeutic thoracentesis. The cost of the new pleural manometer was calculated. Results: We built a small, portable device which can precisely measure intrapleural pressure. The measurement results showed very high agreement with those registered with a water manometer (r = 0.999; p < 0.001). The initial evaluation of the electronic manometer during therapeutic thoracentesis showed it was easy to use. The total time needed for 6 measurements after withdrawal of different volumes of pleural fluid in 1 patient did not exceed 6 min. The total cost of the device was calculated to be <2,000 EUR. Conclusions: In the face of very limited offer of commercially available pleural manometers, it is possible to successfully construct a self-made, reliable, electronic pleural manometer at modest costs. The device is easy to use and enables data display and storage in the personal computer.

A new endotracheal tube for infants--laboratory and clinical assessment: a preliminary study.

Conventional endotracheal pediatric tubes offer high resistance due to their small diameters and relatively high flow during ventilation. Any increase of the diameter of the tube lumen decreases the airway resistance and subsequently, the work of breathing (WOB). We compared ventilation mechanics using a new, cone‐shaped endotracheal tube of our design to the Cole and standard tubes.

Sympathetic nerve blocks for the management of postherpetic neuralgia - 19 years of pain clinic experience.

BACKGROUND Sympathetic system involvement in postherpetic neuralgia (PHN) has been targeted using peripheral sympathetic nerve blocks for a number of years with variable efficacy. The aim of this report is to present the outcomes of PHN management with concomitant use of pharmacological treatment and sympathetic nerve blocks. METHODS We retrospectively evaluated clinical data on 563 patients with PHN symptoms treated in the pain clinic and identified cases in which sympathetic nerve blocks were implemented in the years 1992-2010. A Numeric Rating Scale was used as a pain severity assessment, with a reduction to values under 3 considered a positive therapy result. Three time intervals were considered: years 1992-1997 (I), 1998-2002 (II) and 2003-2010 (III). RESULTS In group I, 27% of patients had poor treatment results, while in group II, the failure rate dropped to 18%. The same 18% failure rate was observed in group III as well. Treatment introduced early yielded the best results, but there was no difference among groups with a similar duration from herpes zoster onset to treatment commencement in the time periods assessed; however, from 1998 onward, the same rate of poor outcomes was also noted in the groups who started the sympathetic blockade, which aided pain clinic treatment up to 3 months and between 3 and 6 months from the onset of herpes zoster. CONCLUSION Major progress in the pharmacological treatment of PHN appears to be an obvious factor contributing to the overall improvement in PHN management (introduction of gabapentin). Nevertheless, safely administered regional anaesthesia techniques, although performed in a very similar manner for many years, appear to provide some support as part of a multimodal approach to PHN management.

Preliminary clinical evaluation of a new differential lung ventilation set-up

Aim: The objective of this study was to access the ability to control and stabilize ventilation of each lung by a newly developed flow/ventilator divider.