Search

In 1993, J.Y. Chevalier described a single needle venovenous extracorporeal membrane oxygenation (ECMO) system using a nonocclusive roller pump and alternating clamps for pulmonary support in neonates. We modified this system to use it in older children as well and for additional indications. Introducing a double raceway and 2 different sizes of tubing sets and performing percutaneous approach, we treated 21 children (age 1 day to 49 months) using this system. Indications for treatment were hypoxia and hypoxic induced myocardial dysfunction resulting from pulmonary failure, sepsis, and congenital defects. Of the chiIdren treated for neonatal indications. 7/9 survived. For 2 children ECMO was terminated because of intraventricular hemorrhage (TVH). In the pediatric group 5/7 of the children could be weaned from ECMO, and 2 children died after more than 30 days on ECMO. Two of the children who had been almost completely weaned died later because of therapy withdrawal following a brain death diagnosis. In the cardiac group, 3/5 of the children survived. We conclude that the described system is an effective venovenous ECMO system that reduces invasivity and expenditure.

We study the metal-insulator transition in two sets of amorphous Si_{1-x}Ni_x films. The sets were prepared by different, electron-beam-evaporation-based technologies: evaporation of the alloy, and gradient deposition from separate Ni and Si crucibles. The characterization included electron and scanning tunneling microscopy, glow discharge optical emission spectroscopy, and Rutherford back scattering. Investigating the logarithmic temperature derivative of the conductivity, w = d ln sigma / d ln T, we observe that, for insulating samples, w(T) shows a minimum increasing at both low and high T. Both the minimum value of w and the corresponding temperature seem to tend to zero as the transition is approached. The analysis of this feature of w(T,x) leads to the conclusion that the transition in Si_{1-x}Ni_x is very likely discontinuous at zero temperature in agreement with Mott's original views., Comment: RevTex-file: 25 pages, 17 Postscript figures, 1 GIF figure (original Ps file can be obtained on request). Published version. Changes of v2: Sec. VII completed by two paragraphs on nature of transition, several refs. added

We evaluated a bedside method of assessing respiratory compliance from chest expansion, which is judged by eye and classified into three tidal volume categories, and from the inflation pressure read on the respirator's manometer. Compliance assessed by this method was compared with the compliance measured by the injection technique in 45 randomly chosen newborns ventilated for various diseases. The compliance assessed from chest expansion and inflation pressure correlated significantly with the measured compliance (r = 0.86, p < 0.001). Interobserver reliability was acceptable for clinical practice and improved within 6 months of training (weighted kappa = 0.67 versus 0.86). Within ten individuals, changes of compliance assessed by this method were also significantly correlated with those of measured compliance (r = 0.85, p < 0.01). This method, termed "optical compliance," is instantaneously and always available for all patients on ventilators without any additional apparatus and thus might improve the assessment of respiratory function in routine care and emergency situations.