The automatic selection of ventilation parameters during the initial phase of mechanical ventilation.

OBJECTIVE: To test a method that allows automatic set-up of the ventilator controls at the onset of ventilation. DESIGN: Prospective randomized crossover study. SETTING: ICUs in one adult and one children's hospital in Switzerland. PATIENTS: Thirty intubated stable, critically ill patients (20 adults and 10 children). INTERVENTIONS: The patients were ventilated during two 20-min periods using a modified Hamilton AMADEUS ventilator. During the control period the ventilator settings were chosen immediately prior to the study. During the other period individual settings were automatically determined by the ventilatior (AutoInit). MEASUREMENTS AND RESULTS: Pressure, flow, and instantaneous CO2 concentration were measured at the airway opening. From these measurements, series dead space (V(DS)), expiratory time constant (RC), tidal volume (VT, total respiratory frequency (f(tot), minute ventilation (MV), and maximal and mean airway pressure (Paw, max and Paw, mean) were calculated. Arterial blood gases were analyzed at the end of each period. Paw, max was significantly less with the AutoInit ventilator settings while f(tot) was significantly greater (P < 0.05). The other values were not statistically significant. CONCLUSIONS: The AutoInit ventilator settings, which were automatically derived, were acceptable for all patients for a period of 20 min and were not found to be inferior to the control ventilator settings. This makes the AutoInit method potentially useful as an automatic start-up procedure for mechanical ventilation.

Les proches dans le Code civil

Le législateur du Code civil a introduit le terme « proche » dans de nombreuses dispositions, mais n'en propose aucune définition, ce qui laisse une grande marge de manoeuvre pour son interprétation et son application. La signification et la portée du terme ne seront ainsi pas les mêmes selon le domaine juridique et la situation de fait analysés. Face à cette grande diversité d'usage du terme, l'auteure de la contribution propose de l'appréhender selon les domaines et les buts dans lesquels il est utilisé par le législateur afin de réussir à tracer les contours des différents cercles de proches envisageables.

Rapport sur le projet d'un code pénal, fait à l'assemblée générale de l'État de la Louisiane , par M. Édouard Livingston, suivi des Observations sur les conditions nécessaires à la perfection d'un code pénal, par M. Mill, avec une introduction et des notes, par M. A.-H. Taillandier,...

Comprend : Observations sur les conditions nécessaires à la perfection d'un code pénal...