No abstract

A patient with obstructive sleep apnea due to Shy-Drager syndrome, who has been successfully managed by cord lateralization, is presented. This has allowed successful rehabilitation of the patient without prejudicing subsequent surgery, and appears to be an effective procedure in this rare condition.

The Heimlich manoeuvre is a well-known intervention for the management of choking due to foreign body airway occlusion, but the evidence base for guidance on this topic is limited and guidelines differ. We measured pressures during abdominal thrusts in healthy volunteers. The angle at which thrusts were performed (upthrust vs circumferential) did not affect intrathoracic pressure. Self-administered abdominal thrusts produced similar pressures to those performed by another person. Chair thrusts, where the subject pushed their upper abdomen against a chair back, produced higher pressures than other manoeuvres. Both approaches should be included in basic life support teaching.

Erythrapheresis was performed in 10 patients with polycythaemia secondary to hypoxic lung disease (mean PaO., 6-8 kPa (51 mm Hg)). The mean packed cell volume decreased from 0-64 to 0-48 in men and from 0 56 to 0-42 in women, with significant decreases in blood viscosity at both high and low shear rates (p< 0001). Patients showed significant improvement in six-minute walking distances (p < 0 001) and in tests of mental alertness (p < 001) compared to control subjects. Visual analogue scales confirmed symptomatic improvement after erythrapheresis.Erythrapheresis significantly improved symptoms, mental function, and work performance in patients with polycythaemia secondary to hypoxic lung disease. The procedure was well tolerated by all patients and no complications occurred.