Extracorporeal life support (ECLS) for pediatric trauma: experience with five cases

Extracorporeal life support (ECLS) was used to treat five pediatric trauma patients (ages 1 to 17 years) with respiratory failure unresponsive to conventional mechanical ventilation. Diagnoses in these patients that resulted in respiratory failure included hydrocarbon aspiration (one patient), multiple trauma with pulmonary contusion (two patients), bronchopleural fistula (one patient), and neardrowning (one patient). Time on ECLS bypass averaged 328 h (range 140–527 h). Physiologic complications included bleeding, cardiac arrest, cardiac tamponade, hypoxemia, and hypotension. Mechanical complications involving the bypass circuit included roller-pump raceway rupture, roller-pump failure, and membrane oxygenator failure. All complications were managed without mortality. Three of the five patients were decannulated from ECLS and survived. Support was terminated in the remaining two due to irreversibility of the pulmonary injury. ECLS may provide life-saving support to pediatric patients with respiratory failure after trauma when conventional means of ventilatory support have failed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47185/1/383_2004_Article_BF00177095.pd

Investigating the local juvenile criminal justice system A system study handbook

4.80SIGLELD:f83/2040 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Investigating the local juvenile criminal justice system A systems study handbook

SIGLELD:f83/1642 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Supporting Multidisciplinary Teams and Early Design Stages Using Storyboards

Abstract. Current tools for multidisciplinary teams in user-centered software engineering (UCSE) provide little support for the different approaches of the various disciplines in the project team. Although multidisciplinary teams are getting more and more involved in UCSE projects, an efficient approach to communicate clearly and to pass results of a user needs analysis to other team members without loss of information is still missing. Based on previous experiences, we propose storyboards as a key component in such tools. Storyboards contain sketched information of users, activities, devices and the context of a future application. The comprehensible and intuitive notation and accompanying tool support presented in this paper will enhance communication and efficiency within the multidisciplinary team during UCSE projects.