A young child with respiratory acidosis and hypoxia from mechanical ventilation with equipment made for adults

BACKGROUND: During mechanical ventilation of young children, problems may arise due to the additional dead space of the ventilation circuit. This may lead to respiratory acidosis and even hypoxia in the child.CASE DESCRIPTION: A 3-month-old boy suffered from frequent apnoea. He was mechanically ventilated for this. Shortly after its initiation, he developed severe respiratory acidosis, hypoxemia and circulatory insufficiency. This was due to a large additional dead space caused by the use of equipment components made for adults. After he was switched to a circuit suitable for himself, he recovered rapidly.CONCLUSION: As a rule of thumb, an additional dead space of 1.5-2 ml/kg body weight is acceptable in young children. Emergency wards for young children should have specific equipment to mechanically ventilate them, and have a protocol paying explicit attention to the dead space.</p

Contestation et image anti-napoléonienne en Hollande au cours de la période napoléonienne (1806-1813)

La période napoléonienne en Hollande (1806-1813) a été, comme l’ont montré certaines recherches, un moment de protestations fréquentes, nombreuses et variées. Il y eut des émeutes et d’autres formes de troubles, dont plusieurs grandes révoltes. Par-delà les troubles, la protestation s’est également manifestée par diverses formes de refus ou de contestation. Cette contribution tente ainsi de mettre en évidence les formes, les aspects et les significations de la construction de l’image anti-napoléonienne en Hollande. L’accent sera mis sur certaines formes de contestation qu’on peut subdiviser en orales, écrites et imprimées. Les protestations écrites et orales ont augmenté dans une période de tension internationale croissante et, au cours de l’annexion (1810-1813), dans un contexte de conscription ; les pasteurs protestants y ont joué un rôle spécifique. Les sources démontrent que les chaires ont souvent contribué à la diffusion de sermons dans lesquels les thèmes eschatologiques se sont mêlés à des propos anti-français, et plus particulièrement anti-napoléoniens. Les imprimés, les brochures et les gravures contestataires, de leur côté, étaient relativement rares en raison d’un contrôle strict de la presse, tout au moins jusqu’à l’effondrement du régime français en Hollande, en 1813, qui s’est accompagné d’une profusion de pamphlets et de caricatures ; la plupart de ces dernières étaient étrangères, même si certaines caricatures néerlandaises ont également circulé.The Napoleonic period in Holland (1806-1813) was – as relative recent historical research has shown – a time of frequent, widespread and varied protest. There were many riots and other forms of unrest, including several large-scale revolts. Besides unrest the protest has also manifested itself in the forms of unwillingness and in the form of incitement. The following contribution will investigate the form, aspects and significance of anti-Napoleonic image making, which took shape in Holland as part of this protest. The focus will be on incitement, which could be subdivided into oral « or spoken » protests, « written » protests and printed « protests ». The oral and written protests increased in times of rising international tension and, during the « Annexation » (1810-1813), in the wake of a cycle of conscription activities. Within these types of protest the protestant ministers took up a special position. Information shows that the pulpits in Holland functioned often as platforms for the spreading of sermons in which eschatological themes were mixed with anti-French, especially anti-Napoleonic feelings. Printed protests, pamphlets and engravings, were relatively scarce because of a strict control of the press. The collapse of the French regime in Holland in November 1813 triggered instantly an avalanche of pamphlets and caricatures. Most caricatures were foreign. However specific Dutch caricatures against Napoleon and the Napoleonic regime were also circulating