Intermittent chest compression is still routinely used in resuscitation for hemorrhagic shock patients. There is a possibility that by using a different resuscitation method with interposed abdominal compressions, through forcing the blood from abdominal organs into the circulation and increasing intraperitoneal pressure, more blood pumps to heart. Therefore, in this study, chest compression resuscitation and interposed abdominal compressions resuscitation were compared in dogs with induced experimental hemorrhagic shock and electrocardiographic changes evaluated as an important diagnostic and monitoring tool in heart conduction and rhythm disorders. Thus hemorrhagic shock was induced by drawing blood from femoral artery in 15 dogs under anesthesia and continued until pulseless electrical activity achieved. The dogs were kept pulseless for 20 minutes, then were randomized to three treatment groups - fluid resuscitation alone with Ringer's lactate solution, chest compressions with fluid resuscitation, and interposed abdominal compression with fluid resuscitation. Resuscitation was conducted until reaching the point of return of spontaneous circulation. Electrocardiograms were recorded before the induction of hemorrhage, at the time that the pulse was lost, after 20 minutes of pulseless state and at the point of return of spontaneous circulation. Changes in P and QRS waves amplitudes, QT interval, heart rate, and electrical axis and morphology of ST segment was significant in different times within groups. but there were no significant changes in P and QRS durations and PR interval and heart rhythm. There were no significant changes in any parameter with different type of resuscitation method. Finally mixed effect of time and groups were also statistically insignificant in all parameters. In conclusion, it seems that there is no positive impact in electrocardiographic parameters using either of chest compression only or interposed abdominal compression resuscitation methods in dogs with induced hemorrhagic shock.

In patients undergoing mechanical ventilation because of an endotracheal tube، mucus production and secretion is high. Because endotracheal suction in these patients is essential، chest physiotherapy techniques such as expiratory rib cage compression before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretion and improving alveolar ventilation. This study was carried out to determine the effect of expiratory rib cage compression before endotracheal suctioning on arterial blood pressure in patients receiving mechanical ventilation. This study was a clinical trial study with a crossover design. The study sample included 50 mechanically ventilated patients hospitalized in intensive care wards of hospitals of Valiasr and Ayatollah Mousavi educational hospitals in Zanjan. Subjects were selected with consecutive sampling and randomly allocated to grope 1 or 2. The patients received endotracheal suctioning with or without rib cage compression; with a minimum 3 hours interval between the two interventions. Blood pressure was measured 5 minutes before، and 15، 25 minutes after endotracheal suctioning. The 2 measurement periods were carried out on the same day. We measured the blood pressure 5 min before suctioning، 15 and 25 min after suctioning. To analyze the data، SPSS16 was used. There was significant differences in the mean blood pressure between 5 minutes before as compared with 15 and 25 min after endotracheal suctioning in rib cage compression method (p<0. 05). There was no significant difference in other method (p>0. 05). Moreover، there was significant differences in the mentioned variables (p=0. 00). According to the findings، the expiratory rib cage compression before endotracheal suctioning improves blood pressure in patients under mechanical ventilation. So، expiratory rib cage compression before endotracheal suctioning is recommended in the patients.

In this case report, A 53 year-old woman is presented whom was prepared for nonemergency laminectomy surgeny under general anesthesia. Balanced anesthesia was chosen for her planned surgery. At the end of the surgery, patients’s blood pressure dropped unexpectedly. Vasopressor durg plus intravenous crystaloid solution were the only treatment then. After turning patient to normal position (supine) and extubation of the trachea, there was another sudden drop in blood pressure, tachycardia, unconciousness and distention of the abdomen. Patient was resuscitated with tracheal intubation, Intravascular fluid adminstration and was returned to operating room for emergency laparatomy. During laparatomy, large amount of blood was inside peritoneal cavity and the source of the bleeding was two tearings in the abdominal aorta. Invasive monitoring was instituted at the beginning of the laparatomy (Arterial line/CV line). After emergency laparatomy, the patient had three episodes of laparatomy for finding of the bleeding source around the abdominal aorta, IVC and vertebral arteries during three consecutive days. Patient received 109 units of blood & blood products during 96 hours after laminectomy Surgery and was retained in ICU for 83 days.

Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients under mechanical ventilation. Chest physiotherapy techniques such as expiratory rib cage compression before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretions and improving alveolar ventilation. This study was carried out to determine the effects of expiratory rib cage compression before endotracheal suctioning on arterial blood gases in patients mechanically ventilated patients. This research was a clinical trial study with a crossover design. The subjects consisted of 70 (35 females, 35 males) mechanically ventilated patients who were admitted to medical and surgical intensive care units and emergency department of Hazrat-Rasool Hospital in Tehran. Subjects were selected with consecutive sampling. The patients received endotracheal suctioning with and without rib cage compression, with a minimum 3-hours interval between the two interventions. Expiratory rib cage compression was performed for 5 minutes before endotracheal suctioning. Arterial blood gases were measured 5 minutes before and 25 minutes after endotracheal suctioning. Data were recorded on the data recording sheet. Data were analyzed using Wilcoxon and paired t-tests. There were a statistically significant differences in the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (Pao2/Fio2), Paco2, and arterial oxygen saturation (Sao2) between before and after endotracheal suctioning in both methods (endotracheal suctioning with and without rib cage compression) (p=0.000). Moreover, there were statistically significant differences in the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (P=0.000), Paco2 (P=0.048), and arterial oxygen saturation (P=0.000) between the two methods. Findings showed that expiratory rib cage compression before endotracheal suctioning improves arterial blood gases exchanges in patients under mechanical ventilation, so, performing expiratory rib cage compression before endotracheal suctioning in these patients is recommended.

Accumulation of secretions in airways is a serious complication in intubated and mechanically ventilated patients. Tracheal suctioning which is done with the aim of secretion removal can be used in conjunction with physiotherapy for effective airway clearance and improving gas exchange. The aim of study was to determine the effects of rib cage compression before suctioning on respiratory parameters in mechanically ventilated patients. In this crossover clinical trial study fifty mechanically ventilated patients were randomly divided to two groups. Each patient received two interventions of endotracheal suctioning with and without rib-cage compression in expiration time with a minimum of 3-hour interval between the two interventions and ten times with three respiratory cycle intervals. Oxygen saturation and dynamic compliance were measured before، 5 and 25 minutes after and data were analyzed using paired t-tests and Greenhouse Geisser and Sphericity. Average cumulative dynamic compliance a minute before، 5 and 25 minutes after intervention with compression was 30. 06، 32. 14 and 30. 93 and 30. 42، respectively and without compression، 32. 26 and 32. 81. Arterial oxygen saturation a minute before، 5 and 25 minutes after the intervention was 97. 67، 98. 09 and 97. 94 respectively in suction with compression and 98. 12، 98. 27 and 98. 17 without compression which were almost similar in the 3 step evaluation and there was no statistically significant difference. In attention to lack of significant differences in oxygen saturation and dynamic compliance in two methods of suction with and without chest compressions، further research is needed in this area.

Studies have indicated that anthropometric measurements and hand dimensions may be effective on hand grip strength and relationship between these dimensions with hand grip strength can predict the success and recognition of athletes who are prone. The purpose of the present study was to examine the relationship of handgrip strength with basic anthropometric variables, upper extremity anthropometric variables and specific hand anthropometric variables and comparison it in athletes and non-athletes men. In order to, we selected 200 male subjects includes 100 student non-athletes (age: 21.14 ± 2.13 yrs, Height: 174.98 ± 5.46 cm, weight: 68.6 ± 10.47 kg) and 100 student athletes (age: 21.66 ± 1.96 yrs, Height: 179.13 ± 6.5 cm, weight: 73.65 ± 8.7 kg). Height, weight, body mass index (BMI) and percent body fat, arm length, forearm length, forearm and hand forearm length, elbow breadth, palmar breadth, wrist breadth, arm circumference, forearm circumference, wrist circumference and specific hand anthropometric variables includes: fingers span, fingers length and fingers perimeter was measured in all subjects. Data were analyzed with independent sample t-test, Pearson and Spearman correlation coefficient, unilateral variance analysis (ANOVA) and stepwise multiple regression statistical models. Level of significant in this study was p<0.05. The findings of this study showed that handgrip strength had a significant relationship with weight, body mass index (BMI) and percent body fat, arm length, arm circumference, forearm circumference, wrist circumference and fifth fingers length in athlete group(p<0.05) and so showed significant relationship with weight, body mass index (BMI), percent body fat, arm length, forearm length, forearm and hand forearm length, arm circumference, forearm circumference, wrist circumference, palmar breadth, wrist breadth, index finger length and fifth finger span in non-athlete group(p<0.05). These findings indicate that anthropometric variables and type of exercise are effective on handgrip strength.

The present study was aimed to evaluate the effect of compacting pressure on the densification and sintering behavior of Cu-28Zn prealloyed powder. For this purpose, samples were compacted at pressures of 100, 200, 300, 400, 500 and 600 MPa and then were sintered at 870 and 890 °C for 30 minutes. According to the obtained results from tests such as densification, hardness and microstructure studies, it was specified that the maximum densification at 870 °C occurred at 300 MPa. With increasing of sintering temperature, the maximum densification shifted to lower pressures. Also the microstructural changes represent the occurring fragmentation and rearrangement of particles is faster in the samples compacted at lower pressures.