Profile of the Northern Region.
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Biomedical subjects
Publications and source records attributed to A B Baker.
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Greyhound dogs were given oleic acid i.v. to induce controlled pulmonary oedema. These animals were then studied using intermittent positive pressure ventilation (IPPV) with four different inspiratory flow waveforms, each at three different inspiratory times, in a fixed respiratory cycle of 4 s at a constant tidal volume. Although there were statistically significant differences in airway and oesophageal pressures between the different waveforms and times, there was little variation in the other physiological parameters studied except for arterial carbon dioxide tension. (PaCO2) which showed statistically significant improvement with reversed ramp and sine wave inputs and at the longer inspiratory time of 2.2s. Venous admixture (Qs/Qt) was also less with the longer inspiratory time of 2.2s.
Emphysema was induced in mongrel dogs by four weekly inhalations of papain. The effects of IPPV were studied using four different inspiratory flow waveforms and each at three different inspiratory times. Tidal volume and respiratory frequency were kept constant and inspiratory time and flow waveform were varied independently. There were statistically significant differences in a number of physiological variables. With a longer inspiratory time of 2.2s and with the reversed ramp flow waveform VD/VT was decreased. With the reversed ramp flow waveform there was a greater total compliance, increased (PAo2-Pao2) and reduced PaCO2. There were statistically significant differences in mean airway and oesophageal pressures which indicate valid differences in the flow waveforms and times.
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An anaesthetic technique (caudal blockade with chloroprocaine and intravenous propanidid) for patients having dilatation and curettage of the uterus as outpatients is presented, and a prospective series of patients reviewed. Results show a high level of patient satisfaction with the technique and a low incidence of side effects.
A survey about staffing of departments of anaesthesia in teaching hospitals, and about the duties of their anaesthetists, showed similar results to a preliminary survey (Baker 1978) which suggested that two-thirds of Australasian departments were understaffed by senior specialists. The survey also showed a high ratio of one, of trainees to senior specialists, which will soon oversupply specialists in practice if allowed to continue.
A survey of Australasian departments of anaesthesia was undertaken. Recommendations for ideal staffing are made and the extent to which present staffing satisfies these recommendations is described.
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A series of experiments was undertaken with Enflurane under hyperbaric conditions to determine whether or not it was explosive under these conditions. No risk of detonation was shown with concentrations of Enflurane up to 5% in either oxygen or nitrous oxide mixtures under conditions of hyperbaria to 3 A.T.A. (Atmospheres Absolute).
A general review of the physiological alterations with artificial ventilation is presented with particular emphasis on the alteration of inspiratory time and flow waveform. The general methods and physiological calibration procedures used in a more elaborate study of inspiratory time and waveform effects are described, with the results of testing these methods showing that the model is satisfactory.
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The autonomic nervous system was blocked in dogs which were exposed to independent alterations in inspiratory flow waveform and time whilst being ventilated artificially at a constant volume and frequency. There were statistically significant differences in cardiac output between the control and blocked states, but these differences were not of marked physiological significance. Alteration in inspiratory waveform or time in the blocked animals did not alter cardiac output significantly.
Flail chest injuries are traditionally managed by long-term artificial ventilation, which in itself is hazardous and expensive. A more conservative therapeutic regime is described, and the results of this regime are compared with those following the previous traditional regime used in the Respiratory Unit, Royal Brisbane Hospital. The place of artificial ventilation in relation to spontaneous ventilation is redefined in the context of this new regime.
A study of flow-volume curves pre- and post-operatively demonstrated a marked difference between bronchitic and non-bronchitic patients. All bronchitic patients showed lower flow rates at low lung volumes post-operatively, when compared with their pre-operative values. Non-bronchitic patients all had higher flow rates for the same comparison.
Lung compliance was studied pre-operatively and post-operatively in a group of patients having abdominal surgery. Lung compliance was shown to be markedly reduced post-operatively especially in the patients with chronic bronchitis.