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Biomedical subjects

A E Cram

Publications and source records attributed to A E Cram.

30 records · Page 2Linked to original sources
PubMed1981

Hemodynamic effects of military anti-shock trousers (MAST) in experimental cardiac tamponade.

The ability of military anti-shock trousers (MAST) to increase central venous pressure and improve cardiac filling pressure suggests that they might be useful in the prehospital treatment of pericardial tamponade. This study utilizes a canine model to examine the hemodynamic effects of MAST inflation on experimentally induced pericardial tamponade. Use of the MAST garment improved cardiac filling, mean arterial pressure, and cardiac output in the decompensated tamponade state. It should be realized that animal data may not correlate with human clinical response.

Animals↗
PubMed1981

Effects of pneumatic antishock trousers on canine intracranial pressure.

The military antishock trouser (MAST) has become an accepted prehospital treatment modality for hypovolemic shock. Our interest in the effect of MAST on intracranial pressure (ICP) was aroused by the manufacturer's written warning that use of the device was contraindicated in patients with suspected head injury. This study was undertaken to determine the effect of MAST device inflation on intracranial pressure in dogs with normal and artificially elevated ICP in both normovolemic and hypovolemic states. The largest increase in hemodynamic parameters was seen in mean arterial pressure (MAP) in hypovolemic animals. Although the ICP did increase with MAST inflation, it never reached levels of clinical significance. Furthermore, the cerebral perfusion pressure (MAP--ICP) was calculated and shown to be improved in all groups when the MAST device was inflated. Data from this study support clinical use of the MAST garment in hypovolemic patients even in the presence of suspected head injury.

Animals↗
PubMed1978

Aortocaval fistula associated with aneurysm of the abdominal aorta: current management using autotransfusion techniques.

Two patients with aortocaval fistula associated with abdominal aortic aneurysm were managed successfully using a patient care plan which includes proper monitoring of the hemodynamic state, careful dissection of the aneurysm, and return of blood loss by autotransfusion while the patient is fully anticoagulated with heparin. This unusual and serious problem in vascular surgery can be managed in an orderly and controlled fashion using these techniques.

Aged↗
PubMed1977

Surgical management of complications of radiation-injured gut.

Radiation-injured bowel has been diagnosed in 5.1 per cent of 1,824 patients receiving pelvic or abdominal radiotherapy over the past ten years. Surgical intervention to manage these complications was required in 35 per cent. The type of procedure employed for large and small bowel complications has been evaluated to define guidelines for future therapy.

Humans↗
PubMedDate not supplied

"Borrowed" burn nurses: a cost-effective option for providing skilled staff during periods of need.

Staffing a burn center with qualified nurses is difficult because of highly variable patient census and the diversity and complexity of required nursing knowledge and skills. There are disadvantages to relying on usual temporary sources of supplemental staff. A viable alternative is the "borrowing" of burn nurses from another burn center during periods of high census. This solution has proved to be cost-effective and functional.

Bed Occupancy↗
PubMedDate not supplied

Short-term skin preservation at 4 degrees C: skin storage configuration and tissue-to-volume medium ratio.

This study was designed to examine the effect of the storage configuration of skin and the ratio of tissue-to-storage medium on the viability of skin stored under refrigeration. Human skin specimens were stored in four physical configurations in RPMI 1640 tissue culture media at 4 degrees C. Skin was transferred to surgically created defects on nude mice after specific storage intervals. Grafts were examined grossly and microscopically after ten days. In the rolled configuration, on storage day 15, the viability of the outside of the roll was significantly better than the inside (P less than 0.01). The graft viability of the outside of the skin rolls was similar for both tissue-to-media ratios as well as for both free-floating configurations (P = 0.27). These findings suggest the optimum cold storage configuration is free floating, and 300 cm2/100 mL is an appropriate skin surface area to volume media ratio. This proportion of tissue to media is in agreement with the minimum ratio currently recommended by the Skin Council of the American Association of Tissue Banks.

Animals↗
PubMedDate not supplied

The microstomia prevention appliance: 14 years of clinical experience.

Partial- or full-thickness perioral facial burns may lead to a contracture of the tissues surrounding the oral commissures that results in microstomia. The current investigators have used the microstomia prevention appliance (MPA) exclusively in the management of commissure burns at the University of Iowa Burn Center since 1972. To assess the effectiveness of the MPA, a retrospective chart review was conducted. The study population consisted of 85 patients admitted to the center between 1974 and 1986 who had incurred burns to the perioral region or to the lower two thirds of the face. The chart analysis of 83 patients revealed that, with diligent and persistent use of the MPA, only one patient required surgical repair for the development of microstomia. The MPA has proved effective in decreasing the need for reconstructive procedures and in preventing the occurrence of microstomia.

Burns↗
PubMedDate not supplied

A comparison of storage viability of nonmeshed and meshed skin at 4 degrees C.

Skin stored in nutrient medium at 4 degrees C produces acceptable short-term viability. This study compared the storage viability of nonmeshed v meshed skin stored at 4 degrees C in nutrient medium. Skin specimens from six human donors were stored for up to 35 days in RPMI 1640 tissue culture medium at 4 degrees C. Skin specimens (1 cm in diameter) were transplanted to surgically created defects on the thorax of nude mice at fixed intervals during the storage period. Gross and microscopic techniques were used to determine the graft viability at 10 days postgraft. Skin was divided into two storage groups as nonmeshed or meshed 1.5/1. The storage configuration was free-floating, 10 cm x 2 cm sheet grafts. The ratio of skin surface area to volume medium was 300 cm2/100 mL. There was no significant difference between the viability of the nonmeshed group compared to the meshed group. Prior meshing of human allograft does not adversely affect the viability of banked skin. Therefore, skin can be stored in a meshed configuration. This eliminates operating room time spent preparing allograft for application, which is cost-effective.

Animals↗