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Biomedical subjects

B I Bodai

Publications and source records attributed to B I Bodai.

36 records · Page 2Linked to original sources
PubMed1983

The esophageal obturator airway. A review.

The esophageal obturator airway (EOA) has been considered a beneficial ventilatory technique for use in cardiopulmonary resuscitation (CPR). At present, seven studies in the literature compare the EOA with other means of ventilation in humans; only one is an actual field study of its effectiveness. We reviewed the available literature dealing with the device to define clearly its role in the ventilatory treatment of patients who require CPR. There appears to be no current evidence of the EOA's effectiveness for ventilation in prehospital cardiac arrest, and fatal complications have been reported with its use. The use of the EOA to replace endotracheal intubation in airway management is not substantiated in the literature.

Esophagus↗
PubMed1983

Emergency thoracotomy in the management of trauma.

The role of emergency room thoracotomy in the management of trauma remains poorly defined despite an increase in its use. Most authors agree that the procedure is effective in the treatment of penetrating thoracic injuries, while its benefit in penetrating injuries below the diaphragm and in blunt trauma has not been established. The best outcome can be expected in patients who have sustained penetrating cardiac and thoracic injuries. Penetrating abdominal wounds that are severe enough to require thoracotomy in the emergency room fare less well; those patients who suffer from blunt thoracoabdominal injuries are least fortunate. The anatomic location and mode of injury greatly influence the outcome of these patients and are useful in determining when to perform this procedure.

Abdominal Injuries↗
PubMed1983

A field evaluation of the Esophageal Obturator Airway.

The Esophageal Obturator Airway (EOA) has been considered an effective ventilatory technique for cardiopulmonary resuscitation; however, few studies of its field effectiveness have been performed. We evaluated the EOA in 158 cases of prehospital cardiac arrest resuscitated by EMT II personnel utilizing the EOA for airway maintenance. The time of insertion from arrival of the unit and the number of unsuccessful attempts were recorded. The EOA took longer than 4 minutes to insert in 47% of cases. It was incapable of being placed in 18.3% of cases, and required two or more attempts at insertion in 30%. There were six survivors in this series (3.7%). Subsequently, we measured arterial blood gas levels during ventilation with the EOA and after endotracheal intubation in 13 patients. Arterial oxygen tension greater than 60 mm Hg was achieved in only four of 13 patients with the EOA. All patients were hypercarbic and acidotic using the EOA. There was marked improvement in all parameters following ET intubation. The EOA presents technical problems which make it inferior to ET tubes in resuscitation of individuals in the field with cardiac arrest. Close monitoring of its use should be undertaken in areas where it is the primary method for airway maintenance.

Adult↗
PubMed1983

Effects of hypoproteinemia and increased vascular pressure on lung fluid balance in sheep.

We compared the effects of a sustained decrease in plasma oncotic pressure on lung fluid balance with those of an increase in vascular pressure in six unanesthetized sheep. Initial plasma protein concentration of 58.0 +/- 2.2 (SE) mg/ml was quickly reduced to 34.0 +/- 1.4 mg/ml via plasmapheresis and held at this value for 24 h. Red cells were returned with lactated Ringer solution infused at a rate adjusted to maintain central venous pressure; cardiac output and pulmonary vascular pressures also remained at base line. Steady-state lymph flows increased from a base-line value of 8.8 +/- 3.2 to 20.1 +/- 5.6 ml/h, while the lymph-to-plasma protein concentration ratio ( [L/P] ) decreased from 0.65 +/- 0.03 to 0.44 +/- 0.04. Decreased lymph protein resulted in reestablishment of base-line plasma-to-lymph oncotic gradient. The increased lymph flow was not the result of increased filtration forces, since all vascular pressures and the oncotic gradient were unchanged; nor was it due entirely to increased surface area since [L/P] was decreased. The decrease in plasma oncotic pressure, delta pi P, was twice as effective at increasing lymph flow (1.66 ml X h-1 X mmHg-1, delta pi P) as an equivalent increase in microvascular pressure, delta PC, at normal plasma protein concentration (0.82 ml X h-1 X mmHg-1, delta PC). Elevation of microvascular pressure during hypoproteinemia had a greater effect on lymph flow (1.44 ml X h-1 X mmHg-1, delta PC) than at normal plasma protein concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

The effect of ketamine on endotoxin-induced lung injury.

We investigated the effects of ketamine HCl on endotoxin-induced pulmonary injury in 20 chronically instrumented sheep with lung lymph fistulas. The caudal mediastinal lymph node was cannulated in 20 ewes (45-55 kg). The catheter was externalized and the lymph allowed to drain freely. Pulmonary injury was induced by an intravenous infusion of Escherichia coli endotoxin (1.0-1.5 micrograms/kg body wt) over a 5-min period in 11 animals. The injury was characterized by an increase in pulmonary arterial pressure, pulmonary arterial wedge pressure, and lung lymph flow. There was no change in mean systemic arterial pressure. These changes were significantly attenuated by intravenous administration of ketamine HCl (5 mg/kg) following endotoxin injury in 9 other animals. When ketamine was given, the pulmonary arterial pressure decreased 32%, lung lymph flow decreased 27%, and systemic blood pressure increased 22%. Potential mechanisms for the hemodynamic effects of ketamine HCl in sepsis are discussed with particular reference to the pulmonary microvasculature.

Animals↗
PubMed1982

Empyema of the gallbladder--potential consequence of medical intensive care.

We present 3 patients who developed empyema of the gallbladder after admission to the medical ICU for diseases unrelated to gallbladder pathology. Empyema of the gallbladder developed during a prolonged stay in the ICU. Modern intensive care practices may predispose the gallbladder to localized, discrete sepsis. Cryptic biliary tract disease should be considered in patients with medical illness, particularly when complicated by recognized predisposing factors and septicemia of unknown origin.

Aged↗
PubMed1982

The role of emergency thoracotomy in blunt trauma.

The benefits of emergency room thoracotomy (ET) in the treatment of blunt trauma are controversial. We retrospectively reviewed 38 consecutive cases in whom blunt trauma required thoracotomy as part of the resuscitative maneuver. There were no survivors in this setting regardless of age, sex, and time from injury to arrival. A review of the literature shows questionable salvage rates in such circumstances. Victims of blunt trauma presenting without signs of life are poor emergency thoracotomy candidates, and we suggest that in such patients this procedure be abandoned. Guidelines for emergency room thoracotomy are suggested: that ET should be used in penetrating chest trauma; that it is indicated for noncardiac injuries only if there is pupil reactivity, voluntary respiratory efforts, or purposeful movement, initially or during resuscitation; following ET, if spontaneous cardiac activity cannot be maintained and systemic blood pressure cannot be maintained at least at 70 mm Hg for 30 minutes, patients should be considered unsalvageable.

Critical Care↗
PubMed1982

Mechanisms for redistribution of plasma protein following acute protein depletion.

Acute plasma protein depletion is followed by a rapid and substantial replenishment of the protein deficit. We studied the effects of plasmapheresis on flow and composition of peripheral lymph in 11 unanesthetized sheep. Whole blood was replaced with red blood cells and lactated Ringer solution to reduce plasma protein concentration ([P]) 26-54%. At 24 h after plasmapheresis, [P] had returned halfway to base line. Lymph flow (L) increased immediately after plasma protein reduction, was maximal 3 h later, and remained elevated for more than 3 days. The increase in L was coupled with a decrease more than 3 days. The increase in L was coupled with a decrease in lymph-to-plasma protein concentration ratio ([L/P]). The plasma-to-lymph oncotic gradient was reestablished by 24 h due to the reduction in lymph protein and the partial return of [P]. After 24 h, L remained elevated despite base-line levels for all measured vascular pressures and plasma-to-lymph oncotic gradients. Although lymph flow was increased, the permeability-surface area product for protein was decreased below base line. The data confirm that the partial return of [P] in the first day after plasmapheresis is due largely to a shift of extravascular protein mass into the vascular compartment and show that redistribution is initiated by increased lymphatic return and maintained by a sustained increase in L and a decrease in protein permeability of the plasma-lymph barrier.

Animals↗
PubMed1981

Effect of hypoproteinemia on pulmonary and soft tissue edema formation.

The effect of acute hypoproteinemia on the rate of fluid flux across the pulmonary and soft tissue microcirculation was studied in the unanesthetized sheep. Lymph flow was used to monitor fluid flux, a protein depletion of 30-50% of baseline value was produced by plasmapheresis. Vascular hydrostatic pressures and cardiac output were maintained constant with crystalloid infusion. The measured oncotic pressure in plasma, pi rho rapidly decreased as did the oncotic gradient between plasma and lymph. Lung and soft tissue lymph flow increased 2- to 3-fold immediately after protein depletion. Lung interstitial oncotic pressure, pi L, as measured in lymph, decreased to return the oncotic gradient and lymph flow to baseline by 24 h. Soft tissue oncotic gradient also returned to baseline by 24 h, but lymph flow remained significantly elevated for the next 48 h, indicating an increase in fluid flux unrelated to changes in oncotic pressure. Lymph flow rapidly returned to baseline when protein was returned. Protein depletion may alter the soft tissue interstitial matrix, allowing for edema formation. More effective mechanisms prevent this from occurring in the lung.

Animals↗
PubMed1978

Current concepts of the undescended testis.

Abnormalities of testicular descent represent the most common genitourinary anomaly in men. Many aspects of testicular maldescent remain controversial. The etiology of the undescended testis is still not known, but results of experimental work in rats strongly support the hormonal theories. Distinction between the truly undescended testis and the retractile testis remains a problem, making retrospective analysis of previous data confusing. Newer aspects of diagnosis of nonpalpable testes include the human chorionic gonadotropin test, herniography, venography and arteriography. Routine aspects of surgical therapy have changed little in recent years, although newer techniques, such as microsurgical procedures and innovative scrotal anchoring methods, are now available. Malignant tumors and infertility are the most worrisome complications. Evidence is presented to suggest that prognosis is related not only to choice of therapy but also to its timing. The recent evidence for Sertoli cell dysfunction, if substantiated may resolve some of the controversies.

Chorionic Gonadotropin↗
PubMed1978

The red eye.

The nonophthalmic physician confronted by a patient with a red eye should be able to distinguish common microbial or allergic conjunctivitis from potentially blinding disorders, such as acute angle closure glaucoma, uveitis, or herpes simplex keratitis, and should remain alert for an associated systemic disease, such as rheumatoid arthritis, polycythemia, or carotid cavernous fistula. The physician should approach the red eye systematically: take a careful history, including type of pain; measure visual acuity; observe the pattern of redness, the type of discharge, the shape of the pupil, and the opacities of the media; and measure the intraocular pressure.

Blepharitis↗
PubMed1978

Urinary tract infections in children: a review.

Urinary tract infections (UTIs) in children are a common and challenging problem for the primary care physician and continue to be a cause of significant morbidity. Except for the neonatal period, UTIs occur most frequently in girls. The symptoms of UTI in the child may be obscure, and often a high index of suspicion is required. Diagnosis ultimately depends on the urine culture. Current concepts in the diagnosis and therapy of UTIs in children include the use of urine culture for initial diagnosis and home cultures for follow-up. Evidence fully supports the concept that even a single episode of documented bacteriuria, symptomatic or asymptomatic, should be investigated with an intravenous pyelogram (IVP) and voiding cystourethrogram (VCUG).

Anti-Bacterial Agents↗
PubMedDate not supplied

The red eye.

Explore the source record for details and available documents.

Blepharitis↗