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Biomedical subjects

C E Gillbe

Publications and source records attributed to C E Gillbe.

10 recordsLinked to original sources
PubMed1992

Use of endotracheal silicone stents for relief of tracheobronchial obstruction.

In this article we describe our initial experience with bifurcated and longitudinal silicone stents that can be inserted entirely endoscopically. A total of 10 patients were stented; half had upper airways obstruction resulting from malignant disease and half had anastomotic obstruction after single-lung (3 patients), double-lung (1 patient), or heart-lung transplantation (1 patient). All patients derived immediate relief of life-threatening stridor. Stents were in place for between 5 days and 2 1/2 years (mean, 232.9 days). In the patients with malignant disease, the stents have provided effective relief from stridor for the remainder of their lives. In the transplant recipients, the medium-term results are encouraging, with the stents providing effective relief from stridor, although the longitudinal stents have been associated with distal migration, requiring that the stents be replaced on up to five occasions. The stents have not been associated with infection in the nonimmunosuppressed patients, and during the relatively short follow-up period there has been no tissue reaction to the material.

Adult↗
PubMed1989

Effect of temperature on rate of left ventricular pressure fall in humans.

The time constant (T) of left ventricular pressure fall is widely used as an index of ventricular "relaxation". It is not known whether its rate limiting step is deactivation, an enzymic energy consuming reaction whose rate is therefore sensitive to temperature, or elastic recoil. To distinguish between these possibilities, the time constant was measured by simple logarithmic (Tlog) and exponential (Texp) methods in 12 patients during cooling before coronary artery grafting. Ventricular loading conditions were altered by transfusion from bypass to maintain arterial and left atrial pressures constant in individual patients, though heart rate fell from 86 (8.4) to 68 (10) beats/min. Tlog increased from 49 (10) ms mean (SD), at 37 degrees C to 86 (15) ms at 31 degrees C, and Texp from 63(14) at 37 degrees C to 112 (23) ms at 31 degrees C with intermediate values at 34 degrees C. Texp proved sensitive to "noise" at low temperatures, but the overall change in Tlog with temperature was 9% per degree C--considerably less than that observed experimentally for the rate of tension decline of isolated myocardium, and possibly itself an overestimate because of the concomitant fall in heart rate. The relatively small effect of temperature on Tlog in humans, associated with a considerable load sensitivity appearing under hypothermic conditions, does not favour simple dependence on deactivation as the rate limiting step of left ventricular pressure fall, but suggests that its determinants may be complex.

Adult↗
PubMed1981

Respiratory mass spectrometry during general anaesthesia.

The performance of a respiratory mass spectrometer, modified commercially for use during general anaesthesia, has been evaluated. Stability and linearity proved satisfactory for monitoring respiratory gases and accurate measurement was possible when the inspired concentration of all gases was less than 80%. The system has been installed centrally in a three-room operating theatre suite and the selection of long sampling probes which permit an adequate response time for all gases is discussed.

Anesthesia, General↗
PubMed1980

Pulmonary function after prolonged mechanical ventilation with high concentrations of oxygen.

The mortality and morbidity resulting from mechanical ventilation with high concentrations of inspired oxygen has been investigated in two groups of patients. Ninety-one patients requiring mechanical ventilation for pulmonary disease included six (group 1) in whom death was attributed directly to respiratory failure but only three in whom oxygen toxicity might have been relevant. Review of the clinical and postmortem findings suggests that oxygen was probably not a contributory factor in two of these three. A second group of 16 patients who survived prolonged mechanical ventilation with oxygen in excess of 40% (average 14.5 days) included five who had been ventilated with 75% oxygen or more for an average of 38 hours. Lung function studies carried out on this second group of patients approximately one year later demonstrated that all but three had significant defects in either ventilation, gas transfer, or both. Oxygen toxicity was thought to be a likely cause in one and a possible contributory factor in three more. It is suggested that the adverse effects of oxygen on the alveolar epithelium are rarely of practical importance in hypoxaemic patients requiring mechanical ventilation but disturbance to the pulmonary defences against infection may well be of greater importance. The fear of inducing oxygen toxicity should not be allowed to interfere with the relief of arterial hypoxaemia in ventilated patients.

Adolescent↗