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Biomedical subjects

C M Dryden

Publications and source records attributed to C M Dryden.

8 recordsLinked to original sources
PubMed1995

A survey of interhospital transport of the critically ill child in the United Kingdom.

Nineteen paediatric intensive care units were surveyed by questionnaire to provide information on the number of interhospital transfers, the experience of personal accompanying the critically ill child and the equipment available to maintain intensive care during transfer. Replies were received from 17 units. An estimated 800 transfers are performed annually. Three units routinely send intensive care staff to collect patients with an estimated 60% of transfers performed by a variety of staff from referring hospitals. Most respondents believed that existing arrangements for transfer were unsatisfactory, but only four units said that transfer may be prevented or delayed by lack of facilities. We believe that any plan to centralize paediatric intensive care in the UK should also include the means by which to transfer the patient without increasing the risk to the patient.

Ambulances↗
PubMed1993

The effect of preoperative beta-blocker therapy on cardiovascular responses to weaning from mechanical ventilation and extubation after coronary artery bypass grafting.

The hemodynamic and electrocardiographic changes during weaning from mechanical ventilation and tracheal extubation were studied in 75 patients after elective coronary artery bypass surgery. Transfer from synchronized intermittent mandatory ventilation to spontaneous respiration through a T-piece was associated with an increase greater than 20% over baseline in systolic (SBP) and diastolic (DBP) blood pressure in 27% of patients, and in heart rate (HR) in 5% of patients. Although baseline SBP, DBP, and HR differed significantly between the patients taking chronic beta-blocker therapy and those not on beta-blockers (P values all < 0.003), there were no differences between these groups in their response to transfer to the T-piece. (P values: SBP = 0.98; DBP = 0.46; HR = 0.20). Tracheal extubation was associated with an increase greater than 20% of baseline in SBP in 18.9%, DBP in 16.2%, and HR in 5% of patients. However, there were significant differences between the chronically beta-blocked and non-beta-blocked groups, both in baseline values for SBP, DBP, and HR (P values all < 0.001), and also in the SBP response (P = 0.007) and HR response (P = 0.02) to extubation. Extubation was associated with a greater than 20% increase in SBP in 8.2% and DBP in 12.2% of chronically beta-blocked patients, compared to 40% and 23% of non-beta-blocked patients, although the DBP response was not statistically different (P = 0.14) between the groups. Similar proportions of patients in both groups increased their HR more than 20% above baseline, but the increase was much greater in the non-beta-blocked group (P = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1993

Efficacy of continuous intercostal bupivacaine for pain relief after thoracotomy.

We studied 20 patients undergoing thoracotomy, in a double-blind, placebo-controlled crossover trial of intercostal bupivacaine. Bupivacaine 0.25% was infused at 5 ml h-1 through each of two catheters placed in the intercostal space at operation. Mean (95% confidence limits) 24-h requirements for morphine from a patient-controlled analgesia device were 29 (22-37) mg during bupivacaine infusion and 44 (32-57) mg during saline infusion (P = 0.04). Patients also recorded significantly smaller visual analogue scores for pain during bupivacaine infusion. There were no adverse effects related to the intercostal infusion of bupivacaine. We conclude that bupivacaine, infused through catheters placed during thoracotomy in the adjacent intercostal spaces, is a useful adjunct to systemic opioid analgesia.

Aged↗
PubMed1993

Laboratory assessment of the Baxter disposable patient-controlled analgesia system.

The performance of the Baxter patient-controlled analgesia infusor system was assessed in the laboratory. The flow of the 5 ml.h-1 infusor was measured gravimetrically with the flow restrictor maintained at 31 degrees C and the reservoir at either 20 degrees C or 25 degrees C. At 25 degrees C the mean flow was 4.98 (SEM 0.06) ml.h-1 and at 20 degrees C the mean flow was 4.32 (0.05) ml.h-1. The patient-control module performed reliably, delivering a mean of 0.42 (0.001) ml following depression of the button, slightly less than the manufacturer's quoted value of 0.5 ml.

Analgesia, Patient-Controlled↗
PubMed1992

Helicopters.

Explore the source record for details and available documents.

Aircraft↗
PubMedDate not supplied

Oxford Optronix MPM 3S: a clinical assessment of a microvascular perfusion monitor.

The Oxford Optronix MPM 3S is a new microvascular perfusion monitor which is promoted as a device for use in the operating theatre. It uses a semiconductor laser diode and applies the Doppler principle to derive a semi-quantitative estimation of microvascular flow. We assessed this instrument with eight healthy volunteers who each performed eight different orthostatic arm manoeuvres while forearm skin blood flow was monitored. The different manoeuvres caused statistically significant changes in the instrument's reading which generally were consistent with expected changes in blood flow. The monitor also was assessed in the theatre environment with four anaesthetized patients. It proved easy to use, and was not subject to electrical interference from other equipment including short-wave diathermy. The major practical limitation of the technique is the semi-quantitative nature of the measurement. The instrument appears to have potential clinical uses in plastic and vascular surgery.

Adult↗
PubMedDate not supplied

Secondary transfer of patients with fulminant hepatic failure.

The principles of stabilisation before and monitoring during transportation are well established in intensive care practice, but fulminant hepatic failure presents especial problems. Transfer of patients to specialist liver failure units needs to be carried out without interruption of therapy aimed at delaying the onset of cerebral oedema, sepsis and haemodynamic instability.

Brain Edema↗