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Biomedical subjects

D E Lees

Publications and source records attributed to D E Lees.

At least 37 records · Page 2Linked to original sources
PubMed1984

Closing the loop: how near is automated anesthesia?

Technologic advances now make automated anesthesia delivery systems theoretically possible; clinical implementation, however, awaits development and refinement in three areas: (1) adjunctive monitoring, which needs to be extremely sophisticated; (2) automated data collection, which will obviate manual record keeping; (3) automated therapeutic intervention, which will control drug, fluid, and gas administration. Reduced health care costs and increased safety are the primary goals; there is also the possibility, however, of increased costs and new hazards.

Anesthesia↗
PubMed1983

Maximal use of microcomputers in anesthesiology.

Microcomputer applications in anesthesiology are increasing rapidly. All areas are affected: research, education, administration and clinical care. In research, microcomputers are accomplishing both process control and analysis, as well as storage of large data banks. In education, computer-aided instruction permits the student to progress at his own speed, while freeing instructor time for individual tutoring. Administrative applications produce more useful information and cost-control with reduced clerical effort. clinical applications offer the possibility of truly integrated monitoring systems that will make automated anesthesia records possible; eventually this will lead to computer-controlled anesthesia. This paper examines the "state of the art" in applications of microcomputers in anesthesia.

Anesthesiology↗
PubMed1983

Neuroanesthesiology: expansion into diagnosis.

Anesthesiologists are now active in the diagnosis of unusual neurologic and neuromuscular disorders. Their skill derives both from a firm understanding of basic sciences and a facility with invasive procedures. Five representative cases are presented to illustrate the scope of diagnostic neuroanesthesiology and the endeavors of the neuroanesthesiologist outside the operating theater.

Adult↗
PubMed1982

Immunological and physiological responses to whole-body hyperthermia.

Current information on the effect of systemic hyperthermia on the host-tumor immunologic response was reviewed. Changes in physiology caused by whole-body heat are described in a review of current studies at the National Cancer Institute and others, with particular regard to cardiovascular, endocrine, and nervous system changes with heat. The importance of these heat-affected alterations of physiology and immunology on chemotherapy and radiotherapy administration is discussed.

Animals↗
PubMed1981

Changes in peripheral vascular and cardiac sympathetic activity before and after coronary artery bypass surgery: interrelationships with hemodynamic alterations.

The plasma catecholamine levels obtained simultaneously from radial artery (A), pulmonary artery (MV), brachial vein (PV), and coronary sinus (CS) were measured concurrent with hemodynamic determinations during coronary artery bypass graft (CABG) operations. Arterial catecholamine levels decreased after induction of anesthesia and increased after sternotomy; changes in veno-arterial norepinephrine (NE) differences ([PV-A]ne, [MV-A]ne, and [CS-A]ne) were of the same magnitude and direction, suggesting that NE release from various organs was of the same extent. After operation, arterial NE increased further, but the veno-arterial NE differences were in striking contrast; [PV-A]ne became markedly positive, whereas [CS-A]ne became markedly negative, indicating that NE release from extremity peripheral vasculature increased markedly while cardiac NE release decreased. These differential changes in regional sympathetic activity appear to be related to postoperative hypertension (HT) and low cardiac output (CO). There were close relationships of changes in [MV-A]ne to mean arterial pressure (r = 0.78, p less than 0.001) and systemic vascular resistance (r = 0.62, p less than 0.010, suggesting that the sympathetic nervous system plays an important role in CABG perioperative hemodynamic alterations.

Adult↗
PubMed1981

Somatosensory evoked potentials during whole body hyperthermia in humans.

Somatosensory evoked potentials (SEPs) and body temperature were recorded in patients subjected to induced total hyperthermia for treatment of advanced neoplasms. Elevation of body temperature up to 42 degrees C for 2 h was achieved using a computer-controlled external heating system. SEPs were recorded continuously on-line during the treatment using finger shock stimulation. Evoked potential components later than 160 msec disappeared in the early part of the treatment, but reappeared quickly during cooling. P50 and P50-N70 amplitudes decreased regularly and significantly over the whole duration of the heating period. During the plateau period, no evoked potential peaks could be detected but short latency peaks reappeared as soon as cooling started. The disappearance of SEPs to finger stimulation during sustained hyperthermia at 42 degrees C confirms the findings obtained by EEG recording that a major neuronal dysfunction occurs under these circumstances which subsides quickly as temperature is dropped.

Body Temperature↗
PubMed1980

Noninvasive determination of core temperature during anesthesia.

A noninvasive, zero heat flux method of determining core (intracardiac blood) temperature was studied in ten anesthetized patients having whole body hyperthermia for the treatment of cancer. True intracardiac blood temperature was determined by a calibrated pulmonary artery thermistor. Accuracy, precision, and responsivity for the noninvasive system were comparable to conventional esophageal thermometry in reflecting intracardiac blood temperatures. This method of contact thermometry is convenient and independent of environmental influence, and it rapidly reflects the small changes in arterial blood temperature which evoke vasomotor responses.

Anesthesia, General↗
PubMed1980

Celiac plexus block: diagnostic and therapeutic applications in abdominal pain.

The celiac plexus block has been "rediscovered" by the modern multidisciplinary pain clinic. Local anesthetic blocks aid in diagnosing unusual syndromes of abdominal pain. Neurolytic blocks are important in the management of intractable pain from abdominal cancer. Therapeutic use of celiac plexus block in managing the pain of chronic pancreatitis has been expanded by the use of intraplexus steroids. This treatment carries less morbidity than surgical interventions and affords long-term pain relief.

Abdomen↗