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Biomedical subjects

D J Thomson

Publications and source records attributed to D J Thomson.

42 records · Page 3Linked to original sources

Deep hypothermic low flow cardiopulmonary bypass in small dogs.

OBJECTIVE: To evaluate the feasibility of and morbidity and mortality associated with cardiopulmonary bypass (CPB) using deep hypothermia and low flow perfusion in adult dogs weighing less than 10 kg. STUDY DESIGN: Prospective, descriptive study. ANIMALS: Two groups of three dogs underwent CPB. Group 1 dogs underwent deep hypothermia (15 to 18 degrees C), 45 minutes of low perfusion flow (20 mL/kg/min) and 1 hour of aortic cross clamp time. In group 2, ultrafiltration of perfusate before discontinuation of bypass was added to the standard treatment. Complete blood counts, serum biochemistry, urine output, ejection fraction, and cardiac output were monitored before and for 7 days after surgery. RESULTS: All dogs were successfully weaned from bypass. Four of six dogs survived, three without major complications. One dog developed and recovered from septic pleuritis. Two dogs died or were euthanatized after surgery because of respiratory or gastrointestinal complications. Minor complications included anemia, hypoproteinemia, and electrolyte disturbances. Transfusion requirements and edema formation were reduced by ultrafiltration. CONCLUSIONS: The observations in this study support the feasibility of low flow hypothermic CPB. Meticulous tissue handling, precise equipment, ultrafiltration, and aggressive postoperative potassium supplementation are recommended for smaller patients. CLINICAL RELEVANCE: Increased sensitivity to adverse sequelae of CPB may be associated with small patient size. Further evaluation is necessary before routine clinical application of low flow hypothermic CPB in this patient population.

Animals↗

De novo coronary artery grafting in a heart transplant recipient.

The current organ shortage prompts reassessment of donor selection. This article describes a patient who underwent heart transplantation with an internal mammary artery graft to the left anterior descending artery beyond a single stenotic lesion in the transplanted heart.

Heart Transplantation↗

Hypersensitivity-like reactions related to insertion of aquavene-based midline and PICC catheters.

Catheter-related hypersensitivity-type adverse reactions have been associated with insertion of the LANDMARK Midline Catheter (Menlo Care Inc., Menlo Park, CA). The authors' retrospective study showed an incidence for these reactions of 0.3% (7/2169) as well as an incidence of 3.3% (2/61) with insertion of CENTERMARK PICC (Menlo Care Inc., Menlo Park, CA), another aquavene-based catheter. The mechanism causing these reactions remains unknown, but the authors think that there is a small but significant risk of potentially life-threatening adverse reactions associated with insertion of these catheters. The health care professional who uses these catheters should be aware of these hypersensitivity reactions and should report any cases that occur to the Food and Drug Administration's MedWatch immediately.

Adult↗