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Biomedical subjects

D Royston

Publications and source records attributed to D Royston.

132 records · Page 8Linked to original sources
PubMedDate not supplied

Positive end-expiratory pressure increases pulmonary clearance of inhaled 99mTc-DTPA in nonsmokers but not in healthy smokers.

Positive end-expiratory pressure (PEEP) is widely used in the treatment of severe pulmonary oedema, although its effects on the clearance of water and small solutes from alveolus to blood are not well characterized. We studied the effect of the application of 10 cmH2O of PEEP on the flux of inhaled 99mTc-diethylene-triamine-penta-acetic acid (DTPA) from lung to blood in six healthy smoking and six nonsmoking subjects. The rate of flux was corrected for possible changes in pulmonary blood volume during PEEP by use of an intravenous injection of 99mTc-DTPA. The baseline clearance rate (K, % X min-1) for nonsmokers was 1.48 +/- 0.12 (mean +/- SE) and increased to 2.40 +/- 0.29 during PEEP (p less than 0.05). In contrast, the mean clearance rate for smokers was 3.26 +/- 0.82 at baseline and 3.03 +/- 0.82 during PEEP (p = NS). The application of positive end-expiratory pressure appears to increase alveolar solute flux in nonsmokers but not in smokers, suggesting that the pathway for solute clearance in smokers is governed by different rate-limiting steps to those of nonsmokers.

Administration, Inhalation↗
PubMedDate not supplied

Aprotinin therapy in heart and heart-lung transplantation.

Patients who undergo cardiothoracic transplantation represent a considerable challenge to any blood conservation program. It is well recognized that excessive bleeding increases the mortality and morbidity rates of any surgical procedure, but patients who undergo heart and lung transplantation, either singly or in combination, have a greater probability of bleeding more frequently and to a greater extent than patients who undergo many other types of surgery. In addition to the problems inherent in excessive bleeding are those associated with the need for increased donor blood transfusion requirements in these procedures. In this regard it is imperative to avoid the transmission of any blood-borne infection to a patient who is immunosuppressed. In particular, the cytomegalovirus is a key problem. With large blood losses and in patients with uncommon blood groups, it may not be possible to guarantee unlimited supplies of cytomegalovirus-negative blood.

Aprotinin↗