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Biomedical subjects

D W Ryan

Publications and source records attributed to D W Ryan.

At least 19 recordsLinked to original sources
PubMed1992

Blood conservation.

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Blood Loss, Surgical↗
PubMed1991

Minitracheotomy Seldinger--assessment of a new technique.

A multicentre, prospective study of 26 patients was undertaken for the assessment of insertion of minitracheotomy tubes by the Seldinger technique. The technique of insertion is described. There were two misplacements, three blockages of the inserting Tuohy needle with fat, and six cases of difficulty in passing the minitracheotomy tube.

Anesthesia, Local↗
PubMed1990

Minitracheotomy.

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Drainage↗
PubMed1990

Nitrogen sparing and the catabolic hormones in patients nursed at an elevated ambient temperature following major surgery.

Fasted patients managed at an elevated ambient temperature following major surgery have reduced nitrogen excretion and body protein catabolism. To investigate the mechanism behind this three 24 h urine collections were made in 16 patients nursed for 48 h following aortobifemoral surgery on a Clinitron fluidized bed at 32 degrees C and analysed for total urinary nitrogen, cortisol and catecholamine excretion. Results were compared with a similar group of patients nursed throughout on a standard ITU bed at 22 degrees C. Patients managed at the elevated ambient temperature showed a significant reduction in the cumulative total urinary nitrogen (20.73 g +/- 6.42 v 28.95 g +/- 6.44; mean +/- S.D.; p less than 0.002) and cortisol excretion (1238 microg +/- 436 v 2197 microg +/- 844; mean +/- S.D.; p less than 0.001). Catecholamine excretion was also reduced but failed to achieve significance. There were significant correlations between cumulative total nitrogen excretion and both cortisol (r = +0.414; p = 0.02; n = 32) and noradrenaline (r = +0.369; p = 0.05; n = 32). These results confirm that the beneficial effect of an elevated ambient temperature on postoperative protein metabolism is brought about through a reduction in metabolic stress.

Aged↗
PubMed1990

Disseminated zygomycosis and systemic lupus erythematosus.

A young woman with long-standing systemic lupus erythematosus and rheumatic fever presented with deteriorating renal function. She had severe gastritis treated with cimetidine and received methylprednisolone when her blood cultures were repeatedly negative. She developed spontaneous bruising and bleeding from venepuncture sites, leading to clotting studies and a diagnosis of thrombotic thrombocytopenic purpura. At post-mortem, extensive evidence of disseminated zygomycosis was found. The likely portal of entry was the gastric route.

Adult↗
PubMed1989

A study of contact pressure points in specialised beds.

Pressure was measured at seven body points liable to develop pressure sores, in four commonly available beds. A small water-filled sensor attached to a transducer and measuring system was used, and the limitations of this system are discussed. The investigation was undertaken in female volunteers lying supine in each of the beds. The results show that compared with the standard, hard mattress normally used in the intensive care bed all the specialised beds have some beneficial effect. The water bed produces an even distribution of body weight but some elevation in pressures, notably in the sacrum and heel regions. The fluidized bed was the most consistent but the low air loss bed also provided safe pressures and has the advantage of greater postural flexibility.

Beds↗
PubMed1986

Charcoal-column haemoperfusion does not significantly enhance chlormethiazole removal.

A 26-year-old man had convulsions after taking an overdose of slow-release aminophylline tablets. The convulsions were treated with an infusion of chlormethiazole and theophylline was removed by charcoal-column haemoperfusion. It has been suggested that haemoperfusion might be useful for removing chlormethiazole and this was investigated. There was no evidence that charcoal-column haemoperfusion could remove clinically significant amounts of chlormethiazole.

Adult↗
PubMed1986

The anion gap.

The majority of doctors can recognize and treat obvious biochemical disturbances on the basis of routine urea and electrolyte results. A useful (although nonspecific) guide to acid-base status is also contained among those figures: this is a derivative known as the anion gap. This article is a guide to the anion gap.

Acid-Base Imbalance↗
PubMed1985

Demonstration of a reduction in postoperative body protein breakdown using the Clinitron fluidized bed with an ambient temperature of 32 degrees C.

Patients managed at an elevated ambient temperature after major surgery have a less pronounced rise in postoperative urinary nitrogen excretion. To investigate the mechanism involved, body protein breakdown was assessed, using a tracer dose of labelled amino acid, in patients following aorto-bifemoral bypass surgery nursed on either a Clinitron fluidized bed at 32 degrees C or a hospital bed at 22 degrees C and correlated with urinary total nitrogen excretion. Results showed a small reduction in measured body protein breakdown on the second postoperative day in patients managed on the Clinitron fluidized bed at 32 degrees C (2.92 +/- 0.91 versus 3.23 +/- 0.84 g protein kg-1 day-1; mean +/- s.d.), which was equivalent to the mean protein sparing (0.29g protein kg-1 day-1) demonstrated by the significant improvement in urinary total nitrogen excretion (9.20 +/- 2.0 versus 12.48 +/- 3.9 g N day-1; mean +/- s.d.: P less than 0.05). Urinary total nitrogen excretion (N) and body protein breakdown (B) showed a weak though significant positive correlation (B = 1.25 + 13.13N; r = +0.55: P = 0.05), whereas no correlation existed between urinary total nitrogen excretion and the derived rate of body protein synthesis. There was also a significant decrease in postoperative stress, measured during the isotope infusion, in patients managed on the Clinitron fluidized bed at 32 degrees C (12.3 +/- 2.2 versus 16.1 +/- 3.2 per cent activity incorporated into plasma proteins; mean +/- s.d.: P less than 0.05). These results show the beneficial effect of managing postoperative patients on a Clinitron fluidized bed at 32 degrees C in conserving body nitrogen through a reduction in body protein breakdown, probably as a consequence of decreased postoperative stress.

Aged↗