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Biomedical subjects

E C Peirce

Publications and source records attributed to E C Peirce.

64 records · Page 4Linked to original sources
PubMedDate not supplied

Clinical trial of a self-sealing PTFE-silicone dialysis graft.

A double wall PTFE graft with a silicone rubber middle layer (PTFE-sil) shown in a canine model to be self-sealing after needle puncture, was tried in 30 dialysis patients. Thirty-five patients with PTFE grafts were controls. All patients were followed for 1 year. In the PTFE-sil group, mean time to first dialysis was 1.3 days after implantation; during first 10 treatments, 17% of punctures did not bleed, 61% bled minimally, and 4% required 10 or more minutes of compression. No bleeding complications were encountered at any time. Complications of PTFE-sil vs. PTFE were as follows: thrombosis 36.6% vs. 28.5%; infection 13.3% vs. 11.4%; seroma 3% vs. 0%; steal 3% vs. 0%; pseudoaneurysm 0% vs. 17.1%; one year primary patency 63% vs. 66%; secondary patency 75% vs. 67%. In conclusion, the PTFE-sil graft, can be used immediately after implantation, sparing patient additional access procedures for acute dialysis. This results in less morbidity, decrease in bleeding complications, considerable shortening of hospital stay and significant reduction in expenses.

Adult↗
PubMedDate not supplied

A practical method of differential hypothermia to permit use of a low pump oxygenator flow.

By cooling the blood just before returning it to the body, marked reduction in the temperature of the heart, brain, liver, and kidney can be produced easily and with great economy in heat transfer, since the great bulk of the animal or patient, consisting of skin, muscle, and bone, is cooled much more slowly. This results in a marked oxygen saving, due to the direct antimetabolic effect of the cooling. Metabolic acidosis can be avoided and so far no irreversible effects of the cooling have been discoverable. Warming is so greatly facilitated by the heat stored in the nonvital areas that it is not necessary to warm the blood returning from the extracorporeal circuit. The use of safe, low, extracorporeal flows offers a number of possible advantages including great simplicity of cannulation and of the pump oxygenator design and operation.

Animals↗
PubMedDate not supplied

Therapeutic implications of phlebographic obstruction in chronic venous stasis.

The purpose of this work was to evaluate the functional characteristics of the venous system of patients with chronic obstruction of their deep veins proved by phlebography. Sixty-eight extremities in 34 normal volunteers and 21 extremities in 17 patients with chronic venous stasis and phlebographically demonstrated obstruction of their deep veins (popliteal-superficial femoral in 33.3%, common femoral in 23.8%, iliac in 33.3% and inferior vena cava in 9.5%) were evaluated using mercury in silastic strain gauges on the feet to measure venous volume changes on elevation and exercise. Regurgitant flow, corrected for arterial foot blood flow, was calculated. In the control group, the apparent regurgitation range was 0 to 2.3 ml %/min (mean +/- 2 SD). Sixty-two percent of extremities with obstructed deep veins had significant functional regurgitation. Regurgitation was detected by phlebography in only 14.3% of cases. From these results we conclude that obstruction of the deep venous system by phlebography may or may not signify functional obstruction and, in itself, therefore, does not indicate that bypass surgery is an appropriate method of treatment. Selection for surgical correction requires quantitative determination of insufficiency since higher grades of regurgitation probably contraindicate venous bypass.

Exercise↗