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Biomedical subjects

G William-Olsson

Publications and source records attributed to G William-Olsson.

At least 37 records · Page 2Linked to original sources
PubMed1988

Association between pulmonary dysfunction and reduced red cell deformability following cardiopulmonary bypass.

Fifty-six patients undergoing open-heart surgery were monitored for red cell trauma during cardiopulmonary bypass (CPB), using a standard red cell microfiltration method. The average red cell deformability was reduced by 38%. Respirator time was shorter in the patients with lesser degrees of red cell trauma, and vice versa. After extubation, the tendency to hypercapnia was greatest in the patients with most red cell trauma during CPB. Hypoxic tendencies in the first 24 postextubation hours were comparably distributed among all levels of red cell trauma.

Cardiac Surgical Procedures↗
PubMed1988

Association between arrhythmias and reduced red cell deformability following cardiopulmonary bypass.

In 56 patients undergoing open-heart surgery, trauma to the red cells (reduced deformability) during cardiopulmonary bypass (CPB) was monitored by estimating reduction in red cell filtration rate (RFR). Treatment-requiring arrhythmias (atrial tachyarrhythmia and ventricular tachycardia) appearing more than 24 hours postoperatively were associated with RFR reduction after CPB. The incidence of arrhythmia was 31% in the patients with less than 25% fall in RFR, 53% in those with greater than 25% fall and 81% when the RFR reduction was greater than 75%. RFR fall preceded appearance of arrhythmia.

Arrhythmias, Cardiac↗
PubMed1986

Surgical treatment of the WPW-syndrome--experience in 30 initial cases.

Between May 1980 and February 1985, 30 patients were operated upon at Sahlgren's Hospital for life-threatening or disabling arrhythmias, caused by Kent's bundles. Two surgical methods were used. The outcome of surgery was fully satisfactory in 19 patients, whereas 4 patients continued to have arrhythmias after surgery. Six patients had a modified delta-wave in the ECG after surgery, but their arrhythmias could be controlled by antiarrhythmic medication. One patient died after surgery due to an undiagnosed cerebral tumor. There were 2 late deaths, between 6 and 12 months postoperatively; neither of these was caused by arrhythmias.

Adolescent↗
PubMed1985

Left ventricular function during anaesthesia induction and sternotomy in patients with ischaemic heart disease. A comparison of six anaesthetic techniques.

A comparison between five anaesthetic procedures, fentanyl (FE), morphine (MO), halothane (HAL), fentanyl/droperidol (NLA) and thiopenthone (two dose levels: PE 3 and PE 6), all supplemented with nitrous oxide, was performed with respect to the left ventricular function (LVF) during anaesthesia induction and sternotomy in 47 patients with good preoperative LVF and maintained beta-blockers. Peroperative LVF was characterized by left ventricular stroke volume (stroke index) and external pressure volume stroke work (left ventricular stroke work index) in relation to filling pressure (pulmonary capillary wedge pressure) and outflow resistance (systemic vascular resistance). The individual patient patterns in each group indicated normal LVF in the awake state. Anaesthesia induction was followed by a moderate depression of LVF in the HAL, MO, PE 3 and PE 6 groups at full dose of anaesthetic agent. After addition of nitrous oxide, there was also a decrease of preload in all groups, masking any additional depressions of LVF. The response to external stimuli, endotracheal intubation and sternotomy was that of mildly depressed LVF in the majority of the patients. The haemodynamic reactions in the FE and NLA groups were more varied. In all groups some patients (approximately 30%) showed signs of left ventricular failing in response to external stimuli. With the exception of the more variable haemodynamic reactions in the FE and NLA groups, the differences between the anaesthesia groups with respect to LVF depended mainly on extracardiac factors.

Anesthesia↗
PubMed1985

Haemodynamic stability during anaesthesia induction and sternotomy in patients with ischaemic heart disease. A comparison of six anaesthetic techniques.

A comparison of haemodynamic stability with respect to arterial pressure, heart rate and cardiac output between six commonly used anaesthetic techniques: fentanyl (FE), halothane (HAL), morphine (MO), fentanyl/droperidol (NLA), and thiopentone (two dose levels: PE 3 and PE 6), all supplemented with nitrous oxide, was performed during induction of anaesthesia and sternotomy in 47 patients with good left ventricular function and maintained beta-blockers undergoing coronary bypass surgery. Interventions were kept to a minimum in order to characterize each anaesthesia group. Statistically, the material fell into two parts. The MO, PE 3 and PE 6 groups showed good stability under steady-state anaesthesia, but variable and often extensive hyperdynamic responses were seen to endotracheal intubation and surgical stimulation. The FE, HAL and NLA groups were characterized by a good stability during the induction-intubation phase but were unstable when combined with nitrous oxide in the absence of noxious stimuli.

Adrenergic beta-Antagonists↗
PubMed1985

Fentanyl-droperidol-nitrous oxide anaesthesia in patients with ischaemic heart disease and various degrees of left ventricular functional impairment.

Haemodynamic stability and left ventricular function (LVF) during induction of anaesthesia and sternotomy were compared in three groups of patients with ischaemic heart disease, angiographically classified as having good, poor and depressed LVF. Anaesthesia was given with fentanyl-droperidol and nitrous oxide. The group with good LVF showed large variations in arterial pressure and heart rate between stimulated and unstimulated states with a reasonable preservation of LVF, expressed as stroke volume, through the whole observation period. The group with poor LVF showed monotonously falling arterial pressure, and no heart rate response to tracheal intubation. These patients maintained remarkably stable stroke volumes in connection with low afterloads. After nitrous oxide, additional volume loading was required because of profound hypotension. The majority of the patients in the intermediate group, labelled "depressed LVF", reacted to intubation and sternotomy with signs of left ventricular failure in connection with tachycardia and increased afterloads. The individual variations between patients with different degrees of left ventricular impairment were considerable, and these haemodynamic patterns need to be confirmed with a larger material.

Anesthesia, General↗
PubMed1985

Mechanical trauma to red blood cells caused by Björk-Shiley and Carpentier-Edwards heart valves.

The haemolytic properties of mechanical and biologic valve prostheses are well established, and it is known that they can shorten red cell survival time (1, 2). Their effects on red cell deformability are not known, however. A comparative study was therefore made of two valve types--Björk-Shiley (BS) and Carpentier-Edwards (CE). Thirty-nine patients with normally functioning valve prostheses (23 BS, 16 CE) were studied at least one year after surgery, by assessing red cell deformability measured as red cell filtration rate (RFR), red cell survival half-time with the Cr-51 isotope method (Cr-51 T1/2) and plasma-haemoglobin (P-Hb). The BS valve was shown to be more traumatic to the cells than the CE valve and effected greater reduction of the deformability of these cells. Significant intercorrelations were found between RFR, CR-51 T1/2 and P-Hb.

Aortic Valve↗
PubMed1985

Changes in red cell deformability associated with anaesthesia and cardiopulmonary bypass in open-heart surgery.

Red cell deformability was observed during open-heart surgery in 59 patients. Deformability, assessed with a standard microfiltration method, was expressed as red cell filtration rate (RFR) in microliter/s. The mean preoperative value, 38.9 +/- 1.0 microliter/s, showed a generally falling tendency. The first significant decrease in mean RFR (by 18%) followed induction of general anaesthesia, and the second (by 15%) was seen 60 min after the start of cardiopulmonary bypass (CPB). The major decrease in RFR during CPB was found at the end of bypass, when it was reduced to 62% of the pre-CPB value. The percentage RFR reduction at the end of CPB showed significant correlation with 1) CPB duration (r = 0.49), 2) oxygen flow rate index (OFRI), i.e. flow/min in the bubble oxygenator/m2 bsa (r = 0.38), and 3) blood flow rate index (BFRI), i.e. average volume of blood pumped through the heart-lung machine/min CPB time/m2 bsa (r = 0.51).

Age Factors↗
PubMed1985

Improved red blood cell survival after cardiac operations with administration of urea during cardiopulmonary bypass.

The plasma hemoglobin and red blood cell survival (half-life of 51Cr) was studied in 48 patients undergoing single valve replacement or coronary artery bypass graft. Urea or placebo was administered during cardiopulmonary bypass in a prospective, randomized, double-blind manner to test the potential effect on mechanical hemolysis. The mean plasma hemoglobin level at the end of extracorporeal circulation was significantly lower in the urea-treated groups (coronary artery bypass 342 mg/L; valve replacement 364 mg/L) than in the control groups (coronary artery bypass 635 mg/L, p less than 0.05; valve replacement 518 mg/L, p less than 0.01). The half-life of 51Cr was significantly longer in the urea-treated patients (coronary artery bypass 18 days; valve replacement 16 days) than in the control groups (coronary artery bypass 12.4 days, p less than 0.01; valve replacement 12.7 days, p less than 0.001) but still below the normal reference value (29 +/- 4 days). The plasma hemoglobin returned to near normal values (50 mg/L) the day after operation (day 1) and remained low with no differences between control and urea-treated groups. The total blood hemoglobin was followed for 2 weeks after operation and showed significantly less anemia in the urea-treated group. The lowest mean blood hemoglobin level was noted between days 5 and 9-114 (coronary artery bypass) and 107 (valve replacement) gm/L in the urea-treated patients compared to 92.3 (coronary artery bypass, p less than 0.01) and 92.2 (valve replacement, p less than 0.01) gm/L in the control subjects. The reduction in the severity of the anemia led to less transfusion in the urea-treated patients (approximately 0.5 unit/patient) than in the control subjects (approximately 1 unit/patient, p less than 0.05) between days 3 and 14.

Blood Transfusion↗
PubMed1985

Resectional operations and long-term results in carcinoma of the esophagus.

The 5 year survival rate after resectional operations for carcinoma of the esophagus is still very low. Many factors have been identified as contributing to these poor long-term results. The main factor found in this study, comprising 102 patients undergoing resection out of 125 patients operated upon during a 10 year period, was nonradical resection. The main cause of nonradical resection was invasion of the tumor into the mediastinum, which was observed in 80% of the patients. In 43 of the 102 patients undergoing resection, the penetration of the carcinoma into the tissue surrounding the esophagus was observed only histologically. Thirty-three of the 38 hospital survivors in this group died within 2 years of the operation of recurrence of carcinoma. Fourteen of 17 survivors after resectional operations in whom the tumor growth was still limited to the esophagus were alive from 2 to 9 years (mean 6 years) after the operation, without evidence of recurrence.

Adult↗
PubMed1985

Immunological abnormalities in shrinking pleuritis with atelectasis.

The immunological status of 14 patients with shrinking pleuritis with atelectasis (SPA) was assessed by skin testing for delayed hypersensitivity reactions and in vitro tests of peripheral blood lymphocyte reactivity. The results were compared with those of 3 control groups, one consisting of healthy men, one of workers exposed to asbestos and one of workers exposed to quartz dust. Only 2 of 14 SPA patients showed a positive skin reaction to 2.4-dinitrochlorobenzene (DNCB). The cutaneous reactions to candida and varidase were significantly increased in the SPA group compared with the other groups (p less than 0.05). The response of the blood lymphocytes to stimulation with phytohaemagglutinin was significantly decreased in the SPA group (p less than 0.01), as was unstimulated lymphocyte proliferation (p less than 0.05). The results suggest a primary or secondary immune abnormality in the SPA group. The exact nature of the defect requires further elucidation.

Adult↗
PubMed1984

Electrocardiographic changes and their relation to serum enzyme activity after heart surgery.

In 80 patients who underwent heart surgery the incidence of electrocardiographic (ECG) changes after the operation was analysed. A precordial grid containing 24 leads and leads II, III and aVF was used. Electrocardiographic measurements were taken the day before the operation and again 5 days after the operation. New Q-waves were observed in 2 patients (2.5%) in the 24 precordial leads, in 2 patients in leads II, III and aVF, and in one patient in both precordial leads and leads II, III and aVF. New T-wave inversions were observed in 20 patients (25%) in the 24 precordial leads, in 5 patients (6%) in leads II, III and aVF, and in 3 patients in both precordial leads and leads II, III and aVF. A similar serum enzyme activity was observed both in patients developing Q-waves as well as T-wave inversions compared with cases in whom ECG changes did not appear.

Adult↗
PubMed1984

Haemodynamic effects of a single large dose of insulin in open heart surgery.

The haemodynamic effects of a single dose of 0.35, 1.5 or 7.5 IU fast acting insulin X kg bw-1 were studied in 24 patients undergoing aortocoronary bypass grafting. No inotropic drugs were used. Blood glucose was measured using a continuous blood glucose monitoring system, and was kept at the preinsulin level by administration of a 40% glucose solution. Injection of 0.35 or 1.5 IU X kg bw-1 of insulin did not have significant haemodynamic effects. Injection of 7.5 IU X kg bw-1 of insulin resulted in significant changes in cardiac index (+20.8%) and in total peripheral resistance (-13.9%) within 2 min. After 10 min a reduction of 16.8% was found in the diastolic pulmonary artery pressure. These haemodynamic effects occurred before glucose had been infused. The arterial pressure and the heart rate were unaffected. It is concluded that the injection of 7.5 IU X kg bw-1 of insulin results in an increase in cardiac index in patients who have undergone open heart surgery. The effects are not primarily related to stimulation of glycolysis.

Adult↗