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Biomedical subjects

I H Black

Publications and source records attributed to I H Black.

6 recordsLinked to original sources
PubMed2000

Central venous pressure measurements: peripherally inserted catheters versus centrally inserted catheters.

OBJECTIVE: To determine whether central venous pressure measurements taken from a peripherally inserted central catheter (PICC) correlate with those from a centrally inserted central catheter (CICC). DESIGN: A pilot bench study followed by a prospective, non-blinded, clinical comparison. SETTING: A 16-bed medical coronary intensive care unit and a 30-bed surgical intensive care unit at a university hospital. PATIENTS: Seven surgical intensive care unit patients and five medical coronary intensive care unit patients. INTERVENTIONS: During the bench study, a simple manometer system was set up to test the catheters. During the clinical study, measurements of central venous pressure were recorded from patients who had an indwelling CICC and PICC concomitantly. Positions of the catheter tips in the chest were verified by radiography. Paired central venous pressure measurements were taken from 19-gauge dual-lumen PICCs and from 7-Fr, 16-gauge, 18-gauge, and pulmonary artery catheter CICCs, all with continuous pressure infusion devices. MEASUREMENTS AND MAIN RESULTS: Bench work showed that PICCs, because of their longer length and narrower lumen, have a higher inherent resistance, which can be overcome with a continuous infusion device. During the clinical study, three to 12 paired, digital, central venous pressure measurements were recorded from each of 12 patients for a total of 77 data pairs. Measurements were recorded at end-expiration. Mean central venous pressure from the CICCs was 11 + 7 mm Hg, and from the PICCs was 12 + 7 mm Hg. PICC pressure versus CICC pressure correlated (r = 0.99) for all data pairs. Analysis by repeated measures showed PICC central venous pressure more than CICC central venous pressure by 1.0 + 3.2 mm Hg (p = 0.02). CONCLUSIONS: PICCs can be used to measure central venous pressure and to follow trends in a clinical setting when used with a pressure infusion device to overcome the natural resistance of the PICC. Central venous pressure recorded via PICCs is slightly higher, but the difference is clinically insignificant.

Adult↗
PubMed1998

Epidural anaesthesia for caesarean section in an achondroplastic dwarf.

We describe the anaesthetic management of a parturient with achondroplasia presenting for Caesarean section under epidural anaesthesia. A block extending from T4 to S4 was established over 25 min using a total of 12 ml of 2.0% lidocaine (lignocaine) with epinephrine (adrenaline) 1:200,000 and fentanyl 37.5 micrograms. Apart from mild discomfort during peritoneal incision, her perioperative course was uneventful. Achondroplasia is reviewed and the anaesthetic implications of the condition are discussed.

Achondroplasia↗
PubMed1984

Reversal of neuromuscular block. Heart rate changes with slow injection of neostigmine and atropine mixtures.

The effect on heart rate of different rates of injection (10 seconds, 1, 3 and 5 minutes) of a fixed dose (neostigmine 2.5 mg and atropine 1.2 mg) and a weight-related dose (neostigmine 50 micrograms/kg and atropine 25 micrograms/kg) of neostigmine-atropine mixture given for the reversal of residual competitive neuromuscular block was studied in 196 healthy adult patients. In both series slow injection lessened and delayed the initial rise in heart rate. The subsequent fall in heart rate was less when the drugs were injected over 3 min compared with the 10 seconds and 1 minute injection groups but when given over 5 minutes there was a steady fall in heart rate, more so with the weight-related dose. It is recommended that a neostigmine and atropine mixture should be administered over 3 min.

Adult↗
PubMed1979

A prospective study of liver enzyme and other changes following repeat administration of halothane and enflurane.

A prospective study of liver enzymes and other measurements following repeat administrations of halothane or enflurane was carried out in patients undergoing minor urological operations. The patient populations were similar with respect to frequency of factors which might influence liver function, social habits, drug therapy and time intervals between administrations. Sixty-three received two or more administrations of halothane and 66 received two or more administrations of enflurane, both drugs given with nitrous oxide in oxygen. There was a greater frequency of increased enzymatic activity following repeat administrations of halothane than following enflurane and the average alanine aminotransferase and gamma glutamyl transpeptidase concentrations were increased to a greater degree following halothane than enflurane. There was no change in the eosinophil count and no significant postoperative morbidity. Change in alanine aminotransferase, lactate dehydrogenase and gamma glutamyl transpeptidase occured more frequently in obese patients receiving halothane.

Aged↗