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Biomedical subjects

J E Gruber

Publications and source records attributed to J E Gruber.

6 recordsLinked to original sources
PubMed1988

Development of acidosis in human beings during closed-chest and open-chest CPR.

We studied the development of acidosis, as measured by blood gases, in a convenience sample of 16 patients undergoing five minutes of closed-chest CPR (CC-CPR) followed by five minutes of open-chest CPR (OC-CPR). To eliminate the influence of variable pCO2 on serum pH, all blood gas values were adjusted to a pCO2 of 40 mm Hg. Adjusted pH fell a mean of 0.09 U (SEM +/- 0.03, P = .02) with five minutes of CC-CPR and then 0.05 U (SEM +/- 0.02, P = .05) with five minutes of OC-CPR. The decline in adjusted pH during CC-CPR was statistically comparable to the decline that occurred during OC-CPR. The development of acidosis as measured by blood gases does not appear to be significantly different for patients undergoing five minutes of CC-CPR versus five minutes of OC-CPR when OC-CPR follows CC-CPR.

Acidosis↗
PubMed1985

Right ventricular enlargement.

Right ventricular enlargement (RVE) encompasses dilatation and hypertrophy of the right ventricular chamber. Severe RVE produces characteristic ECG changes including right axis deviation and large S waves in the left precordial leads. Treatment is directed at the underlying cause.

Cardiomegaly↗
PubMed1985

Left ventricular enlargement.

UNLABELLED: Electrophysiology/Characteristics/Morphology: Increased duration of QRS interval, delay of intrinsicoid deflection, and increased QRS voltage tend to occur. "Strain" refers to T-wave inversion with depressed upwardly convex ST segments in the setting of LVE. Leftward axis is common, but not always found with LVE. EKG diagnosis: See Romhilt-Estes Scoring System outlined in Table 1. Conditions impairing diagnosis: asymmetrical septal hypertrophy, prior MI, CHF, pericardial or pleural effusions, anasarca, pulmonary emphysema, RBBB, LBBB, obesity, concomitant right ventricular enlargement. False positive diagnosis can occur in children and young adults, or in patients who are emaciated or have a slender body build. SIGNIFICANCE: Hypertension is the most common cause. New onset or increasing strain pattern may signify LV dilatation and failure, or myocardial ischemia, and warrants careful evaluation. TREATMENT: As per underlying cause.

Cardiomegaly↗
PubMed1982

Paths and gates: the sources of recidivism and length of stay on a psychiatric ward.

Four "pathway" (age, sex, social class, and number of dependents) and three "gatekeeper" (previous admission, previous ward terms, and severity of patient disorder) variables are used to predict recidivism rates and lengths of stay for patients admitted to a psychiatric ward in a general hospital during a 1-year period. There were three major findings. First, the gatekeeper variables were, by themselves, useful for predicting length of stay; additional information, in the form of the pathway variables, was needed to adequately explain differences in recidivism. Second, while most of the effects on recidivism were direct, most of the effects on length of stay were indirect or mediated through the variable of the severity of patient problems. Third, it was discovered that recidivism and length of stay are inversely related: patients with high recidivism rates, for example, tend to have relatively short average lengths of stay. Based on four patterns of recidivism and length of stay, a typology was developed to facilitate a better understanding of patient behavior.

Adult↗
PubMedDate not supplied

Protracted metabolic acidosis: the impact of acute ethanol in hemorrhagic shock.

The effects of acute ethanol administration on acid-base balance and hemodynamic parameters were studied in a canine model. Ten mongrel dogs, anesthetized and maintained on a volume ventilator, underwent splenic artery ligation 30 minutes prior to study. Group A (N = 5) served as controls. Thirty minutes after drug administration, the animals underwent a 20-cc/kg hemorrhage over 15 minutes. Thirty minutes postphlebotomy, resuscitation was performed with the same volume of homologous blood. Acid-base and hemodynamic parameters were monitored over 3.5 hours. Ethanol levels peaked 60 minutes following administration at 207 +/- 13 mg%. During the entire study, no differences were observed in heart rate, pulmonary capillary wedge pressure, systemic vascular resistance index, pO2, or pCO2, between the two groups. Following hemorrhage, statistically significant decreases in pH, mean arterial pressure (MAP), cardiac index (CI), and left ventricular stroke work index (LVSWI) developed in group A compared to controls. Maximal disparity developed in pH (7.21 +/- 0.05 to 7.33 +/- 0.02, P < 0.01), MAP (67 +/- 11 v 110 +/- 9 torr, P < 0.01), CI (1.69 +/- 0.24 compared to 2.72 +/- 0.19 L/min/M2, and LVSWI (18.7 +/- 1.2 compared to 44.9 +/- 4.8 gr-meter/M2/beat, P < 0.01) at 60, 45, 30, and 75 minutes postphlebotomy. In this study, ethanol directly or indirectly caused an increased metabolic acidosis and myocardial depression in the post-hemorrhage period.

Acidosis, Lactic↗