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Biomedical subjects

J S Redding

Publications and source records attributed to J S Redding.

At least 37 records · Page 2Linked to original sources

Comparison of two automated instrument systems for rapid susceptibility testing of gram-negative bacilli.

The Vitek AutoMicrobic System with GSC-plus cards and the Abbott MS-2 system were tested in parallel and the results were compared directly with those of a reference microdilution minimal inhibitory concentration (MIC) procedure on a group of 262 clinical isolates of the family Enterobacteriaceae and of Pseudomonas aeruginosa. Results of both systems were compared with the reference MIC for category agreement, and in addition, the Vitek MICs were compared with those obtained by the reference procedure. The Vitek system provided an essential category correlation of 89.4% for enteric bacteria and 97.0% for P. aeruginosa. Vitek MICs agreed within 1 twofold dilutional increment for 86.3% of the enteric bacteria tested and for 96.2% of the P. aeruginosa isolates. The Abbott MS-2 essential categoric agreement was 92.0% for enteric bacteria and 92.4% for P. aeruginosa. If only aminoglycosides or carbenicillin were considered for P. aeruginosa isolates, the essential category agreement was 92.5% for the Vitek and 93.3% for the MS-2. The majority of MS-2 category errors (13 of 19) with P. aeruginosa involved gentamicin results on isolates whose reference MICs were 8 micrograms/ml and whose MS-2 results were susceptible (MIC less than or equal to 4 micrograms/ml). Retesting of the P. aeruginosa isolates in calcium-supplemented MS-2 broth increased the essential agreement for the aminoglycosides to 97.5%.

Anti-Bacterial Agents↗

Comparison of dopamine, dobutamine, and epinephrine in CPR.

Two new catecholamines, dopamine and dobutamine, have found widespread use for cardiovascular support. The relative efficacy of these drugs in aiding resuscitation from cardiopulmonary arrest is unknown. Dogs were subjected to either asphyxial or fibrillatory cardiac arrest. Resuscitation was attempted with artificial ventilation, closed chest cardiac massage, and one of four iv drug protocols: dopamine, 40 mg; epinephrine, 1 mg; dobutamine, 50 mg; or no drug. The incidence of successful resuscitation from both asphyxial and fibrillatory arrest was significantly greater in groups receiving dopamine or epinephrine than in groups receiving dobutamine or no drug. There was no difference in success between the dopamine and epinephrine groups. The authors conclude that, in dogs, dopamine is a useful adjunct to CPR because of its alpha-adrenergic stimulating activity at high doses. Dobutamine does not appear to be of value as the initial therapy of cardiac arrest. If the response in man is similar to that in dogs, dopamine may provide an alternative to epinephrine during CPR.

Animals↗

Flail chest syndrome and pulmonary contusion.

Controlled mechanical ventilation has been the mainstay of treatment in the flail chest syndrome for more than 20 years, retrospective studies have recently suggested that the technique is unnecessary, and they infer that spontaneous ventilation or intermittent mandatory ventilation are equally effective. The common theme of these investigations is that mechanical ventilation is required only to relieve hypoxemia associated with the underlying contusion. In two cases of flail chest, spontaneous respiratory efforts resulted in complete disruption of the fracture sites and thus prolonged the duration of mechanical ventilation that was required. In severe cases of flail chest syndrome, there is still a need for controlled mechanical ventilation to splint the rib fractures in a position which facilitates union of the fragments.

Adult↗

Airway management in patients with central nervous system depression.

In central nervous system (CNS) depressed patients, a sequential approach is necessary to prevent airway obstruction and aspiration of vomitus. Endotracheal intubation is indicated if the lash reflex is absent, response to stimulation is not purposeful, or airway obstruction develops when the patient's neck is flexed. Aspiration may result from CNS depression, abnormal glottic function, or extreme debilitation. It may occur in cannulated patients with improper cuff management or after decannulation while glottic reflexes are ineffective.

Adolescent↗

Oxygen concentrations received from commonly used delivery systems.

The mean inhaled oxygen concentrations received from five devices commonly used for delivering supplemental oxygen to spontaneously breathing patients were determined. The ideal technic for the determination would require direct measurement of mean alveolar oxygen concentration. Since this is not feasible, we plotted arterial oxygen tensions against known inhaled oxygen concentrations in volunteers. The fitted equations were then used to determine mean inhaled oxygen concentrations received by the volunteers while breathing from each device. The volunteers received accurately determined oxygen concentrations from those devices employing the Venturi principle at settings of 40% or less. The concentrations received did not coincide with the settings with the Venturi devices above 40%, and highly variable with the non-Venturi devices. Variability in the concentrations received was related to the fact that the volunteers' peak inspiratory flow rates exceeded total gas flows delivered by the devices.

Humans↗