Biomedical subjects

K Tremain

Publications and source records attributed to K Tremain.

3 recordsLinked to original sources

PubMed2000

The effects of continuous blood gas monitoring during cardiopulmonary bypass: a prospective, randomized study--Part I.

The use of continuous in-line blood gas management (CILBGM) is steeped in controversy concerning its potential utility and impact on patient outcomes. The purpose of this study was to determine whether the use of CILBGM results in improved quality of patient care. Fifty-nine patients were enrolled in a Institutional Review Board-approved, prospective, randomized study. An in-line blood gas monitor (CDI 500) was placed into the arterial and venous lines for all patients. Blood gas monitoring in the control group was managed by intermittent sampling (every 20-30 min), while the treatment group was managed with continuous monitoring. There were no differences between groups in preoperative, surgical, anesthetic, or perfusion variables. The accuracy of the in-line monitor was comparable to laboratory analysis for arterial blood gas parameters (N = 160; pH bias = 0.00; PaCO2 bias = -1.1 mmHg; and PaO2 bias = 0.7 mmHg). There was less deviation from target values (pH = 7.40, PaCO2 = 40 mmHg, PaO2 = 150-200 mmHg) when in-line monitoring was used versus intermittent sampling (N = 784; pH deviation = 0.05 +/- 0.03 vs. 0.03 +/- 0.01, p < 0.0001; PaCO2 deviation = 4.0 +/- 2.9 mmHg vs. 2.0 +/- 0.9 mmHg, p < 0.0001; and PaO2 deviation = 22.7 +/- 16.9 mmHg vs. 11.7 +/- 8.3 mmHg, p < 0.0001). In conclusion, the results of part I of this study demonstrate that the use of CILBGM results in more accurate blood gas management during CPB.

Analysis of Variance↗

PubMed2000

The effects of continuous blood gas monitoring during cardiopulmonary bypass: a prospective, randomized study--Part II.

The impact of blood gas management during cardiopulmonary bypass (CPB) on patient care has not been examined and remains controversial. The purpose of this study was to determine whether precise blood gas management during CPB influences patient outcome. Fifty-nine patients were enrolled in an Institutional Review Board-approved, prospective, randomized study. An in-line blood gas monitor (CDI 500) was placed into the arterial and venous lines for all patients. Blood gas monitoring in the control group was managed by intermittent sampling (every 20-30 min), while the treatment group was managed with continuous monitoring. Blood gas control and measured parameters were as follows: pH 7.40 +/- 0.05, PaCO2 40 +/- 5 mmHg, PaO2 200 +/- 50 mmHg. The treatment group had the CDI 500 guide clinical decisions. Compared to the control group, the treatment group consisted of significantly more diabetic (7% vs. 47%, p < or = 0.001), renal failure (3% vs. 13%, p < or = 0.01), and chronic obstructive pulmonary disease patients (7% vs. 20%, p < or = 0.01). Internal thoracic artery utilization was higher in treatment patients than control patients (67% vs. 95%, p < or = 0.02). No other differences existed in demographic, pharmacological, surgical, or anesthetic parameters. In the perioperative period, the control group required antiarrythmic support more frequently than the treatment group (10% vs. 0%, p < or = 0.05). Compared to the control group, the treatment group required antiarrythmic (18% vs. 10%, p < or = 0.05) and cardiac glycoside therapy (11% vs. 0%, p < or = 0.05) less frequently in the postoperative period. Although treatment patients required less intraoperative pacing and cardioversion and spent less time on mechanical ventilation, in the intensive care unit (ICU), and in the hospital than control patients, statistical significance was not achieved. In conclusion, the use of continuous, in-line blood gas monitoring resulted in improvement in a number of postoperative outcome variables, although ICU and hospital stay was not effected.

Aged↗

PubMed1980

Amblyopia and cortical binocularity.

Both the visual acuity of sustained-X cells in the area centralis of the retina and the binocular properties of visual cortical cells were studied in control cats, and in cats reared with divergent or convergent squint in one eye or with uniocular or binocular atropinization. The sustained-X cell acuity was normal in control cats with squint but with alternating fixation. The cellular acuity was reduced significantly in the squinting eye of the cats which lost the ability to fix with the deviating eye and in all penalized eyes of the cats regardless of whether one or both eyes had been atropinized. However, regardless of whether X cell amblyopia was present or not, all squinting cats and cats with uniocular penalization showed a significant reduction in the number of binocularly driven cortical cells. Nevertheless, the amblyopia of X cells in the retina was correlated with a loss of proportion of cortical cells driven by the amblyopic eye compared with that driven by the non-amblyopic eye. Thus amblyopia and loss of cortical binocularity (not stereo acuity) appear to have different physiological bases.

Amblyopia↗