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Biomedical subjects

L D Lane

Publications and source records attributed to L D Lane.

25 records · Page 2Linked to original sources

Hemodynamic, ventilatory, and biochemical responses of panic patients and normal controls with sodium lactate infusion and spontaneous panic attacks.

Hemodynamic, ventilatory, and biochemical variables were measured in ten healthy adults and ten panic patients during infusion of 0.5 mol/L of sodium lactate. Physical activity, fitness level, and ambulatory electrocardiograms were also recorded. Lactate infusion doubled cardiac output, increased blood lactate levels by sixfold, and produced hypernatremia, hypocalcemia, and decreased serum bicarbonate levels in both groups but raised arterial pressure only in the patients. The patients hyperventilated before and during the infusion. Physiological responses and somatic complaints with the infusion differed little between the groups, but emotional complaints were six times more frequent among the panic patients. Eight patients but no control subjects interpreted their symptoms as a panic attack. Heart rate increased with only 14 of 31 recorded spontaneous outpatient panic attacks. Sodium lactate infusions appear to produce panic by mimicking the physiology of spontaneous panic. Treatment with cardioactive agents is not indicated in the absence of cardiopulmonary or autonomic nervous system abnormalities.

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Cardiovascular effects of vasoactive intestinal peptide in healthy subjects.

Hypotension and flushing are occasionally observed in patients with pancreatic cholera syndrome. Similar effects are produced when vasoactive intestinal polypeptide (VIP) is administered to healthy subjects. To characterize further these responses, serial measurements of heart rate, blood pressure, cardiac output and forearm blood flow were made in 6 healthy subjects during constant VIP infusion (400 pmol/kg/hr for 100 minutes). VIP infusion caused sustained vasodilatation and decreased total peripheral resistance and mean arterial pressure by 30 and 12%, respectively. Forearm resistance decreased by 65%. The effects on cardiac output and stroke volume were biphasic. During the early phase of VIP infusion (0 to 70 minutes), heart rate and cardiac output increased with only minor changes in stroke volume. Later (71 to 100 minutes) the tachycardia persisted, but cardiac output decreased toward control levels due to decreased stroke volume. Echocardiograms during the infusion demonstrated increased left ventricular contractility as defined by the relation between end-systolic wall stress and shortening fraction. These data document potent vasodilatory and inotropic actions of VIP. It is likely that intravascular volume losses from increased intestinal secretion account for the decreased stroke volume seen late in the VIP infusion period and immediately thereafter. The tachycardia appears to be an appropriate compensatory mechanism to maintain blood pressure in the presence of vasodilatation and loss of intervascular volume. These observations provide an explanation for the cardiovascular findings in patients with sudden release of VIP from tumors.

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Dangling: a review of relevant physiology, research, and practice.

Although dangling is a common nursing intervention, little research has been conducted to test its effectiveness or to compare various dangling methods. By contrast, abundant information is available about orthostatic responses. In this article the authors explain the physiologic principles underlying orthostatic responses, focusing on blood volume distribution and the role of the mechanoreceptors, discuss typical and atypical responses to dangling and standing, describe clinical manifestations of orthostatic hypotension and syncope, present research-based practice guidelines, and, provide specific recommendations for future research. Because of the wide variability in heart rate and blood pressure responses to orthostasis, the authors stress the importance of signs and symptoms such as nausea, pallor, dizziness, visual dimming, and impaired consciousness in assessing orthostatic tolerance. Studying rituals such as dangling can advance nursing practice, improve patient outcomes, and move nursing to a research-based practice.

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Oxygen uptake and cardiovascular responses in control adults and acute myocardial infarction patients during bathing.

Physiological responses before, during, and after three types of baths were determined in 18 patients who were 5 to 17 days postinfarction and 22 control adults. In the patients, oxygen consumption (VO2) averaged 6, 7, and 7 ml/kg/min, peak heart rate 105, 108, and 112 beats per minute, and rate pressure product 115, 120, and 111 for basin, tub, and shower bathing, respectively. Oxygen consumption during bathing was less than 3 times resting levels. The patients had a significantly lower VO2 during bathing than the control subjects. The patients' peak heart rates were higher than anticipated for the level of exertion, and sometimes exceeded the target heart rates used in predischarge testing. Peak heart rate and occurrence of dysrhythmia did not differ significantly between the three types of baths. In the women patients, rate pressure product was significantly higher after tub bath than after basin bath or shower. The subjects had no cardiovascular symptoms during bathing, rated all three baths as light exertion, and disliked the basin bath. The data show that the physiologic costs of the three types of baths are similar, differences in responses to bathing seem more a function of subject variability than bath type, and many cardiac patients can take a tub bath or shower earlier in their hospitalization. However, more research is needed to predict patients likely to have an exaggerated response to bathing and to develop clear guidelines for bath method selection and progression.

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