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Biomedical subjects

L R Del Guercio

Publications and source records attributed to L R Del Guercio.

At least 37 records · Page 2Linked to original sources
PubMed1982

Intraoperative anticoagulation during arterial reconstructive procedures.

The technique of thromboelastography was used to monitor the intraoperative administration of heparin during vascular surgical procedures. Interpatient response to 70 units per kilogram of heparin varied widely. There was no need, in any patient, for the use of protamine to reverse the effect of heparin. This, coupled with the absence of hemorrhagic complications, indicates that thromboelastography is a useful method for monitoring the administration of heparin during vascular surgical procedures.

Aged↗
PubMed1981

Noninvasive flowmetry in vascular surgery: use of a noninvasive electromagnetic flowmeter.

Using an in vitro model, the measurements made using a noninvasive electromagnetic flowmeter have been validated using standard square wave electromagnetic flowmetry. Clinically, the noninvasive electromagnetic flowmeter provides information as to the functional significance of vascular occlusive disease that is not available through other techniques, gives an accurate, quantitative measurement of the peak pulsatile blood flow through a limb, thus providing an index of tissue perfusion and therefore, the degree of involvement of the disease in the peripheral vascular system.

Arterial Occlusive Diseases↗
PubMed1981

Noninvasive cardiopulmonary monitoring.

Contrast dilution curves have been utilized for evaluation of hemodynamic function. Noninvasive techniques for this purpose usually have been qualitative, expensive, and cumbersome with minimal applicability to the newborn infant. The technique of roentgen densitometry has been utilized to screen children with heart murmurs. Characteristic curve patterns were identified for normal subjects and for patients with shunts with correlation to catheterization data. This technique is now being applied in a quantitative fashion to estimate cardiac output and left-to-right ductal shunts. Cardiac output volumes were inversely proportional to the difference of the second moments of the dilution curves obtained--the second moment being a measurement of the peak dispersion. The estimation of the percent of left-to-right shunt is related to the exponential decay of the left-sided curve.

Absorptiometry, Photon↗
PubMed1980

Monitoring operative risk in the elderly.

To reduce operative mortality in elderly patients, a system of preoperative staging, based on invasive monitoring, was developed. All of the 148 consecutive patients studied had been cleared for surgery by standard assessment, but only 13.5% had normal measured, hemodynamic, respiratory, and oxygen transport function. Mild physiologic aberrations, not requiring a delay in surgery, or more severe abnormalities, indicative of high operative risk, were found in 63.5% of the patients. Advanced and incorrigible functional defects found in the remaining 23% made them unacceptable risks for major surgery under general anesthesia, and all who underwent the planned operation in spite of the warning died. Invasive preoperative assessment of elderly patients discloses a high percentage of serious physiologic abnormalities requiring a delay in some and cancellation of the operation in others.

Aged↗
PubMed1980

Monitor-guided responses. Operability with safety is increased in patients with peripheral vascular diseases.

Poor cardiopulmonary reserve was demonstrated in a group of 75 elderly patients undergoing elective vascular reconstruction when cardiovascular hemodynamics were analyzed with the automated physiologic profile (APP) preoperatively. Only 25 patients (33.3%) had normal left ventricular function (LVF) and did not need any corrective therapy before surgery. Increment in preload was necessary in 20 patients (26.7%) to improve myocardial function; 30 patients (40%) revealed abnormal LVF and hence required pharmacologic modulation and preload adjustment, inotropic support, and afterload reduction to enhance the ventricular performance. Conventional methods of clinical evaluation did not reveal the degree of compromised ventricular function and potential high risk of surgical morbidity and mortality in many of these patients. The APP disclosed subtle and important physiologic aberrations indicating modification of anesthetic and operative procedures and precise modulation of physiologic factors. Optimization was achieved in all except two patients, and only one was denied the benefits of vascular reconstruction.

Aged↗
PubMed1980

The use of mixed venous blood gas determinations in traumatic shock.

A series of 10 seriously injured patients requiring resuscitation and definitive operative control of hemorrhage was studied. Simultaneous arterial and mixed venous blood gases were measured sequentially throughout the resuscitative and operative periods. Improvement of the mixed venous oxygen saturation was associated with survival. In this study, mixed venous oxygen saturations were valuable predictors of survival and were a helpful parameter to monitor during the resuscitative, operative, and immediate postoperative periods.

Humans↗
PubMed1978

Documentation of vasomotor dysfunction by indicator dilution curve analysis.

Indocyanine green dye dilution curves with abnormal contours have been recorded in four patients with acute and critical illnesses using standardized recording methods. The abnormal curves are characterized by a high and prolonged concentration of dye occurring after the peak concentration. This altered contour can be detected by use of routine mathematical processing since the derived hemodynamic parameters are affected by the altered contour. A physiologic basis for the altered curve contour is proposed.

Acute Disease↗
PubMed1978

A shunt equation for estimating the splenic component of portal hypertension.

A modification of the Berggren pulmonary shunt equation was derived for use in estimating the splenic component of portal hypertension. It was used in nine patients, six of whom had sufficient decreases in portal flow and pressure after splenic artery and coronary vein ligation. The average decrease in portal flow was 52%.

Adult↗
PubMed1977

Physiologic profiles in circulatory support and management of the critically ill.

An automated system has been developed for measuring hemodynamic, oxygen transport and tissue utilization functions. Rapid measurement and data analysis of physiologic profiles by paramedical personnel allow prompt evaluation of altered cardiovascular function. Evaluation of physiologic function allows therapeutic interventions to be instituted on a timely basis, appropriately directed toward improvement of the measured cardiovascular abnormalities. Physiologic profile studies were performed on 1016 occasions in 580 patients during a three-year period and form the basis of this report. Although utilized on hospitalized patients, there are implications for use in evaluating and treating all critically ill patients.

Biological Transport, Active↗