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Biomedical subjects

M F Babinski

Publications and source records attributed to M F Babinski.

6 recordsLinked to original sources
PubMed1987

Anesthetic considerations in the patient with acute spinal cord injury.

The extent and level of the spinal cord injury as well as the presence of associated injuries affects the choice of anesthetic agents, techniques, and monitoring modalities. The role of the anesthesiologist is not limited only to the administration of anesthesia, but frequently his active participation in the team approach care of the spinal cord injury patient is needed during preoperative treatment and postoperatively in the ICU setting. Understanding of the pathophysiologic changes related to the spinal cord injury helps in the delivery of better anesthetic care for severely handicapped patients.

Anesthesia, General↗
PubMed1986

Continuous-flow apneic ventilation during thoracotomy.

Continuous-flow apneic ventilation (CFAV) by endobronchial insufflation of conditioned gas was evaluated in dogs during thoracotomy. In Group 1 (n = 6), dogs were anesthetized with pentobarbital (25 mg/kg). An endobronchial catheter (2.5 mm ID) was introduced into each mainstem bronchus using a fiberoptic bronchoscope and held in place by an endotracheal tube. Before the onset of CFAV (total flow 1.01 X kg-1 X min-1, the animals were paralyzed with pancuronium bromide and muscle relaxation was monitored with a peripheral nerve stimulator. The CFAV delivery system consisted of a flow meter, air/oxygen blender, oxygen analyzer, heated humidifier, and ultrasonic spirometer. Blood gas values were measured after 30 min of spontaneous ventilation, and CFAV with: 1) closed chest, fractional inspired O2 concentration (FIO2) 0.21; 2) open chest, FIO2 0.21; 3) open chest, FIO2 0.21, continuous positive airway pressure (CPAP) 5 mmHg; and 4) open chest FIO2 0.4, CPAP 5 mmHg. This last combination resulted in a mean PaO2 of 113.1 +/- 5.5 (SEM) mmHg and a PaCO2 of 35.0 +/- 2.1 (SEM) mmHg. In Group 2 (n = 6), animals with open chests were ventilated with CFAV (FIO2 0.4 and CPAP 5 mmHg) for 5 h. Adequate oxygenation and ventilation were achieved. PaCO2 after 5 h of CFAV was 41.8 +/- 1.9 (SEM) mmHg compared with 40.8 +/- 1.9 (SEM) mmHg during spontaneous breathing. PaO2 after 5 h of CFAV was 138.1 +/- 11.7 (SEM) mmHg. There were no significant changes observed in vascular pressures. Significant differences in other hemodynamic parameters were probably due to pentobarbital anesthesia. Adequate gas exchange can be achieved during CFAV in dogs with open chests for 5 h.

Animals↗
PubMed1986

Effect of nitrogen on carbon dioxide elimination during continuous flow apneic ventilation in dogs.

Continuous endobronchial insufflation of air in paralyzed animals (continuous flow apneic ventilation - CFAV) has been shown to maintain adequate oxygenation and carbon dioxide removal. CFAV in patients using oxygen resulted in adequate oxygenation but a mean rise in PaCO2 of 0.6 mmHg/min (0.08 kPa/min). This experiment compared carbon dioxide removal in dogs with air and oxygen. Ten dogs were anesthetized and paralyzed, and CFAV was used for 1 h with either air or oxygen in a randomized fashion. Adequate oxygenation was obtained with air and oxygen. Normal PaCO2 levels were obtained with air; however, in the animals where oxygen was used, PaCO2 levels rose to a mean of 6.45 +/- s.e. mean 0.4 kPa (48.5 +/- s.e.mean 3.2 mmHg).

Air↗
PubMed1985

Volume-controlled high frequency positive pressure ventilation for upper abdominal surgery. A clinical report.

Volume-controlled high-frequency positive pressure ventilation was evaluated and compared to intermittent positive pressure ventilation during anesthesia in 74 patients undergoing biliary tract surgery. There were no statistically significant differences in oxygenation or ventilation. Significantly lower airway pressures and lower tidal volumes were recorded during high frequency positive pressure ventilation. This technique was also used in eight morbidly obese patients during gastric stapling surgery, and provided adequate oxygenation and ventilation. Used intra-operatively, it also produced a quiet operative field, which the surgeons appreciated during cannulation of the biliary duct and stapling of the stomach. At the end of the anaesthesia, high frequency positive pressure ventilation was superimposed on spontaneous breathing and operated as a new mode of intermittent mandatory ventilation. This reduced the risk of hypoxia at the time of emergence from anaesthesia and at tracheal suctioning.

Anesthesia, General↗
PubMed1985

Clinical application of continuous flow apneic ventilation.

Continuous flow apneic ventilation (CFAV) was studied in five adult female patients. After induction of anesthesia with thiopental sodium (5 mg/kg) and fentanyl (5 micrograms/kg), and paralysis with pancuronium bromide (0.12 mg/kg), the patients were ventilated with oxygen at an FIO2 of 1.0 by face mask. Two polyethylene catheters (outside diameter [OD] 2.5 mm) were each inserted into the right and left mainstem bronchi. Each catheter had a curved tip measuring 2 cm in length. The angulation of the catheter tip from the axis was 20 degrees for the right side and 30 degrees for the left side. The endobronchial position was checked by fiberoptic bronchoscopy. Subsequently, tracheal intubation was performed using a 7.5 mm OD tracheal tube. CFAV was started when both catheters were connected to the gas delivery system. Humidified oxygen was delivered at total flows between 0.6 and 0.7 1/min. Arterial blood gases were analyzed every 5 min for 30 min. Monitoring included electrocardiogram, indirect blood pressure, heart rate, temperature, and peripheral nerve stimulation. Adequate oxygenation was maintained in all patients, 39.76 +/- 4.32 kPa (299 +/- 37 mmHg) at 30 min. There was a significant rise in Paco2 (P less than 0.05) at 30 min compared to the control, 4.92 +/- 0.25 kPa compared to 7.30 +/- 0.53 kPa (37.0 +/- 1.9 mmHg compared to 54.9 +/- 4.0 mmHg). There was a mean rise in Paco2 of 0.03 kPa/min (0.6 mmHg/min) compared to 0.5 kPa/min (3.8 mmHg/min) with apneic diffusion ventilation. In one patient there was no increase in Paco2 during the 30 min of CFAV.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗