Biomedical subjects

M Halligan

Publications and source records attributed to M Halligan.

5 recordsLinked to original sources

PubMed2003

A clinical evaluation of the Bonfils Intubation Fibrescope.

The Bonfils Intubation Fibrescope is a rigid optical instrument for performing orotracheal intubation. We describe its introduction into our clinical practice in 60 patients with normal airways who required orotracheal intubation for elective surgery. Two anaesthetists each performed 30 attempts to intubate, in turn, in patients who received a standard general anaesthetic with neuromuscular blockade. Intubation was successful in 59 out of 60 cases. The median (IQR [range]) time to intubation was 33 s (24-50 [13-180] s). Median (IQR [range]) verbal rating score for difficulty was 2 (1-3 [0-10]). There was a significant correlation between the intubation times and the verbal rating score (p < 0.01). There was evidence of airway trauma in the single patient in whom intubation failed. The Bonfils Intubation Fibrescope is an effective instrument for orotracheal intubation in normal subjects.

Adult↗

PubMed2002

Effects of chronic occupational exposure to anaesthetic gases on the rate of neutrophil apoptosis among anaesthetists.

BACKGROUND AND OBJECTIVE: Volatile anaesthetic agents are known to influence neutrophil function. The aim was to determine the effect of chronic occupational exposure to volatile anaesthetic agents on the rate of neutrophil apoptosis among anaesthetists. To test this hypothesis, we compared the rate of neutrophil apoptosis in anaesthetists who had been chronically exposed to volatile anaesthetic agents with that in unexposed volunteers. METHODS: Venous blood (20 mL) was withdrawn from 24 ASA I-II volunteers, from which neutrophils were isolated, and maintained in culture. At 1, 12 and 24 h in culture, the percentage of neutrophil apoptosis was assessed by dual staining with annexin V-FITC and propidium iodide. RESULTS: At 1 h (but not at 12 and 24 h) in culture, the rate of neutrophil apoptosis was significantly less in the anaesthetists--13.8 (12.9%) versus 34.4 (12.1%) (P = 0.001). CONCLUSIONS: Chronic occupational exposure to volatile anaesthetic agents may inhibit neutrophil apoptosis. This may have implications for anaesthetists and similarly exposed healthcare workers in terms of the adequacy of their inflammatory response.

Adult↗

PubMed1993

Short-term and long-term failures of anterior polymethylmethacrylate construct with esophageal perforation.

Three patients with a history of anterior spinal surgery treated with a polymethylmethacrylate construct had extrusion of their constructs. In two instances, there were life-threatening esophageal fistulas, mediastinitis, and sepsis 3 months to 10 years after the original surgery. Surgical treatment required removal of the construct, treatment of the esophageal injury, and use of new spinal stabilization. Based on their experience and a review of the literature, the authors strongly recommend against the use of polymethylmethacrylate alone in anterior procedures involving the cervical spine except to treat malignancies in patients with a short life expectancy.

Adult↗

PubMed1985

Ethics committee develops supportive care guidelines.

In response to widespread physician noncompliance with "do not resuscitate" (DNR) guidelines in 1983, the ethics committee at St. Joseph's Hospital, St. Paul, MN, set out to clarify the confusion over "supportive care only" (SCO) and DNR orders. A task force of nurses and physicians developed tentative supportive care guidelines and a subcommittee related ethical principles to the supportive care concept. The completed draft, "Principles and Guidelines in Deciding to Forego Life-Sustaining Treatment," was reviewed by the medical executive board and hospital attorney. St. Joseph's medical staff and board of trustees approved it in May 1985, and the document became hospital policy. The policy addresses patient autonomy, the burden/benefit principle, informed consent, and patient competency. It lists six guidelines for making supportive care plans. St. Joseph's has implemented the policy in several ways. Committee members make "ethics rounds" to discuss patient cases and the guidelines with hospital personnel. A brochure acquaints patients and their families as well as community groups with the guidelines. Nurses have introduced the guidelines to physicians in critical care units. When necessary, new insights will be incorporated into the guidelines.

Catholicism↗

PubMedDate not supplied

The effect of the anaesthetic agent isoflurane on the rate of neutrophil apoptosis in vitro.

BACKGROUND: Volatile anaesthetic agents influence neutrophil function, and potentially, the inflammatory response to surgery. AIM: The objective of this study was to determine the effect of isoflurane (1-4%) on human polymorphonuclear neutrophil apoptosis in vitro. METHODS: Venous blood from 12 healthy volunteers was exposed to 0, 1, and 4% isoflurane delivered via a 14G Wallace flexihub internal jugular cannula, at a fresh gas flow of 0.51/min for 5 minutes. Isolated neutrophils were assessed for apoptosis at 1, 12, and 24 hours in culture using dual staining with annexin V-FITC and propidium iodide (Annexin-V FITC assay). Data were analysed using paired, one-tailed Student's t-tests. p<0.05 was considered significant. RESULTS: At 1 hour apoptosis was inhibited in the 1% (5.1 [6.8]%; p=0.017) and 4% (4.8 [4.5]%; p=0.008) isoflurane groups compared to control (11.3 [6.9]%). At 12 and 24 hours, a dose-dependent inhibition of apoptosis was demonstrated, i.e. 4% > 1% > 0%. CONCLUSION: Human neutrophil apoptosis is inhibited in a concentration-dependent manner in vitro by isoflurane in clinical concentrations.

Adult↗