Search PubMed⌕ Search

Biomedical subjects

M I Gold

Publications and source records attributed to M I Gold.

At least 37 records · Page 2Linked to original sources
PubMed1984

The epidemiology of defibrillation in a medical school complex.

Defibrillation is the definitive treatment for ventricular fibrillation (VF). Participation of physicians, paramedical personnel and lay people in cardiopulmonary resuscitation has significantly increased the survival from ventricular fibrillation. The number of defibrillators has increased and their primary placement within the hospital and community has changed. We studied the location, age, history, characteristics and maintenance of every defibrillator (n = 190) within a three hospital, medical school complex. Most defibrillators had been acquired recently but some dated from 1967. More than 85% were plug-in, non-portable. The government hospital had the lowest ratio of defibrillators to beds, but its maintenance, reliability and records were ths most efficient. We conclude that the increase in the number of defibrillators and its modernization reflects their importance, and that the type of hospital determines the age, type of machine, maintenance, and quantity.

Electric Countershock↗
PubMed1983

Chronic obstructive pulmonary disease and respiratory complications.

Patients with chronic obstructive pulmonary disease (COPD) (N = 148) underwent general anesthesia with halothane (H) or isoflurane (I) each administered randomly to 74 patients. One hundred and ten pre-, intra-, and postoperative variables were analyzed, including outcome variables, which included intra- and postoperative respiratory complications. Univariate computer analyses demonstrated no differences between H and I groups with respect to all variables, the exception being tachycardia, which occurred significantly more frequently in patients given I. Log-linear analyses revealed that no interactions existed between H or I groups, the non-outcome variables, and the complications. We conclude that patients with COPD respond similarly to H and I and that these anesthetics are associated with similar incidences of respiratory complications.

Anesthesia, Inhalation↗
PubMed1981

The mini-Wright expiratory peak flow meter.

The purpose of this study was to compare the recently modified mini-Wright peak flow meter with the Wright peak flow meter. One hundred adult patients were arbitrarily divided into two groups, based on their average peak flow on the mini-Wright device. A strong positive correlation in excess of 0.90 was shown. We believe that the smaller, cheaper device is as accurate as the Wright peak flow meter.

Adult↗
PubMed1981

Temperature correction of arterial blood-gas parameters: A comparative review of methodology.

The need for accurate clinical diagnosis and appropriate intervention requires that a modern blood-gas laboratory have the means to correct for significant discrepancies between patient temperature and the temperature at which in vitro blood samples are analyzed. Recent advances in mini- and microcomputer technology permit application of any or all of the correction formulas above at modest cost and minimal inconvenience (See the Appendix). An expanded program for a TI-59 desk-top calculator and P-100C printer which gives labeled hard-copy readout of temperature-corrected pH, PCO2, PO2, and hemoglobin saturation values, as well as bicarbonate concentration and in vivo base excess is in daily clinical use in our operating room and is available from the authors upon request.

Bicarbonates↗
PubMed1981

Arterial oxygenation in conscious patients after 5 minutes and after 30 seconds of oxygen breathing.

This study compares continuously measured arterial oxygen tension (PaO2) in normal unanesthetized patients after four maximally deep breaths of 100% O2 within 30 seconds, to (PaO2) values observed after 5 minutes of spontaneously breathing 100% O2 at normal rates and tidal volumes. Mean (PaO2) after 5 minutes of O2 breathing was 350 +/- 36 (SD) torr, not significantly higher (p greater than 0.05) than after four breaths of O2 (339 +/0 34 torr). Mean arterial oxygen content was 19.6 +/- 2.1 vol % in both periods. For purposes of increasing arterial oxygenation before anesthetic induction the four-breath, 30-second technique and 5 minutes of oxygen breathing are equally effective.

Adult↗
PubMed1981

Arterial oxygenation during laryngoscopy and intubation.

Arterial oxygenation during laryngoscopy and tracheal intubation was studied in 37 patients, 22 taking four maximally deep breaths of O2 within 30 seconds, and 15 breathing air immediately before anesthetic induction. In both groups of patients induction was followed by ventilation with 100% O2 by face mask before laryngoscopy, which was followed by intubation. Both mean arterial O2 tension (PaO2) and mean arterial O2 content (CaO2) increased significantly after four breaths of O2 in 30 seconds (339 +/- 34 (SD) vs 77 +/- 5, p less than 0.05, and 19.6 +/- 2.1 vs 18.8 +/0 2.1, respectively, p less than 0.05). At the end of laryngoscopy, mean PaO2 remained significantly greater in preoxygenated patients than in air-breathing patients (353 +/- 33 torr vs 319 +/- 26 torr, respectively, p less than 0.05). After intubation, mean PaO2 in preoxygenated patients remained higher than in air-breathing patients (332 +/- 34 vs 289 +/- 23 torr, p less than 0.05). Calculated mean CaO2 was not significantly different for the two groups during either maneuver. We conclude that four breaths of O2 in 30 seconds before anesthetic induction elevates PaO2 but provides insignificant improvement in CaO2 during laryngoscopy and intubation when the anesthetic routine includes ventilation of the patient with O2 by face mask after induction and before laryngoscopy.

Adult↗
PubMed1981

Isobaric tetracaine spinal anesthesia and the lithotomy position.

The extent and pattern of anesthesia produced by hyperbaric and by isobaric 0.5% tetracaine spinal anesthesia were compared in this blind-observer, randomized study of 103 spinal anesthetics performed in 98 patients having genitourinary surgery in the lithotomy position. Pinprick stimulation showed no significant differences in maximum segmental sensory levels, times to maximum level, or duration of anesthesia for isobaric as compared to hyperbaric tetracaine. No parameters were significantly altered by barbotage of isobaric tetracaine solutions. With injections given to patients in the sitting position and with patients subsequently maintained in a horizontal lithotomy position before being put in the lithotomy position, the addition of dextrose to tetracaine solutions injected at room temperature into the subarachnoid space does not significantly alter the cephalad spread of spinal anesthesia.

Adult↗
PubMed1981

Density of normal human cerebrospinal fluid and tetracaine solutions.

Density and specific gravity (SG) were determined at two or more temperatures between 23 and 37 C for 15 samples of normal human cerebrospinal fluid (CSF) and CSF mixed with tetracaine, and for tetracaine solutions commonly used for spinal anesthesia. Density was determined from measured weight and volume, and SG was calculated using the density of water at the same temperature. With 95% confidence limits, SG of normal human CSF at 37 C ranges from 1.0063 to 1.0075, less variation than previously reported. Changes in temperature altered the densities of dextrose, tetracaine, and CSF, alone or in combination, in a parallel manner, but SG remained constant for each solution over the observed temperature range.

Adult↗
PubMed1979

Pulmonary mechanics during general anaesthesia. The influence of mechanical irritation on the airway.

The changes in pulmonary resistance (RL) and compliance (CL), following airway irritation and surgical stimulation, were investigated in 19 anaesthetized, paralysed patients. Thirteen were normal, while six had objective evidence of chronic obstructive pulmonary disease (COPD). Broncho-carinal irritation with a suction catheter produced a 27% increase in RL (0.58+/-0.32kPa litre-1 s to 0.74+/-0.40, P less than 0.01) and a 10% decrease in CL (0.87+/-0.19 litre kPa-1 to 0.81+/-0.22, P less than 0.01). These changes were associated with a significant increase in systolic arterial pressure and heart rate during clinical stages of anaesthesia (end-tidal enflurane, 1.3+/-0.4%, PaCO2 5.20+/-0.53 kPa). These changes did not correlate with depth of anaesthesia, but all returned to the pre-irritation value within 5 min. There was no difference in subjects considered normal and those with COPD. Surgical stimulation did not produce significant changes in pulmonary mechanics; however, repeated broncho-carinal irritation during surgery was associated with a transient increase in RL (P less then 0.01).

Adult↗
PubMed1978

Comparison of two methods of postoperative respiratory care.

After abdominal surgery, 64 patients were managed with one of the following two techniques of respiratory care: (1) deep breathing by way of a new device, an incentive spirometric three-ball, flow-measuring device (Triflo); and (2) standard episodic intermittent positive-pressure breathing (IPPB) every four hours. Both series of patients received therapy with a bronchodilator drug by nebulization. All patients had preoperative spirometric measurements followed by five consecutive days of therapy and spirometry. Chest x-ray films were obtained for all patients. There were no significant differences between the two methods of respiratory care, but 57 percent (17/30) in the group receiving therapy with IPPB developed pneumonia, atelectasis, or bronchitis, while only 29 percent (10/34) did so in the group using the incentive spirometric device (P less than 0.05). Spirometric differences were minimal, although the trend favored the incentive spirometric device. Principal conclusions were as follows: (1) deep breathing under the conditions of this investigation was equal to episodic therapy with IPPB; and (2) from an economic standpoint, IPPB, as it is currently practiced, may be disadvantageous when compared with the incentive spirometric device.

Abdomen↗