Biomedical subjects

M M McCall

Publications and source records attributed to M M McCall.

12 recordsLinked to original sources

PubMed1997

Adding hetastarch to the adult cardiopulmonary bypass prime does not affect patient outcomes.

Hespan (hetastarch), a synthetic colloid, is often used in priming cardiopulmonary bypass circuits. The purpose of this study is to determine the efficacy of adding hetastarch to the prime compared to adding no hetastarch. Twenty-four adult patients undergoing cardiopulmonary bypass received Hespan in the prime, while twenty-nine patients did not. Outcomes were compared using paired t-test, analysis of variance, analysis of covariance, and descriptive statistics, where p < 0.05 was considered significant. There were no significant differences in change in lung compliance, weight gain, time on the ventilator, or length of stay in the intensive care unit. Adding colloids to the adult CPB prime does not improve patient outcomes over priming exclusively with crystalloids.

Cardiopulmonary Bypass↗

PubMed1996

Comparison of three methods to estimate heparin loading dose for cardiopulmonary bypass.

Three available methods used to determine heparin loading dose were studied to determine the most reliable method for reaching a target pre-bypass activated clotting time (ACT) of 510 seconds. One hundred and seven patients were randomly assigned to one of three treatment methods: A) 300 units/kg; B) Hemostasis Management System (HMS); C) RX/DX. Five different lots of heparin were assigned to Groups A and B, and Group C had one heparin lot. Different lots were used to account for possible variations in heparin activity. Post-skin incision ACTs, post-heparin pre-bypass ACTs, and heparin loading doses were compared. The mean and standard deviation of the post-heparin pre-bypass ACTs were used to determine which method was most reliable to obtain a desired ACT. There was no statistical difference between different heparin lots. There was no difference in the post-heparin ACTs for the three methods (A:487 +/- 135 vs. B:474 +/- 105 vs. C:474 +/- 111 sec). There was a statistically significant difference between the standard deviation for the HMS and 300 u/kg standard deviations (p < 0.05). The HMS has the smallest deviation which makes it the most reliable predictor of heparin loading doses to reach a target ACT for cardiopulmonary bypass.

Adult↗

PubMed1995

Ventricular tachycardia may masquerade as supraventricular tachycardia in patients with preexisting bundle-branch block.

We present the cases of three patients with preexisting bundle-branch block in whom wide-complex tachycardias were considered to be of supraventricular origin because QRS morphologies were essentially unchanged from those during normal sinus rhythm. The patients experienced adverse effects from medications for supraventricular tachycardia. Ventricular tachycardia eventually was diagnosed in all three by means of invasive electrophysiologic studies. Ventricular tachycardia may masquerade as supraventricular tachycardia in patients with fixed intraventricular conduction disturbance. Emergency therapy based solely on the QRS identity criteria may result in poor clinical outcome.

Aged↗

PubMed1980