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Biomedical subjects

M W Hall

Publications and source records attributed to M W Hall.

7 recordsLinked to original sources
PubMed1985

Transcutaneous oxygen monitoring: economic impact on neonatal care.

Five years (1978 to 1982) of respiratory care data were reviewed to determine the changes in patient charges, hospital costs, and frequency of neonatal blood gas analysis created by the introduction of transcutaneous oxygen monitoring. During the 4 years of transcutaneous oxygen monitoring (1979 to 1982), an estimated $196,000 reduction in patient charges was accomplished. When reduced patient charges were balanced with the increased cost to the hospital for equipment, supplies, and personnel time, a net reduction of more than $100,000 for health care delivery was achieved. Transcutaneous oxygen monitoring is an example of technologic achievement in which society receives both economic and medical benefits.

Costs and Cost Analysis↗
PubMed1984

Effect of selected dietary buffers upon utilization of concentrate- or roughage-based cattle diets: laboratory studies.

Four chemical buffers were evaluated with in vitro rumen fermentation studies using both an 80% concentrate and a 50% roughage diet. Treatments included a positive control (PC), negative control (NC) and four buffered diets in which 500 mg of either CaHPO4, CaCO3, NaHCO3 or Na4P2O7 were added. The PC consisted of unbuffered diet with one part rumen fluid and four parts McDougall's artificial saliva. In the unbuffered NC and buffered treatments, three-fourths of the artificial saliva was replaced by iso-osmotic saline. In the concentrate-based diet, NaHCO3 and Na4P2O7 elevated (P less than .05) pH above the NC. Starch digestion and total VFA were increased (P less than .05) by NaHCO3 compared with the NC while the molar proportion of individual VFA was not altered. Tetrasodium pyrophosphate had no effect on starch digestion or total VFA, but did increase (P less than .05) the molar proportion of acetic acid. Regarding the 50% roughage diet, both NaHCO3 and Na4P2O7 elevated (P less than .05) starch and cellulose digestion and total VFA compared with the NC. Both NaHCO3 and Na4P2O7 increased (P less than .05) the molar proportion of acetate to equal that of the PC. Tetrasodium pyrophosphate decreased (P less than .05) apparent starch digestion compared with the NC, but increased (P less than .05) the molar proportion of acetate. Compared with the NC, CaHPO4 and Na4P2O7 increased the quantity of microbial alpha-amino N in both diets. Soluble P was highly correlated with microbial protein synthesis in both the concentrate- and roughage-based diets (.92 and .90, respectively).

Ammonia↗
PubMed1983

Infant ventilator design: performance during expiratory limb occlusion.

We examined the specifications and design of the inspiratory pressure regulating valve of 8 continuous flow, pressure-limited infant ventilators. Two pressure regulating designs are currently available; one placing the primary pressure regulating valve on the inspiratory limb, the other placing it on the expiratory limb. Seven ventilators incorporate the latter design to limit inspiratory pressure and must have a safety pressure-relief valve located on the inspiratory limb to vent pressure in case of circuit occlusion. These pressure-relief valves are generally set by the manufacturer far in excess of pressures normally used for infant ventilation. Alarm systems are often absent or inadequate to warn of high pressure conditions during circuit obstruction. A case report detailing the fatal complication of prolonged excessive airway pressure during circuit occlusion is presented. Improvements in the pressure-relief valve designs currently available are possible, and may be necessary to provide adequate protection from barotrauma. The majority of infant ventilators currently available expose the patient to unnecessary excessive airway pressures in the case of expiratory limb occlusion, and the lack of alarm systems may leave the operator unaware of malfunction.

Air Pressure↗
PubMedDate not supplied

In vitro model for studying the effects of hemodynamics on device induced thromboembolism in human blood.

Biomateria related thromboembolism is a complex phenomenon, affected by such variables as biomaterial surface chemistry, hemodynamics, and individual donor variations. Thus, isolation of the individual variables would greatly facilitate the understanding and inhibition of this phenomenon. A low volume in vitro model with this potential has been developed, with the initial focus on studying the influence of hemodynamics on thromboembolism (TE) in human blood. Patterned after a larger in vitro model for bovine blood used successfully in our laboratory, the smaller model directed fresh human blood in a single pass through 1/32 inch ID PVC tubing and a flow cell at 3 ml/min. The flow cell consisted of alternating abrupt expansions and contractions of cylindrical tubing that could be modified to study the effects of hemodynamic parameters on TE. Thrombus growth in the flow cell was monitored visually by transillumination microscopy. Emboli from the flow cell were detected continuously by a light-scattering microemboli detector (LSMD), and their strength was assessed by using the constant-pressure filtration (CPF) method. Preliminary studies confirmed the potential of this model. Thrombi were observed visually in the flow cell at sites of high vorticity and at flow separation and reattachment points and were also observed to embolize. Emboli were detected by the LSMD downstream of the flow cell in significantly greater numbers than upstream and were coincident with the embolization of thrombi observed visually. Emboli collected downstream of the flow cell occluded the CPF filters at 50 mm Hg, suggesting that they possessed sufficient strength to occlude microvessels. This model may be used to aid in developing a computer model of thromboembolism, which could subsequently be refined with clinical data.

Hemodynamics↗
PubMedDate not supplied

Formation of occlusive platelet aggregates in whole blood caused by low concentrations of ADP.

Minute concentrations of ADP are released when platelets are exposed to shear stress during extracorporeal flow. However, based on current methods, these low concentrations have not been shown to have a significant impact on platelet function. We report here the formation of rigid microaggregates (MA) in response to low concentrations of ADP. A newly developed light scattering whole blood aggregometer (LSWBA) was used to detect an aggregation dose response to ADP (0-2 microM) in heparinized (1.5 U/ml) human blood. Although the LSWBA showed that ADP induced MA were reversible, evidence provided by constant pressure filtration (50 mm Hg) suggested that aggregates existed as rigid particles in the blood for up to 6 minutes. The possible implications of these findings to extracorporeal circulation are discussed.

Adenosine Diphosphate↗