An inexpensive device for analyzing and monitoring the electroencephalogram.
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Biomedical subjects
Publications and source records attributed to N T Smith.
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The effects of prolonged enflurane and halothane administration on urine-concentrating ability were determined in volunteers by examining their responses to vasopressin before anesthesia and on days 1 and 5 after anesthesia. A significant decrease in maximum urinary osmolality of 264 +/- 34 mOsm/kg (26 per cent of the preanesthetic value) was present on day 1 after enflurane anesthesia, whereas subjects anesthetized with halothane had a significant increase in maximum urinary osmolality of 120 +/- 44 mOsm/kg. Serum inorganic fluoride level peaked at 33.6 muM and remained above 20 muM for approximately 18 hours. Thus, the threshold level for inorganic fluoride nephrotoxicity is lower than previously suspected.
Concentrations of 6-beta-hydroxycortisol (6-OHF), a polar metabolite of cortisol formed in the endoplasmic reticulum (microsomes) of the liver, and 17-hydroxycorticosteroids (17-OHCS) were measured in the urines of six healthy adult male volunteers exposed to a mean of 9.6 MAC-hours of enflurane anesthesia as an index of possible enzyme induction. The ratio of 6-OHF to 17-OHCS in 24-hour urine specimens collected five days before anesthesia was compared with the ratio of these metabolites in 24-hour urine specimens collected 16 to 18 hours after anesthesia. The ratio of 6-OHF to 17-OHCS increased markedly in five and decreased slightly in one volunteer following anesthesia. The results indicate that enflurane may cause induction of hepatic microsomal enzymes.
Changes in the peripheral blood leukocyte count and in the ability of lymphocytes to transform in response to phytohemagglutinin were studied in healthy volunteers undergoing prolonged enflurane or halothane anesthesia without coincident surgical operation. Anesthesia was associated with a modest leukocytosis that persisted into the first post-anesthesic day, primarily due to an influx of neutrophils into the circulation. There was no significant alteration, either during or following anesthesia, in the ability of the volunteers' lymphocytes to transform in response to phytohemagglutinin when compared with either preanesthetic values or unanesthetized controls. Depression of lymphocyte transformation does not appear to follow prolonged enflurane or halothane anesthesia in the absence of a surgical procedure.
A new pulse contour method to determine stroke volume and cardiac output continuously in patients on a beat-to-beat basis from the aortic pressure wave has been implemented in the form of a simple, inexpensive, fully automatic computing module for a commercially available patients monitoring system (Philips Medical Systems). Its reliability has been tested and shown in a computer analog, in experimental studies in 10 dogs (not reported here), in 22 hemodynamic studies on 20 young healthy volunteers and during 41 days in 20 postsurgical patients in the ICU, the most important result being that erros figures (15 and 19% respectively in the two human studies) are of the same order as when two standard methods, Fick and dye dilution are compared. The clinical studies have further indicated the easy applicability of the module 1 degree in the monitoring of critically ill patients in ICU's, 2 degrees as a monitor of the systemic circulation during anesthesia, and 3 degrees as a tool for studying the hemodynamic effects of pharmacological agents. The instrument consitutes no burden to the patients and has, several times during the course of the evaluation, provided an early warning of a deteriorating hemodynamic status of the patient to the physician.
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Resting cardiac output can be predicted reasonably accurately from body mass in man and other mammals. We measured the stroke volume of a 4,500-kg whale and found that Iberall's formula holds true even when body mass is very large. In addition, the Bcg acceleration trace and cardiac indices were remarkably similar to those of 20-gram and 70-kg mammals, mouse and man.
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