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Biomedical subjects

P Husby

Publications and source records attributed to P Husby.

35 records · Page 2Linked to original sources
PubMed1993

High-dose vecuronium may be an alternative to suxamethonium for rapid-sequence intubation.

Endotracheal intubation conditions 60 s after intravenous administration of either high-dose vecuronium (0.3 mg kg -1; n = 25) or suxamethonium (1.0 mg kg -1; n = 25) were compared in a blind, randomised study. No significant differences were found between the two drugs. In 96% of the patients intubation conditions were characterized as excellent or good. In only one patient (4%) in each group were intubation conditions unsatisfactory. According to our findings, high-dose vecuronium provides satisfactory intubation conditions after 60 s and may be used instead of suxamethonium for rapid sequence intubation when a long duration of neuromuscular blockade is acceptable.

Adolescent↗
PubMed1993

Duration of vecuronium-induced neuromuscular blockade predicted by dose and onset time.

We investigated the adequacy of using dose and onset time as variables to predict the duration of action of vecuronium in patients. The onset time until 95% twitch depression and the duration until 25% twitch recovery were measured for doses ranging from 0.1 to 0.3 mg kg-1. Statistical analyses were performed by simple and multiple regressions. The duration of action was better predicted by dose (r2 = 0.61) than by onset time (r2 = 0.51). However, the predictability was significantly improved by a multiple regression model of the variables, and the explanatory power was largest when using the square root of duration as the dependent variable (r2 = 0.69). We conclude that the duration of neuromuscular blockade after vecuronium can be predicted more accurately by the combined use of dose and onset time than by dose alone.

Adolescent↗
PubMed1991

[Deep accidental hypothermia with asystole. A successful treatment with heart-lung machine after prolonged cardiopulmonary resuscitation].

Extracorporeal circulation can be utilized successfully to rewarm accidental hypothermia victims. This paper describes a 51 year-old man who had been immersed in cold sea water for about 45 minutes. At the time of rescue his ECG was isoelectric. The core temperature was 27 degrees C. Cardiopulmonary resuscitation was performed for 190 minutes before extracorporeal circulation was established. Without active surface rewarming the temperature had dropped to 24 degrees C. Biventricular heart failure became evident during rewarming. Sternotomy and pericardiotomy were carried out to exclude cardiac tamponade, which was not found. After two hours of reperfusion the patient could be weaned from bypass supported by high-dose vasopressor infusion. He was extubated the following day. He was discharged after 12 days without any signs of permanent damage to organs.

Accidents↗
PubMed1991

Anesthesiologist-manned helicopters and regionalized extracorporeal circulation facilities: a unique chance in deep hypothermia.

Norway has nine light ambulance helicopters, four heavy sea rescue helicopters and seven ambulance air planes in 24-hours duty spread all over the country. Most are manned with anesthesiologists. Five regional hospitals in all parts of the country, offer facilities for extracorporeal circulation. A case in which a 33 year old woman was found hypothermic at 21 degrees C is presented. She developed ventricular fibrillation at the time of her rescue. She was intubated and received chest compression for 70 minutes until she was rewarmed by extracorporeal circulation. She was discharged without signs of cerebral damage. The decision to bypass less advanced hospitals en route to the regional hospital proved correct in this case, and is suggested as standard procedure in deep hypothermic patients.

Adult↗
PubMed1990

Accidental hypothermia with cardiac arrest: complete recovery after prolonged resuscitation and rewarming by extracorporeal circulation.

A 51-year-old male remained immersed in sea water (6 degrees C) for 40 min. Brought ashore, the ECG showed asystole. Advanced life support was immediately commenced. On arrival in hospital his rectal temperature was 27 degrees C, but continued to fall to 24 degrees C. The ECG remained isoelectric. Cardiopulmonary resuscitation was continued until extracorporeal circulation was established 190 min after rescue. Upon rewarming ventricular fibrillation occurred which was converted to sinus rhythm with a bolus of lignocaine followed by D.C. conversion at 31.5 degrees C. When rewarming was complete after 60 min, signs of severe heart failure became evident. Sternotomy and pericardiotomy were performed to exclude cardiac tamponade. After 60 min of re-perfusion the patient was be weaned from bypass supported by a high-dose vasopressor infusion and nitroglycerine. He was discharged after 13 days with no evidence of any permanent organ damage. Given the advantage of providing circulatory support, extracorporeal circulation may be useful when rewarming hypothermic victims with cardiac arrest.

Extracorporeal Circulation↗
PubMed1989

[Anaphylactic shock during elective cesarean section. Sensitizing mechanisms and follow-up].

Anaphylactic reactions during anaesthesia are increasing. Women experience these reactions more often than men. In about 50% of the cases the reaction is due to a muscle relaxant drug. Recently, Australian and French researchers have described these reactions as possibly mediated by IgE in most of the patients. As regards Ig-antibody binding, the quaternary ammonium ions seem to be potential determinants in the muscle relaxant molecule. Patients may have been sensitized by exposure to cosmetics, disinfectants or solvents, and cross-reactivity between different neuromuscular blocking agents has been described earlier. We refer to a patient who experienced an anaphylactic shock during anaesthesia by suxamethonium. She was successfully treated with epinephrine, crystalloids and mechanical ventilation. We discuss peroperative treatment, further investigation, and management at later anaesthesiological procedures.

Anaphylaxis↗
PubMed1989

Midazolam does not potentiate the effect of vecuronium in patients.

Reports of midazolam interaction with vecuronium in animals prompted us to compare midazolam (0.25 mg kg-1) with thiopentone (5 mg kg-1) for possible interactions with vecuronium in patients, when used for induction of anaesthesia. After the administration of either of the two induction agents, the patients received vecuronium 0.1 mg kg-1. The onset time, duration of action and 25-75% recovery index of the neuromuscular blockade were recorded by measuring the force of thumb adduction evoked by ulnar nerve stimulation. We found no differences between patients receiving either midazolam or thiopentone in their response to vecuronium. In three of the ten patients receiving midazolam, the injection of this drug produced a 8-29% reduction of the initial twitch height.

Adult↗
PubMed1988

Comparison of large dose of vecuronium with pancuronium for prolonged neuromuscular blockade.

Dose-duration relationships for vecuronium were determined and the duration of action produced by vecuronium 0.3 mg kg-1 shown to equal that of pancuronium 0.1 mg kg-1. Using these doses, the neuromuscular blocking properties and cardiovascular effects of the two drugs were compared. With large dose administration of vecuronium (0.3 mg kg-1), both the onset time (mean 81 s) and the 25-75% recovery index (mean 13.9 min) were about one-half those associated with pancuronium (mean 168.5 s and 29.3 min, respectively). The duration of action until 25% recovery was similar with both drugs. There was no evidence of cardiovascular instability with the large dose of vecuronium. Heart rate, however, was significantly slower (range 89.7-94.2% of control) 2-20 min after the injection of vecuronium. Vecuronium 0.3 mg kg-1 may have more favourable neuromuscular blocking effects than pancuronium 0.1 mg kg-1 and may be preferable to pancuronium when prolonged neuromuscular blockade is required.

Adolescent↗
PubMed1982

Studies on the efflux of metalloporphyrin from isolated rat liver mitochondria. Effect of respiratory substrates and metabolic inhibitors.

Intramitochondrially synthesized Co-deuteroporphyrin is released to the incubation medium at a rate inversely correlated to the energy state of the mitochondria; i.e. the rate of efflux increases when substrate is depleted, respiration inhibited or the mitochondria are uncoupled. The efflux of Co-deuteroporphyrin from mitochondria remains low as long as the residual membrane potential is above one-third that of maximally energized mitochondria. Globin enhances the efflux of Co-deuteroporphyrin not only from mitochondria depleted of substrates [Husby & Romslo (1980) Biochem. J. 188, 459-465], but also from maximally energized mitochondria. The results provide further evidence for a co-operative mechanism between the mitochondria and their surroundings for the mobilization of metalloporphyrin from mitochondria.

Animals↗
PubMed1981

Studies on the efflux of metalloporphyrin from rat liver mitochondria. Effect of K+ and other cations.

The mechanism by which metalloporphyrins synthesized within the mitochondria escape to the incubation medium was studied in isolated rat liver mitochondria. In a low-ionic-strength sucrose medium, the efflux of metalloporphyrins is markedly decreased when K+ (greater than 10 mM) is added. The effect of K+ is not dependent on the energy state of the mitochondria and it can in part be abolished by adding globin, but not albumin. K+ also decreases the uptake of porphyrins by the mitochondria and thereby the rate of synthesis of metalloporphyrins. Qualitatively similar results are found with Na+, Li+, Mg2+ and Ca2+. Quantitatively, however, the efficiency of cations to inhibit the release of metalloporphyrins decreases in the order: Mg2+ greater than Ca2+ greater than K+ greater than Li+ greater than Na+. Co-protoporhyrin behaves essentially as Co-deuteroporphyrin. The results provide further evidence that the efflux of metalloporphyrins from the mitochondria depends on haem-binding ligands of the suspending medium and also on the ionic strength of the incubation medium.

Animals↗
PubMed1980

Studies on the efflux of metalloporphyrin from rat-liver mitochondria. Effect of albumin, globin, haemin and haemoglobin.

The mechanism by which metalloporphyrins escape from mitochondria has been studied in isolated rat-liver mitochondria using Co-deuteroporphyrin as the model compound. During the first 10--15 min of incubation the efflux is about 10% of the total amount of Co-deuteroporphyrin synthesized. The efflux then increases to a second steady-state leve of 25--35% after 30--45 min of incubation. The efflux is inversely correlated to the energy state of the mitochondria. Globin at concentrations less than 0.4 mumol/l enhances the efflux of Co-deuteroporphyrin, but has no effect on the degree of energy coupling or on the rate of Co-deuteroporphyrin synthesis. The effect of globin can be competitively inhibited by adding haemin. Haemin (0.5--1.0 mumol/l) when added to the medium in the absence of globin reduces the efflux of Co-deuteroporphyrin by 20--30%, but has no effect on the metal-chelatase activity. Neither albumin nor haemoglobin increases the efflux of Co-deuteroporphyrin from intact mitochondria. The results suggest that the efflux of metalloporphyrin is regulated in part by the energy state of the mitochondria and in part by the presence of metalloporphyrin-binding ligants and unattached haemin in the incubation medium.

Animals↗