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Biomedical subjects

P Nightingale

Publications and source records attributed to P Nightingale.

66 records · Page 4Linked to original sources
PubMed1988

Reversal of intractable septic shock with norepinephrine therapy.

Ten patients with severe septic shock were studied. After plasma volume expansion to an optimal pulmonary artery wedge pressure, above which there were no further increases in cardiac index, all patients remained hypotensive and oliguric. The arterial hypotension was unresponsive to increasing doses of dopamine and dobutamine alone and to a fixed combination of both. In all patients studied, infusion of norepinephrine alone reversed the hypotension and increased significantly the mean arterial pressure, systemic vascular resistance and left ventricular stroke work index (p less than .005). There were only minor increases in heart rate. Oxygen transport indices measured in six patients demonstrated variable alterations in oxygen delivery and consumption.

Adult↗
PubMed1988

Apache II scores.

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Decision Making, Computer-Assisted↗
PubMed1985

Dystrophia myotonica and atracurium. A case report.

Atracurium was used to produce neuromuscular blockade in a patient with dystrophia myotonica. Operating conditions were excellent and myotonia was not seen. Sensitivity to atracurium was not seen and spontaneous recovery was not prolonged.

Adult↗
PubMed1985

Induction of anaesthesia with propofol ('Diprivan') or thiopentone and interactions with suxamethonium, atracurium and vecuronium.

A randomized study involving 60 healthy patients was performed to examine the induction characteristics and the possible interactions between propofol 2.5 mg/kg or thiopentone 4 mg/kg and three neuromuscular blocking agents, suxamethonium, atracurium and vecuronium. The time of onset to maximum blockade, the degree of blockade and the duration of blockade were measured using the electromyogram. The response to each muscle relaxant was not significantly different after induction of anaesthesia by propofol or thiopentone. A decrease in arterial blood pressure which occurred after both induction agents was greater after propofol than after thiopentone P less than 0.05. There was no significant difference in the increase in heart rate which occurred after the injection of either propofol or thiopentone.

Adult↗
PubMed1985

Propofol in emulsion form: induction characteristics and venous sequelae.

Propofol in a 1% emulsion was used to induce anaesthesia in 20 female patients premedicated with diazepam (10 mg). A dose of 2.5 mg kg-1 produced a rapid loss of consciousness and only minor excitatory effects. Discomfort during the injection was not severe. Cardiovascular changes included a fall in blood pressure similar to that which occurs with other induction agents, and a decrease in pulse rate. Apnoea occurred after each induction and in some patients (13) was prolonged (greater than 60 s). There were no venous sequelae, and patient acceptance was high. Propofol given in an emulsion to induce anaesthesia merits further study.

Adult↗
PubMedDate not supplied

Shock index: a re-evaluation in acute circulatory failure.

STUDY OBJECTIVE: To evaluate the relationship between the shock index SI (ratio of heart rate to systolic arterial pressure) and cardiac function and oxygen transport in an experimental model of hemorrhage and clinical septic shock. METHODS AND RESULTS: This study was conducted in a hypovolemic circulatory failure model; 40% hemorrhage in the anesthetized pig and normovolemic hyperdynamic septic patients in the intensive care unit (ICU). Hemodynamic and oxygen transport variables were measured and their relationships to SI was examined. SI was inversely related to blood loss, cardiac index (CI), stroke volume (SV), mean arterial pressure (MAP) and left ventricular stroke work (LVSW) (r = -0.73, -0.75, -0.89 and -0.75, respectively P less than 0.01) following hemorrhage in the anesthetized pig. Oxygen transport variables, i.e. oxygen delivery (DO2) and mixed venous oxygen saturation (SvO2P) (r = -0.68 and -0.74, respectively, P less than 0.01) were also inversely related to the SI. Oxygen consumption (VO2) increased initially with increasing SI and fell when SI was greater than 3.0. In clinical septic shock and following blood volume expansion, the SI was not correlated to CI, SVI, MAP or systemic vascular resistance (SVR) (r = -0.01, -0.47, -0.34 and -0.14, respectively, P-value NS) but was inversely related to LVSWI (r = -0.68, P less than 0.01). There were no relationships between the SI and oxygen transport variables (DO2, SvO2) (r = -0.02 and -0.17, P-value NS) in septic shock. CONCLUSION: SI provides a non-invasive means to monitor deterioration or recovery of LVSW during acute hypovolemic and normovolemic circulatory failure and its therapy. SI may be of limited value in the assessment of systemic oxygen transport and response to therapy in clinical shock.

Animals↗