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Biomedical subjects

R D Cane

Publications and source records attributed to R D Cane.

At least 37 records · Page 2Linked to original sources
PubMed1986

Perioperative complications of elective tracheostomy in critically ill patients.

This study was designed to examine prospectively the incidence of perioperative complications associated with elective tracheostomy in critically ill patients. An experienced surgeon and anesthesiologist participated in every tracheostomy procedure. In 81 procedures, there was no loss of airway control for greater than 20 sec, no airway obstruction, no blood loss exceeding 50 ml, and no aspiration. One patient (1.2%) had cardiovascular instability. During the next 48 h, two patients (2.4%) required wound packing to control hemorrhage but did not require blood transfusion and two patients (2.4%) had evidence of supraclavicular subcutaneous emphysema that was physiologically inconsequential. There was no perioperative mortality or major morbidity associated with the tracheostomy procedure. We conclude that, under controlled conditions, elective tracheostomy can be performed safely in critically ill patients.

Adolescent↗
PubMed1984

Impact on ventilator-check time of an in-circuit computerized respiratory monitoring system.

To ensure appropriate quality control of mechanical ventilatory support in our institution, checks of patient status and ventilator performance are made every 2 hours. Our standard method of surveillance requires disconnecting the patient from the ventilator and connecting him to extraneous monitoring devices. We assessed the use of an in-circuit computerized respiratory monitoring system for ventilator surveillance and found that with this system significantly less therapist time was required to perform a check (5.8 +/- 1.18 minutes vs 9.9 +/- 1.53 minutes for the standard procedure) and that use of this system avoids the potential hazards associated with disconnecting a patient from the ventilator and introducing additional monitoring devices to the airway.

Chicago↗
PubMed1983

The reliability of electrolyte measurements in plasma.

The difference between serum and plasma electrolyte measurements and the effects of delay, cooling and addition of sodium heparin on plasma electrolyte measurements were observed. Delay of more than 30 min from sampling to analysis renders plasma potassium measurements unreliable. All other factors assessed produced no changes in plasma electrolyte measurements. Arterial blood gas laboratories can, therefore, reliably provide rapid or serial measurements of plasma sodium and potassium provided the analysis is performed within 30 min of obtaining an appropriate arterial blood sample.

Cold Temperature↗
PubMed1982

Tongue extrusion as an aid to blind nasal intubation.

Blind nasal intubation often results in esophageal placement of the tube because reflex swallowing and supralaryngeal structures direct the tube posteriorly. Extrusion of the tongue, which inhibits swallowing and shifts the supralaryngeal structures anteriorly, facilitated blind placement of a nasotracheal tube in 14 of 16 critically ill patients. The technique avoids manipulation of the neck, the use of heavy sedation or anesthesia, and requires no specialized training or equipment.

Adult↗
PubMed1980

The spectrophotometric absorbance of Intralipid.

The spectral absorbance of Intralipid, a phospholipid emulsion, was investigated to discern its effect, when parenterally administered, on the spectrophotometric measurement of hemoglobin (Hb), oxyhemoglobin (HbO2), and carboxyhemoglobin (HbCO). While accounting for dilutional factors, various concentrations of Intralipid in both water and hemoglobin solutions were analyzed at six wavelengths commonly used to measure Hb, HbO2 and HbCO. Absorbance increased linearly with Intralipid concentration at all wavelengths, and ranged from 0.034 at 505 nm to 0.019 at 626.6 nm per mg of Intralipid. Therefore, in patients receiving Intralipid, significant errors in Hb, HbO2 and HbCO measurements can be introduced if these measurements are made by oximetry, and the authors suggest that such measurements should be accomplished by methods other than spectrophotometry.

Absorption↗
PubMed1980

Minimizing errors in intrapulmonary shunt calculations.

In 100 critically ill patients, intrapulmonary shunts (Qsp/Qt) calculated by assuming a carboxyhemoglobin (HbCO) of zero and a hemoglobin saturation (HbO2) derived from the Severinghaus nomogram were compared to shunts calculated utilizing measured values of HbCO and HbO2. The differences were statistically significant (p less than 0.001). These 100 patients had a mean Hb of 11.9 g/dl and a mean HbCO of 1.7%. Measured shunt calculations in 30 critically patients were prospectively compared with shunt calculations utilizing the mean assumed values derived from the 100 patients initially studies. No statistically significant differences occurred between these two shunts. It is, therefore, concluded that errors attributable to the common practice of assuming zero HbCO and deriving HbO2 from nomograms will produce falsely high calculated intrapulmonary shunt values in critically ill patients. It is, therefore, important to measure accurately HbCO and HbO2 concentrations when monitoring intrapulmonary shunting in critically ill patients. However, if such measurements cannot be obtained, utilization of an assumed value of 1.5% for HbCO and HbO2 nomogram values will minimize errors in the shunt calculation.

Carbon Dioxide↗
PubMed1980

Changes in intrapulmonary shunting with administration of 100 percent oxygen.

The effects of increasing the fractional concentration of oxygen in the inspired gas to 1.0 on intrapulmonary shunting (Qsp) was evaluated in 82 intubated cardiovascularly stable patients in intensive care, regardless of airway pressure therapy or preexistent pulmonary pathologic abnormalities. Intrapulmonary shunting following administration of 100 percent oxygen increased in 132 of 140 measurements, decreased in seven, and remained unchanged in one measurement. The direction of change of Qsp with 100 percent oxygen shows no correlation with either airway pressure therapy or preexisting pulmonary disease.

Adult↗