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Biomedical subjects

R H Geuze

Publications and source records attributed to R H Geuze.

7 recordsLinked to original sources

Motor response processing in clumsy children.

Twelve clumsy children and 12 controls executed a four choice reaction time task in two compatibility conditions and three precue conditions. The experimental results indicated that the cognitive decision process of response selection contributed to the slow but not to the inaccurate performance of clumsy children. Clumsy children, compared with controls, had more problems with the translation of the stimulus code (s) to the response code (r) when this translation required more transformations. Response selection is a cognitive process that is likely to be important for deficits in perceptual-motor skills.

Attention

Evaluation of transthoracic countershock with initial energy levels up to 200 J in a coronary care unit.

In a five year prospective study, transthoracic countershock of patients in the coronary care unit was evaluated with respect to efficacy, transthoracic resistance and arrhythmias. Those patients dying within 12 hours of the recorded event are referred to as agonal patients. Atrial arrhythmias were generally first treated with quinidine or disopyramide and/or a digitalis preparation. Patients with coronary heart disease were treated with lidocaine, disopyramide, or verapamil when there was time for appropriate diagnosis. The efficacy of the first shock with an energy level between 50 J and 200 J in non-agonal patients was: for atrial fibrillation, 44% (N = 34), and between 83% and 93% for tachycardias and ventricular fibrillation. The cumulative efficacy of two shocks with energy levels between 50 J and 200 J was: in atrial fibrillation 53% and others between 90% and 96%. In agonal patients with ventricular fibrillation and acute myocardial infarction the efficacy of one shock of 100-150 J was 39% and two shocks of 100-200 J, 69% (N = 13). No correlation was found between the transthoracic resistance and parameters such as body-weight, length or thorax-circumference, indicating that these should not be taken into account in the choice of the energy level for countershock. In non-agonal patients without coronary heart disease arrhythmias due to countershock increased in duration when the energy of the countershock increased (p less than 0.01, N = 39). It is concluded that the initial stored energy for defibrillation and cardioversion of nonagonal patients in a coronary care unit may be limited to 200 J (160 J delivered energy), even with atrial fibrillation after drug therapy in which case an initial energy level of 200 J seems more appropriate.

Arrhythmias, Cardiac

Ventricular fibrillation and transient arrhythmias after defibrillation in patients with acute myocardial infarction.

Ventricular fibrillation (VF) and transient arrhythmias after defibrillation were analyzed from the recordings of 28 patients containing at least one episode of ventricular fibrillation. An R-on-T extrasystole initiated VF in 60% of the episodes. Other initiating factors were a late premature beat (24%), stable ventricular tachycardia (VT) (7%), accelerating idioventricular rhythm (5%) and cardioversion of VT (5%) with a sinusoidal waveform. After the initiating beat, in most cases, evidence was found of a transient ventricular tachycardia which then deteriorated into VF. With a stable VT this may occur after a long time; in the case of apolymorphic VT (with changing amplitude) it generally occurred within 30 s. The main transient arrhythmias generated by circulatory arrest during VF and by the defibrillation shock were: total arrest, total AV-block and/or bradycardia. The combination of a longer duration of VF and a high energy level generally resulted in an increase in the duration of these arrhythmias (P less than 0.01, N = 30). Comparison of episodes of VT and VF recorded in a single patient also shows that arrhythmias are more unfavourable and of longer duration after VF than after VT. These data emphasize fast defibrillation, initially with stored energy levels less than 250J.

Adult

Arrhythmias and left ventricular function after defibrillation during acute myocardial infarction in the intact dog.

The purpose of this study was to assess the recovery of the left ventricular pressure (PLV), and the incidence and type of arrhythmias after effective low-dose defibrillation (Imax = 18-70 A) in healthy hearts and in hearts with acute myocardial infarction (AMI) in the intact dog. In fifteen dogs 84 episodes of fibrillation-defibrillation were studied in the healthy heart and 53 episodes were studied in the acute phase of myocardial infarction 1/2 to 3 hours after occlusion of a part of the left anterior descending artery by a catheter technique. Time to recovery of PLV depended on duration of fibrillation (tF) and cumulative defibrillation current (I 1/2), and became critical at tF greater than 45 seconds and I 1/2 greater than 45 A. Total duration of arrhythmias due to defibrillation increased with increasing tF and I 1/2. Arrhythmias which have a relative greater chance of resulting in refibrillation or which may seriously decrease the cardiac output occurred more often with I 1/2 greater than 55 A (p less than 0.001), when 50% of episodes were followed by these arrhythmias. No differences were found in responses between the healthy heart and the heart with AMI.

Animals

Effects of duration of ventricular fibrillation and heart massage on haemodynamic responses after defibrillation in dogs.

The purpose of this study was to investigate the effects of duration of ventricular fibrillation (VF), and of closed chest manual cardiac massage during VF on the recovery of the circulation. 24 open chest episodes and 50 closed chest episodes were studied. Longer duration of VF resulted in slower recovery. The critical recovery time was 60 to 90 s, beyond which no recovery occurred spontaneously. Heart massage improved recovery in nearly all cases. This indicates that the favourable effect of heart massage is not only confined to carotid flow to the brain but also that it has a favourable effect on the contractility of the heart, probably by the generation of coronary flow. Changes in coronary flow during spontaneous recovery were similar to those in reactive hyperaemia. The maximum mean coronary flow during recovery was 1.7 to 6 times the steady state values. When the duration of VF was longer than 60 s the recovery of the circulation was often worsened by a pronounced transient bradycardia, occasional ventricular tachycardia or frequent ventricular premature excitations.

Animals