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Biomedical subjects

R L Berger

Publications and source records attributed to R L Berger.

At least 91 records · Page 5Linked to original sources
PubMed1978

Variability of oxygen affinity of normal blood: an automated method of measurement.

Oxygen equilibrium curves of 48 healthy adult subjects have been measured by the method of Rossi-Bernardi et al. (Clin. Chem. 21: 1747, 1975), in which H2O2 is gradually added to a sample of deoxygenated blood that contains an excess of catalase. The mean P50 for nonsmokers was 26.9 Torr and the distribution of values was slightly skewed to the right (range 24.2--29.9 Torr). The method differs from others previously available in that pH, PCO2, and HCO3-- are constant during oxygenation. The system for control of the experiment and data collection and processing has been automated by the use of a microprocessor so that the equilibrium curve can be obtained quickly, reproducibly, and relatively simply. With the aid of a digital computer, the parameters of the generalized Adair equation can also be estimated.

Bicarbonates↗
PubMed1978

Massive impalement wound of the chest. A case report.

A 29-year-old man sustained an impalement wound of the right side of the chest with a 6 foot long, 4 by 4 inch wooden post during a high-speed automobile accident. The post entered the right side of the chest anteriorly and exited posteriorly. The great vessels of the chest were spared, but the right lung was lacerated and contused. Removal of the post, treatment of pulmonary parenchymal damage, and reconstruction of the two large chest wall defects presented problems in management. Rapid transport of the patient to the hospital, effective emergency treatment, surgical repair of the chest injury, and appropriate supportive measures contributed to his survival.

Adult↗
PubMed1977

Oxygen equilibrium curve of normal human blood and its evaluation by Adair's equation.

Oxygen equilibrium curves of fresh, normal human blood have been measured by new methods which allow the control of pH, pCO2, and 2,3-diphosphoglycerate and which yield higher accuracy at the extremes of saturation than was possible previously. The curve determined by these techniques lies slightly to the right of the standard curve of Roughton et al. (Roughton, F.J.W., Deland, E.C., Kernohan, J.C., and Severinghaus, J.W. (1972) in Oxygen Affinity of Hemoglobin and Red Cell Acid Base Status (Astrup, P., and Rørth, M., eds) pp. 73-83, Academic Press, New York). The greatest difference is at low oxygen saturation, probably owing to the fact that the latter data were obtained under conditions which would lead to depletion of cellular 2,3-diphosphoglycerate. The range of p50 (oxygen pressure at half-saturation) values for four normal subjects was 28.3 mm Hg to 29.0 mm Hg. Adair's stepwise oxygenation scheme has been used to analyze the curves with the result that a1 = 0.1514 X 10(-1) (+/- 10%) mm-1; a2 = 0.9723 X 10(-3) (+/- 8%) mm-2; a3 = 0.1703 X 10(-3) (+/- 50%) mm-3; a4 = 0.1671 X 10(-5) (+/- 2%) mm-4 for the best of four data sets. Because these constants are very sensitive to changes in the shape of the oxygenation curve, this analysis is much more useful than p50 measurements in the investigation of the various allosteric effectors of the function of hemoglobin within the red cell.

Diphosphoglyceric Acids↗
PubMed1977

Managment of thoracic empyema.

Over a ten year period, 102 patients with thoracic empyemata were treated at Boston City Hospital. Only three patients died from the pleural infection while twenty-six succumbed to the associated diseases. Priniciples of management include: (1) thoracentesis; (2) antibiotics; (3) closed-tube thoracostomy; (4) sinogram; (5) open drainage; (6) empyemectomy and decortication in selected patients; and (7) bronchoscopy and barium swallow when the etiology is uncertain.

Adolescent↗
PubMed1977

Polybrene neutralization as a means of monitoring heparin therapy for extracoporeal cirulation.

Dose-response effects of heparin and protamine in 34 adult patients undergoing cardiac operations were monitored by an in vitro analysis utilizing hexadimetharine bromide (Polybrene) neutralization. Heparin administered prior to cannulation for cardiopulmonary bypass in a dose of 3.0 mg (300 units) per kilogram of body weight, and 1.5 mg (150 units) per kilogram for each subsequent hour of bypass, routinely produced circulating heparin concentrations greater than 1.0 units per milliliter of plasma. A protamine dose equal to 80% of the total number of milligrams of heparin given resulted in no detectable plasma heparin in 23 of the 34 patients one-half hour after administration. No patient required protamine in an amount greater than the total number of milligrams in the heparin dose to achieve heparin neutralization. Modest postoperative chest tube drainage (mean, 784 ml in 48 hours) in these patients provides clinical support for low-dose protamine administration for heparin neutralization at the conclusion of cardiopulmonary bypass.

Adult↗
PubMed1976

Carbon monoxide accumulation during extracoporeal membrane oxygenation for acute respiratory failure.

A marked increase in the carbon monoxide level in the blood sufficient to interfere with oxygen binding of hemoglobin was observed in a 43-year-old man during the course of extracorporeal membrane oxygenator support for acute respiratory failure from viral pneumonitis. The increased carbon monoxide level in this man was temporally related to the transfusion of large amounts of old bank blood. The etiology of an increased level of carbon monoxide in the blood during extracorporeal circulation is discussed and solutions to this problem are suggested.

Adult↗
PubMed1976

Cardiac output measurement by thermodilution during cardiac operations.

Measurement of cardiac output by the thermodilution (COTD) technique through a flow-advanced pulmonary artery catheter is simple, reliable, and practical at the bedside. Rapid repeat determinations are possible, facilitating dynamic description of myocardial performance through construction of ventricular function curves. Replicate determinations of cardiac output indicate that the thermodilution method is more accurate than the indocyanine green technique. Examples of the clinical application of COTD in cardiac surgical patients are provided.

Animals↗
PubMed1976

Comparative evaluation of a new disposable rotating membrane oxygenator with bubble oxygenator.

The comparative in vivo performance of adult-size bubble and rotating membrane oxygenators was evaluated during closed-chest cardiopulmonary bypass for six hours in two groups of dogs. The results show that the rotating membrane oxygenator is efficient in oxygen and carbon dioxide transfer with minimal trauma to blood, while platelet destruction and hemolysis were marked with the bubble oxygenator. Cerebral, cardiac, and respiratory complications were frequent with the bubble oxygenator and absent with the membrane oxygenator.

Animals↗
PubMed1976

Mechanical circulatory assistance with intra-aortic balloon counterpulsation for major abdominal surgery.

Intra-aortic balloon counterpulsation (IABC) provides effective mechanical circulatory assistance (MCA) in many patients with cardiac disease characterized by low cardiac output and/or myocardial ischemia. The intra-aortic balloon pump (IABP) has been used almost exclusively in the care of patients with cardiac disease as their primary medical disorder. This report presents use of the IABP in three cases where cardiac disease was present, but abdominal pathology necessitating urgent surgical intervention was the primary medical concern. Experience with these three cases suggest that operative and early postoperative use of IABC in patients with documented heart disease undergoing major non-cardiac surgical procedures may reduce the high incidence of cardiac complications.

Abdomen↗