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Biomedical subjects

R Wenstone

Publications and source records attributed to R Wenstone.

15 recordsLinked to original sources
PubMed2000

Successful resuscitation from recurrent ventricular fibrillation secondary to butane inhalation.

Resuscitation from cardiac arrest caused by volatile substance abuse is rarely successful. Large doses of catecholamines given during resuscitation, in the presence of butane, may cause recurrent ventricular fibrillation. We report a case of prolonged resuscitation in a young man who had inhaled butane. Cardiac output was restored 10 min after the administration of intravenous amiodarone. We suggest that antiarrhythmic agents should be used early during resuscitation to prevent recurrent arrhythmias.

Adolescent↗
PubMed1998

Nitrous oxide.

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History, 18th Century↗
PubMed1996

Cerebral venous thrombosis associated with inhalational drug abuse.

Cerebral venous thrombosis is a life-threatening disorder for which the management has been controversial. A 23-year-old critically-ill man with superior sagittal sinus thrombosis (SSST) and cavernous sinus thrombosis secondary to sinusitis following inhalational drug abuse was managed with full heparinization from the fourth day of presentation. He went on to make a full recovery. The association between this form of drug abuse, sinusitis and SSST is an important one, and warrants antibiotics and early aggressive anticoagulation therapy.

Adult↗
PubMed1994

The laryngeal mask airway and positive-pressure ventilation.

BACKGROUND: The utility of the laryngeal mask airway during positive-pressure ventilation has yet to be determined. Our study was designed to assess whether significant leaks occurred with positive-pressure ventilation and if leaks were associated with gastroesophageal insufflation. METHODS: Forty-eight patients undergoing elective surgery were studied. After induction of anesthesia and paralysis, controlled ventilation was used with four different peak pressure settings in each patient (15, 20, 25, and 30 cmH2O). The order of ventilator pressure settings was assigned from a randomized block schedule. Data collected included inspiratory and expiratory volumes, qualitative assessments of gastroesophageal insufflation, and leak at the neck. After data collection during laryngeal mask use, the anesthesiologist intubated the trachea and measurements were repeated for tracheal tube ventilation. Leak was calculated by subtracting the expiratory from the inspiratory volume and expressed as a fraction of the inspiratory volume. RESULTS: Ventilation with the laryngeal mask airway was adequate at all ventilation pressures and comparable with tracheal tube ventilation. Leak fraction (mean +/- SD) at 15, 20, 25, and 30 cmH2O for laryngeal mask ventilation were 0.13 +/- 0.15, 0.21 +/- 0.18, 0.25 +/- 0.16 and 0.27 +/- 0.17, respectively, and 0.03 +/- 0.03, 0.05 +/- 0.03, 0.05 +/- 0.03 and 0.04 +/- 0.03, respectively, for tracheal tube ventilation. Leak fractions for ventilation with the laryngeal mask were consistently greater than those measured for tracheal tube ventilation at similar ventilation pressures. Leak fraction with laryngeal mask ventilation increased with increasing airway pressures, whereas leak with tracheal tube ventilation remained unchanged. The frequency of gastroesophageal insufflation ranged from 2.1% at a ventilation pressure of 15 cmH2O to 35.4% at 30 cmH2O. CONCLUSIONS: Ventilation using the laryngeal mask appears to be adequate if airway resistance and pulmonary compliance are normal. Gastroesophageal insufflation of air will become a problem in the presence increased ventilation pressure.

Adolescent↗
PubMed1993

Too many sharps.

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Acquired Immunodeficiency Syndrome↗
PubMed1991

Renal function after cardiopulmonary bypass in children: comparison of dopamine with dobutamine.

We have compared low dose dopamine with dobutamine in conserving renal function in 142 children younger than 10 yr undergoing cardiopulmonary bypass (CPB). Patients were allocated randomly to receive a continuous infusion of either dopamine 2.5 micrograms kg-1 min-1 (group 1) or dobutamine 2.5 micrograms kg-1 min-1 (group 2) from the time of induction of anaesthesia. Administration of inotropes and diuretics was controlled strictly to agreed regimens. There was no clinical or statistically significant difference between the two groups in postoperative urine output, serum concentration of creatinine, fractional sodium excretion or need for diuretic therapy. This was true also of the subgroup of patients who received no other inotropic support. However, the subgroup of patients in group 1 who underwent periods of CPB in excess of 2 h (n = 17) had persistently greater postoperative serum concentrations of creatinine. Low dose dopamine did not appear to be superior to dobutamine for protection of renal function in these patients.

Acute Kidney Injury↗
PubMed1988

Contralateral haemothorax: a late complication of subclavian vein cannulation.

Contralateral haemothorax developed as a late complication of subclavian vein cannulation following gradual erosion of the wall of the superior vena cava by the tip of the catheter. The use of a relatively rigid catheter and a left-sided approach may have contributed to this rare, but potentially fatal complication.

Aged↗