Search PubMed⌕ Search

Biomedical subjects

S S Moorthy

Publications and source records attributed to S S Moorthy.

At least 55 records · Page 3Linked to original sources
PubMed1985

Postoperative phrenic nerve palsy in patients with open-heart surgery.

We prospectively studied patients undergoing open-heart surgical procedures to evaluate the role of phrenic nerve palsy in the causation of the high incidence of pulmonary complications reported in these patients. Although atelectasis, or infiltrates, or both developed in the left lower lobe of 98% of the patients (43 of 44) with or without similar changes on the right side, only 5 (11%) of the 44 patients had diaphragmatic dysfunction following operation. In 1, the left phrenic nerve became inexcitable; 2 had paresis of the left hemidiaphragm, and 2 had paresis of the right hemidiaphragm. Although damage to the phrenic nerve can occur during open-heart operations, a relatively low incidence of this complication does not support it as the major cause of postoperative pulmonary complications.

Adult↗
PubMed1985

Electrophysiologic evaluation of phrenic nerves in severe respiratory insufficiency requiring mechanical ventilation.

Diaphragmatic paralysis in patients with respiratory insufficiency compounds the problems in the management. In the presence of lower lobe atelectasis, pleural effusion, or a patient's poor respiratory effort, fluoroscopic examination is often not a reliable way to diagnose diaphragmatic paralysis. We observed that transcutaneous phrenic nerve stimulation in the neck and recording the diaphragmatic potentials from electrodes placed on the lower part of the chest is a simple, reliable, and noninvasive technique to diagnose diaphragmatic dysfunction at the bedside in critically ill patients. In 14 postoperative patients and one with cervical spinal cord injury with respiratory failure, we found ten patients who showed phrenic nerve dysfunction. Besides diagnostic utility, the electrophysiologic evaluation of phrenic-diaphragmatic function provides critical information needed for therapy.

Adult↗
PubMed1985

Monitoring urinary bladder temperature.

We evaluated bladder, rectal, and esophageal temperatures compared with nasopharyngeal temperatures in 12 patients who underwent cardiac surgery that required CPB. Changes in bladder temperature lagged behind those of esophageal and nasopharyngeal temperature during rapid cooling and rewarming. Changes in rectal temperature were the slowest. Bladder and rectal temperatures were similar after surgery. Monitoring bladder temperature represents the core temperature in a steady state.

Adult↗
PubMed1984

Monitoring of somatosensory evoked responses during carotid endarterectomy.

During carotid endarterectomy (CEA), we monitored somatosensory evoked responses (SERs) ipsilaterally over the scalp following stimulation of the contralateral median nerve at the wrist. Thirty-eight CEAs in 36 patients were studied. Of the 10 CEAs performed with patients under general anesthesia, three involved marked changes in SERs, reversed by shunt insertion. The remaining 28 CEAs were done with patients under local anesthesia. The SERs remained stable during an average clamp time of 30 minutes in all except one patient, in whom SER changes developed within a minute of clamping; the changes were reversed by shunt placement. Four of the 38 CEAs required a shunt based on SER changes, although measurement of stump pressure (less than 50 mm Hg) would have indicated the necessity of a shunt in eight additional operations. We concluded that SERs are useful in signaling cerebral ischemia and the need for a shunt during CEA.

Aged↗
PubMed1984

Monitoring of multimodality evoked potentials during open heart surgery under hypothermia.

Multimodality evoked responses (ERs) were monitored in 16 adults who had cardiac surgery under cardiopulmonary bypass and moderate hypothermia (19-25 degrees C). Cooling affected all sensory ERs by progressively increasing the latencies of the major components. The effect was more profound on the later than on the earlier ER components. Visual evoked responses (VERs) were most inconsistent and always disappeared at temperatures below 25 degrees C. The later components of the long latency somatosensory evoked responses (SERs) also attenuated or disappeared rather early during hypothermia. On the other hand, short latency SERs were more resistant to the effects of hypothermia. They were always recordable at temperatures of 25 degrees C or above; and usually persisted even at temperatures between 20 and 25 degrees C. Brain-stem auditory evoked responses (BAERs) were consistently present at temperatures above 25 degrees C, wave V was recordable in majority between 20 and 25 degrees C. All sensory ERs disappeared with severe hypothermia (20 degrees C or less) except the components generated more peripherally such as N10 of the short latency SERs. We feel that BAERs and short latency SERs may serve as useful intraoperative monitors of brain function during hypothermia.

Adult↗
PubMed1984

Electrophysiologic evaluation of diaphragm by transcutaneous phrenic nerve stimulation.

Phrenic nerve function was evaluated by transcutaneous stimulation in the neck and recording the diaphragmatic potential from surface electrodes placed at the ipsilateral seventh intercostal space (7CS) and the xiphoid process (XP). Simultaneous recordings from 7CS and XP electrodes connected together (XP-7CS) and each connected to a remote reference (knee-7CS and knee-XP) disclosed that the 7CS electrode was always more active and showed electropositive activity, whereas the XP electrode, which was only minimally active, showed electronegative response. Out-of-phase summation of opposite polarity activity at the two electrodes resulted in a higher amplitude response in XP-7CS derivation. Phrenic nerve studies are useful in establishing phrenic nerve injury following cardiothoracic operation. They may also provide evidence of phrenic nerve or diaphragmatic involvement in demyelinative neuropathies, motor neuron disease, and muscular dystrophies.

Adult↗
PubMed1983

Transient paralysis of the diaphragm following radical neck surgery.

We have observed transient diaphragmatic paralysis with high alveolar to arterial oxygen partial pressure difference following radical neck surgery. Patients required supplemental oxygen for maintenance of arterial oxygenation. Patients following radical and neck surgery should be followed with chest roentgenograph to exclude pneumothorax and diaphragmatic paralysis and arterial blood gases in the immediate postoperative period.

Aged↗