Biomedical subjects
Publications and source records attributed to T E Oh.
Clinical biochemical and haematological parameters during long-term continuous infusion of alfathesin were studied in twelve neurosurgical patients who did not have multiple organ failure. Significant changes which were possibly caused by alfathesin were an alteration of blood film morphology, an elevation of plasma triglyceride and a reduction in plasma high-density lipids.
A pressure infusor was used to apply external pressures of 300, 250, 200, and 150 mm Hg to 500-ml plastic bags of saline. At constant applied pressure, 50-ml aliquots of saline were periodically withdrawn. The delivered pressures were less than the applied pressures, and the difference increased as the volume of saline within the bag decreased. This inherent pressure difference should be considered when the system is used with a continuous flush device.
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The method of Chiou et al. was used to predict theophylline kinetics in eleven critically ill patients with either acute severe asthma or bronchoconstriction. Following the commencement of an accurately metered infusion of aminophylline, venous blood samples were taken at approximately 1, 5 hours and 7-12 hours for measurement of plasma theophylline concentration. The 1- and 5-hour levels were used to estimate total body clearance and plasma concentration of theophylline at the 7-12 hour sampling time. Using these values, the infusion rate was adjusted if necessary and the protocol repeated. Initial predictions were unreliable in two patients because of continued absorption of theophylline from pre-infusion therapy with aminophylline suppositories or slow-release theophylline tablets. In the remaining studies there was a significant correlation (y = 0.9x + 0.55, r2 = 0.93, p less than 0.01, n = 19) between predicted and actual plasma concentrations at the 7-12-hour sampling time. In three patients, sequential estimates of theophylline clearance showed an approximate twofold variation and in another two patients, there was evidence of concentration-and/or time-dependent theophylline kinetics.
The Gairdner Hospital Automatic Pressure Regulator was developed to deliver a constant pre-set gas pressure for the continuous inflation of infusion pump cuffs or pneumatic tourniquets. It has been found to be economical, safe, reliable and easy to use. The device facilitates both continuous flushing of catheters and rapid intravenous infusions especially during emergency situations. It may also be used in other clinical situations where a continuous gas supply at a pre-set constant pressure is required.
The infusion of ascitic fluid from the peritoneal cavity into the central venous circulation may relieve massive intractible ascites, and improve renal function when hepatorenal syndrome is present. preoperative preparation of these patients includes investigation of hepatic, renal, pulmonary, cardiac and neurological function, correction of electrolyte and coagulation abnormalities, restoration of normal fluid balance and the provision of supplemental vitamins and calories. Premedication is achieved with an oral benzodiazepine or an intramuscular injection of a narcotic agent. General anaesthesia is provided by thiopentone, suxamethonium, nitrous oxide, oxygen, pancuronium and a narcotic, with intermittent positive pressure ventilation. Close monitoring of cardiac, respiratory and renal function is imperative perioperatively. Postoperatively, supervision in an Intensive Care Unit is advised as complications such as cardiac failure, septicaemia and disseminated intravascular coagulation may occur.
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Two disposable condenser humidifiers were evaluated in nine ventilated intensive care patients. The Portex "Humid Vent" delivered end-inspired absolute humidities of 22--26.3 g/m3 at end-inspired temperatures of 27--28.3 degrees C. Corresponding humidities and temperatures with the Servo "Humidifier 150" were higher and were constant, at 27.7--29 g/m3 and 29.3--29.7 degrees C respectively. These disposable devices can be used for humidification in intensive care, but only for patients breathing room air, or on a short term basis.
A thirty-year-old female presented with a high fever, conjunctivitis, confusion, vomiting, watery diarrhoea, diffuse erythroderma, shock and oliguric renal failure. Staphylococcus aureus phage 29/52 (Group 1) was isolated from a high vaginal swab. In addition to all the previously reported features which defined toxic shock syndrome, there were pustular skin vesicles, altered red cell morphology, and severe myocardial involvement. Treatment with fluid replacement, cloxacillin, haemodialysis, positive inotropic agents, and supportive measures resulted in a full recovery.
Intravenously administered N-acetylcysteine was used to treat 11 patients at risk of hepatic damage from paracetamol poisoning. Complete protection against liver failure was seen in all cases without any adverse effects. The efficacy and safety of intravenously administered N-acetylcysteine make it the treatment of choice in paracetamol poisoning.
Increases in endotracheal tube cell volume and pressure during anaesthesia have been reported to be due to the diffusion of nitrous oxide into the cuff. This study compared cuff volume and pressure changes in anaesthetized intubated patients who were ventilated with those allowed to breath spontaneously. The cuffs of Magill red rubber endotracheal tubes were inflated with either air or a nitrous oxide-oxygen mixture. Serial pressure and volume recordings confirmed that both parameters increased when the cuff was inflated with air. The increase in cuff pressure was however, greater during intermittent positive pressure ventilation than for spontaneous respiration. There were no significant changes when the cuff was inflated with the nitrous oxide-oxygen mixture.
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A case of unilateral pulmonary oedema following "Mandrax" overdose is presented. The pulmonary oedema is believed to result from hypoxia and increased pulmonary vascular permeability. A multi-factorial pathophysiology including patient posture, may have been responsible for the unusual unilateral distribution of the oedema. This report should serve to increase awareness of this interesting clinical entity.
Droperidol is used in the anaesthetic management of pheochromocytoma because of its sedative, anti-dysrhythmic and alpha-adrenoreceptor blocking properties. However, droperidol when used in pheochromocytoma, has been reported to produce a paradoxical hypertensive response. In vitro experiments with perfused rabbit ear arteries using a histochemical fluorescence technique, showed droperidol to be an inhibitor of noradrenaline uptake into sympathetic nerve endings, and this uptake inhibition was dose related. The uptake inhibition effect did not, however, produce pressor changes in experiments simulating pheochromocytoma in cats. The hypertensive response to droperidol may be due to blockade of presynaptic alpha-adrenoreceptors and this possible mechanism of action is discussed.
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