Lead time bias and standardised mortality ratios in intensive care patients.
Explore the source record for details and available documents.
Bias↗
Biomedical subjects
T E Woodcock
Publications and source records attributed to T E Woodcock.
An improved Hartmann's solution for anaesthetists in the 1990s?
Explore the source record for details and available documents.
Fluid Therapy↗
Management of autonomic dysfunction in severe tetanus: the use of magnesium sulphate and clonidine.
The treatment of severe tetanus with autonomic dysfunction is discussed, with emphasis on the use of magnesium sulphate. An exemplary case is reported, describing the inadequate response to magnesium, but the previously unreported and successful use of clonidine to control sympathetic overactivity. The properties of clonidine are reviewed. Clonidine is felt to be a logical and appropriate drug for the treatment of autonomic dysfunction in severe tetanus.
Autonomic Nervous System Diseases↗
Comparison of anxiety before induction of anaesthesia in the anaesthetic room or operating theatre.
Explore the source record for details and available documents.
Anesthesia↗
Clonidine premedication for isoflurane-induced hypotension. Sympathoadrenal responses and a computer-controlled assessment of the vapour requirement.
The effect of single-dose clonidine premedication on the vapour requirement for isoflurane-induced hypotension in patients undergoing middle ear or nasal surgery was evaluated in an open, controlled, randomized study. Inspired isoflurane concentration was regulated by a microcomputer-based, self-tuning control program when hypotension was required. Patients given clonidine 0.6 mg by mouth 2 h before operation required a mean inspired isoflurane concentration of 2.0% to induce hypotension (mean intra-arterial pressure 50 mm Hg) compared with 3.01% in the control group (P less than 0.05). Five out of 10 patients in the control group required a supplementary dose of labetalol 5 mg i.v. to achieve satisfactory hypotension, compared with one of 10 patients given clonidine premedication (Fisher's exact probability, 0.07). A mean concentration of 1.4% isoflurane was required to maintain hypotension in the clonidine group, compared with 2.3% in the control group (P less than 0.01). Plasma adrenaline and noradrenaline concentrations did not increase during induced hypotension in each group.
Adolescent↗
Pharmacologic EEG suppression during cardiopulmonary bypass: cerebral hemodynamic and metabolic effects of thiopental or isoflurane during hypothermia and normothermia.
We have determined the effects of thiopental or isoflurane upon cerebral blood flow (CBF) and the cerebral metabolic rate for oxygen (CMRO2) when these agents are used in sufficient dose to attain a deep burst suppression pattern on the electroencephalogram (EEG) during hypothermic and normothermic cardiopulmonary bypass (CPB). Thirty-one patients undergoing coronary artery bypass graft surgery were anesthetized with fentanyl 0.1 mg X kg-1, and were randomly allocated to one of three groups: control (no further anesthetics during bypass and continuous EEG activity), thiopental treatment (EEG suppression), or isoflurane treatment (EEG suppression). Hypothermia (25-29 degrees C) was routinely induced at onset of nonpulsatile cardiopulmonary bypass. In the treatment groups, thiopental or isoflurane were used during bypass to achieve a deep burst suppression pattern. Cerebral blood flow and cerebral metabolic rate for oxygen were determined during hypothermia and upon rewarming to normothermia (37 degrees C). Pharmacologic EEG suppression with either isoflurane or thiopental was associated with lower cerebral metabolic rate than control values during both hypothermic and normothermic bypass. However, only thiopental-induced EEG suppression was associated with lower cerebral blood flow than control. Cerebral blood flow during isoflurane-induced EEG suppression was similar to control values in spite of the reduced cerebral metabolic rate.
Blood Gas Analysis↗
Mixed venous oxygen saturation changes during tension pneumothorax and its treatment.
A case is reported of tension pneumothorax following left subclavian venous cannulation for placement of a fibreoptic pulmonary artery flotation catheter. Mixed venous oxygen saturation was continuously monitored and a fall in this was the first indication of the problem. Observations on the cardiovascular consequences of tension pneumothorax were made and followed during its treatment. The value of continuous monitoring of mixed venous oxygen saturation in the early detection of haemodynamic disturbances is emphasized.
Adult↗