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Biomedical subjects

T J Clark

Publications and source records attributed to T J Clark.

At least 163 records · Page 9Linked to original sources
PubMed1971

A review of experience operating a general medical intensive care unit.

From 18 months' experience of operating a four-bedded general medical intensive care unit a high staff-to-patient ratio was the most important factor in its success. Heavy capital spending does not appreciably reduce the importance of adequate numbers of trained staff, though patient-monitoring equipment can be useful and sometimes vital. As the scope for intensive care widens, the problems of clinical care become difficult, because no doctor is likely to be competent enough to provide for all categories of patients, and there is no intensive care equivalent of the general physician. Intensive care is likely to function best in a divisional specialist system of clinical care.

Acute Kidney Injury↗
PubMed1970

Inspiratory obstruction.

Obstructing lesions of the trachea and larynx which cause a predominantly inspiratory obstruction can be satisfactorily diagnosed by measuring both F.I.V.(1) and F.E.V.(1). Chronic airways obstruction involving intrathoracic airways produces a much lower F.E.V.(1)/F.I.V.(1) percentage than normal, whereas obstruction to larynx and trachea causes a raised F.E.V.(1)/F.I.V.(1) percentage. If flow-volume measurements are not available the F.E.V.(1)/F.I.V.(1) percentage should provide a simple and useful method for diagnosis of upper airways obstruction.In one of the patients reported a predominantly inspiratory obstruction caused CO(2) retention. In patients with airways obstruction the correlation between Pco(2) and F.I.V.(1) was found to be the same as between Pco(2) and F.E.V.(1). This suggests that respiratory failure can be caused by either inspiratory or expiratory airways obstruction and that neither is of greater importance in producing CO(2) retention.

Adult↗
PubMed1970

Effect of personality on alveolar ventilation in patients with chronic airways obstruction.

A study has been made of the personality of 44 patients with chronic airways obstruction (using the Eysenck Personality Inventory), this being related to the difference between their observed Pvco(2) and that predicted from their F.E.V.(1). This was designed to test the hypothesis that those patients with a lower Pvco(2) than predicted were the more extravert.The results showed a significant correlation between extraversion and the departure of Pvco(2) from predicted Those patients having a lower Pvco(2) than predicted were more extravert than those with a Pvco(2) higher than predicted. There was no correlation between neuroticism and the Pvco(2).These results support the hypothesis that the personality of a patient may play an important part in determining the alveolar ventilation found in patients with chronic airways obstruction. Patients known as "pink puffers" could more appropriately be named "pugnacious pink puffers."

Asthma↗
PubMed1969

The effect of CO2 on ventilation and breath-holding during exercise and while breathing through an added resistance.

1. Ventilation was measured while subjects were made to rebreathe from a bag containing CO(2) and O(2) in order to expose them to a steadily rising CO(2) tension (P(CO2)). The object of the experiments was to determine the effect of a variety of stimuli upon the increase in ventilation and fall in breath-holding time which occurs in response to the rising P(CO2).2. Steady-state exercise at 200 kg.m/min resulted in a small fall in the slope of the ventilation-CO(2) response curve (S(V)) and a small, though not statistically significant, fall in the P(CO2) at which ventilation would be zero by extrapolation (B(V)). There was a marked fall in the slope of the breath-holding-CO(2) response curve (S(BH)) and an increase in the P(CO2) at which breath-holding time became zero by extrapolation (B(BH)).3. These results have been interpreted with the aid of a model of the control of breath-holding and it is suggested that there is no change in CO(2) sensitivity on exercise, either during rebreathing or breath-holding.4. An increase in the resistance to breathing caused a marked reduction in S(V) and B(V), but no change in the breath-holding-CO(2) response curve. These findings suggest that the flattening of the ventilation-CO(2) response curve is mechanical in origin and acute airway obstruction produces no change in CO(2) sensitivity.5. On the basis of these results, we suggest that more information about CO(2) sensitivity can be obtained by a combination of ventilation and breath-holding-CO(2) response curves.

Apnea↗