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Biomedical subjects

T J Gal

Publications and source records attributed to T J Gal.

47 records · Page 3Linked to original sources
PubMed1980

Airway responses in normal subjects following topical anesthesia with ultrasonic aerosols of 4% lidocaine.

Airway dynamics were studied in seven healthy unanesthetized male subjects before and after topical anesthesia with ultrasonic aerosols of 4% lidocaine to assess the effects of this clinically useful technique on normal pulmonary function. Responses to the ultrasonic mist per se were evaluated by studies on separate days with physiologic saline. Significant increases in expiratory flow rates during maximal and partial expiratory flow-volume curves occurred in response to lidocaine. In contrast, flows during partial expiratory flow-volume curves were reduced following saline inhalation. Lung elastic recoil was unaffected by either aerosol. Results of single breath nitrogen washout and responses to breathing helium were unchanged following topical anesthesia with lidocaine, but the saline aerosol significantly increased the slope of phase III during nitrogen washout and volume of isoflow after breathing helium. These changes indicate that topical anesthesia of the airway with 4% lidocaine given as an ultrasonic aerosol produces mild bronchodilation in healthy subjects, whereas saline administered in the same fashion causes mild bronchoconstriction. The effects of both aerosols most likely represent direct action on the smaller peripheral bronchi.

Adult↗
PubMed1976

Partial paralysis with d-tubocurarine and the ventilatory response to CO2: An example of respiratory sparing?

d-Tubocurarine (dTc) was administered intravenously to six healthy unanesthetized volunteers to assess the effects of partial paralysis on ventilatory response to CO2. Each subject received during a 40-minute period 0.2 mg/kg, consisting of five incremental doses at intervals 10 minutes apart. Isohypercapnia with PETCO2 6-7 torr above each subject's resting level was maintained throughout dTc administration. Ventilation at this level of stimulus was 23.8 +/- 1.1 1/min (mean +/- SE) before administration of dTc, about three times resting levels. Steady-state minute ventilation measured during the period 4-6 minutes after each dose of dTc failed to decrease significantly; the levels of ventilation were maintained principally by increased respiratory frequency, since tidal volumes declined significantly from an average of 1,550 ml to 1,050 ml (P less than 0.025). Changes in the slope of the CO2-response curve varied widely among subjects. Although the control slope of 2.65 +/- 0.76 1/min/torr (mean +/- SE) was reduced to 1.50 +/- 0.36 1/min/torr after partial curarization, the change was not significant (P greater than 0.10) Ventilation was maintained at a time when grip strength was 6 per cent of control, vital capacity was 52 per cent of control, and maximum static respiratory pressures were 35-40 per cent of control. Nevertheless, the results suggest significant impairment of vital respiratory functions such as coughing, deep breathing, and the ability to maintain a patent airway in the absence of endotracheal intubation.

Adult↗
PubMed1975

Hypertension in the immediate postoperative period.

Sixty patients out of 1,844 recovery room admissions had significant postoperative arterial hypertension. Nearly 60% of them had a history of hypertension. The postoperative hypertension usually began within 30 min from the end of operation and lasted about 2 hours. In 20% of the patients it lasted 3 hours or longer. Complications attributable to hypertension were confined to this latter group. The principal factors possibly contributing to the pressure elevations were pain (35%), hypercarbia (15%) and emergence excitement (16%). Ten of the patients (17%) had no demonstrable cause for hypertension. The hypertension in this group appeared to have a shorter and more benign course.

Adult↗
PubMedDate not supplied

Brain stem auditory evoked potential monitoring during profound hypothermia and circulatory arrest.

The effects of decreased temperature on brain stem auditory evoked potentials (BAEP) have been previously described in mild to moderate hypothermia. This report describes BAEP monitoring during profound hypothermia (11 degrees C) and circulatory arrest for repair of an aortic arch aneurysm. Recording of BAEP were interpretable during cooling to 14 degrees C, and demonstrated increasing interpeak (I-V) latency compatible with prolongation of brain stem conduction time. The changes rapidly returned to normal during rewarming from profound hypothermia, in a fashion similar to that seen after mild hypothermia, and therefore appear to be completely reversible.

Aorta, Thoracic↗
PubMedDate not supplied

Tests of minimal obstruction in the small airways: interrelationships and physiologic significance.

Several technics have become popular to detect airway obstruction in the small (less than 2 mm diameter) peripheral bronchi which appear to be the site of the early lesions in chronic obstructive pulmonary disease (COPD). These include determining maximal midexpiratory flow rate (MMFR) from the expiration spirogram, maximum expiratory flows at low lung volumes from the maximum expiratory flow-volume (MEFV) curve, a comparison of flow-volume curves during air and helium/O2 breathing, demonstration of frequency dependence of compliance, and the measurement of closing volume (CV). This discussion attempts to interpret the literature relative to these tests, examining their physiologic basis and clinical significance while relating them to the standard spirometric tests. The aim is to provide the clinical anesthesiologist with a better understanding of the information they provide, since their physiologic basis relates well to the many aspects of abnormal lung function which appear during anesthesia and the entire perioperative period.

Airway Obstruction↗