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T R Billiar

Publications and source records attributed to T R Billiar.

263 records · Page 15Linked to original sources
PubMed1987

Risk factors for the development of renal failure following the surgical treatment of traumatic aortic rupture.

A retrospective study of 44 patients who were treated surgically for traumatic aortic rupture was undertaken to determine risk factors for the development of postoperative renal failure. Renal failure occurred in 11 of 41 patients (27%) eligible for analysis. The Pearson product-moment correlation showed no significant relationship between the occurrence of renal failure and the patient's age, injury severity score, initial blood pressure, or the interval between accident and thoracotomy. Renal failure was significantly correlated with cross-clamping only (r = .2751, p = .043). There was no relationship between renal failure and total cross-clamp times. The mortality rate was significantly higher for patients with renal failure.

Acute Kidney Injury↗
PubMed1985

Risk factors for survival following surgical treatment of traumatic aortic rupture.

Linear discriminate analysis was used to determine the effects of age and Injury Severity Score on survival in 37 consecutive patients treated surgically for traumatic rupture of the thoracic aorta. Pearson product moment correlations were calculated between associated injuries and survival. The age of the injured patients was the only variable that correlated statistically with survival: the lower the patient's age, the greater the chance of survival (r = 0.3535; p = 0.016). The severity of the injury, as represented by the Injury Severity Score, showed a tendency toward decreased survival with increasing Injury Severity Score (r = -0.2523; p = 0.066). Specific types of associated injuries did not correlate with survival. Survival rates were not statistically different for patients who underwent cardiopulmonary bypass compared with those in whom a temporary plastic shunt was used (chi-square = 1.72; p = 0.19). We conclude that age is the most significant factor in predicting survival in patients who undergo surgical repair of traumatic aortic rupture.

Adolescent↗
PubMed1984

Maltose absorption as an indicator of small-intestinal allograft rejection.

Maltose and lactose absorption, which require an intact brush border for breakdown and absorption as glucose, was evaluated as a function test to monitor the integrity of the small-bowel graft. Using the rat model of accessory small-bowel transplantation, absorption tests (in the form of an oral glucose tolerance test) were performed on iso- and allografts with either portal (PP-A) or caval venous drainage (PC-A). In isografts the absorption of maltose was found to be reproducible and not influenced by the type of venous drainage. This was not the case with the use of lactose which thus was not studied further. Allografts with PC-A demonstrated a reduction in their capacity for maltose absorption on the fifth postoperative day, as the glucose peak at 30 min (T30) was significantly blunted in comparison to that for isografts with PC-A (167 mg% +/- 12 vs 204 mg% +/- 8). Functional impairment preceded histologic changes which did not arise before the sixth-to-seventh postoperative day in rats with PC-A. Allografts with PP-A absorbed maltose on the fifth postoperative day nearly as effectively as did isografts (T30 min: 185 mg% +/- 14 vs 213 mg% +/- 8). By the ninth postoperative day, the serum glucose curve after maltose administration was flattened for grafts with PC-A (T30 min: 137 mg% +/- 11) which were rejected acutely (host's death) after 11.8 days +/- 0.45. A similar impairment of maltose absorption was not seen in the PP-A group (chronic graft rejection after 22.8 days +/- 1.8) until the 15th postoperative day.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗
PubMedDate not supplied

The vasoregulatory role of endothelium derived nitric oxide during pulsatile cardiopulmonary bypass.

The role of pulsatile flow as a physiologic stimulus for endothelium mediated vasoregulation is poorly understood. Furthermore, non pulsatile flow, which is associated with increased vascular resistance and end-organ failure, has been demonstrated to lead to a decrease in nitric oxide (NO) production in vitro. Anesthetized pigs (23.4 +/- 0.3 kg) were placed on cardiopulmonary bypass using either non pulsatile or pulsatile perfusion for 60 min. In both groups, animals were maintained with a constant mean aortic flow (1.0-1.3 L/min). Serum samples obtained during bypass were assayed for the stable end-products of NO (nitrate [NO3-] and nitrite [NO2-]) by a method based on the Greiss reaction. Systemic vascular resistance was higher after 60 min in the non pulsatile (3712.5 +/- 481.2 dyne sec cm(-5)) vs the pulsatile group (2672.6 +/- 427.0 dyne sec cm(-5)), but not statistically significant (p > .05). However, NO production was decreased in the non pulsatile flow group (27 +/- 6%) vs the pulsatile flow group (14 +/- 5%) at a statistically significant level (p < .005). The results suggest that non pulsatile flow is associated with diminished endothelial shear stress and a reduction in endothelial nitric oxide production. This may contribute to the detrimental physiologic effects observed in prolonged non pulsatile flow states.

Animals↗
PubMedDate not supplied

Nitric oxide, sepsis, and arginine metabolism.

Nitric oxide is one of the most versatile molecules produced by mammalian cells. Its role in sepsis and inflammation has been the subject of intense investigation since its discovery as a cell product in 1987. The role of arginine in sepsis and trauma has also received considerable attention, but most of the earlier studies on arginine preceded the studies on nitric oxide and the discovery that arginine serves as the nitrogen donor for nitric oxide synthesis. This review will explore the role that nitric oxide plays in sepsis and the effects of arginine metabolism on nitric oxide synthesis.

Animals↗