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Biomedical subjects

V S Sidhu

Publications and source records attributed to V S Sidhu.

16 recordsLinked to original sources
PubMed1999

The laryngeal mask airway in tonsillectomy: the surgeon's perspective.

The laryngeal mask airway presents certain advantages in the management of the airway during general anaesthesia. However, from the surgeon's perspective, there have been reports of problems occurring when the laryngeal mask airway is used in tonsillectomy. This study of 90 patients undergoing tonsillectomy suggests that surgical access is inferior with a laryngeal mask airway and the weight of tonsillar tissue excised is less. In addition the laryngeal mask airway needs to be changed to an endotracheal tube during the procedure in 11.4% of patients.

Airway Obstruction↗
PubMed1995

External high frequency oscillation in normal subjects and in patients with acute respiratory failure.

External high frequency oscillation was performed on 20 healthy volunteers using a cuirass-based system, the Hayek Oscillator. Five-min periods of oscillation were carried out on each subject at frequencies of 1, 2, 3, 4 and 5 Hz. Effective ventilation was measured in terms of the fall in alveolar partial pressure of carbon dioxide immediately after oscillation. The optimum frequency for oscillation was 1-3 Hz but most of the subjects were adequately ventilated over a wide range of frequencies. Thus, the Hayek Oscillator is capable of adequately ventilating normal subjects by means of chest wall oscillation. We also compared external high frequency oscillation with intermittent positive pressure ventilation in five patients with respiratory failure. Using the same inspired oxygen fraction, the external high frequency oscillation replaced intermittent positive pressure ventilation for a 30-min period. External high frequency oscillation improved oxygenation by 16% and reduced the arterial carbon dioxide by 6%. These preliminary findings suggest that normal subjects and intensive care unit patients can be adequately ventilated by means of external high frequency oscillation.

Acute Disease↗
PubMed1995

A fibreoptic laryngoscope for paediatric anaesthesia. A study to evaluate the use of the 2.2 mm Olympus (LF-P) intubating fibrescope.

A technique for the use of the Olympus LF-P as an aid to tracheal intubation, via the oral route, in 40 anaesthetised, spontaneously breathing children is described. The technique was completely successful in 30 (75%) of the children. Complications occurred in the remaining ten (25%); two developed laryngospasm and in seven the fibrescope flipped out of the trachea during the initial passage of the tracheal tube over the fibrescope. In one child the wrong tracheal tube was initially chosen. The two children who developed laryngospasm and three of the children in whom the fibrescope flipped out of the trachea required conventional laryngoscopy and tracheal intubation. Whilst this technique allowed for training in the use of the LF-P in paediatric anaesthesia there were a number of complications.

Child↗
PubMed1994

A heat and moisture exchanging filter in long-term ventilation.

We report our experience of using the Pall BB50T heat and moisture exchanging filter (HMEF) in critically ill patients undergoing long-term ventilation. Three hundred and sixty-four ventilated patients humidified with the Pall HMEF were studied prospectively. Thirty-five patients (mean APACHE II score 24.6, mean predicted mortality 50.9%) were ventilated for more than 10 days (mean 18.9), accounting for 661 patient-ventilated days. During this period two patients suffered tracheal tube occlusion. No other complications could be attributed to the filter. We conclude that the Pall BB50T heat and moisture exchanging filter is safe in patients undergoing long-term ventilation. However, its use demands a high degree of respiratory care.

APACHE↗
PubMed1993

A technique of awake fibreoptic intubation. Experience in patients with cervical spine disease.

We report our experience of 58 patients undergoing awake fibreoptic intubation for cervical spine surgery. Topical anaesthesia was administered using a 'spray as you go' technique. The tracheas of 57 patients were intubated successfully. The mean time from starting topical anaesthesia to intubation was 16.1 min (SEM 1.0). The procedure was associated with cardiovascular stability, a low incidence of severe cough and had a high patient acceptance. There was a low failure rate amongst trainees. The minimum mean arterial oxygen saturation was 92.9% (SEM 1.1). There was no relationship between the time taken to intubation and the episodes of desaturation or the grade of laryngeal visibility at direct laryngoscopy. This method of producing topical anaesthesia for awake fibreoptic intubation is recommended.

Adolescent↗
PubMed1992

Ventilatory responsiveness to carbon dioxide below the normal control point in conscious normoxic humans.

A recently developed CO2 pulse technique was used to test for ventilatory sensitivity to CO2 in four normal men following 2 min voluntary hyperventilation down to an end-tidal CO2 tension (PETCO2) of 20 mmHg (2.7 kPa). Pure CO2 was injected into the inspiratory limb of a breathing circuit at 0.4 l.min-1 for 30 s and any small ventilatory response was detected against background noise by ensemble-averaging of multiple runs. Following hyperventilation, ventilation was initially often above control and apnoea was not seen. In one subject, the ventilatory response to the CO2 pulse was barely detectable either before or after hyperventilation. In another subject, there was a response to pulses given before hyperventilation and 3 and 5.5 min after hyperventilation but not 30 s after hyperventilation when PETCO2 was about 25 mmHg (3.3 kPa) and rising. In the two remaining subjects ventilatory responses were seen to CO2 pulses started 30 s after hyperventilation, although PETCO2 following the pulse remained some 5 mmHg (0.7 kPa) below baseline. We conclude that in some subjects the PETCO2 threshold lies well below the normal PETCO2. The technique is tedious for the experimental subject because of the large number of repetitions required and, therefore, unsuitable for a study on a large number of subjects.

Adult↗