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Biomedical subjects

W J Russell

Publications and source records attributed to W J Russell.

At least 109 records · Page 6Linked to original sources
PubMed1988

Induction using fentanyl to suppress the intubation response in the cardiac patient: what is the optimal dose?

Eighty patients undergoing coronary artery surgery were randomly allocated to receive either 0, 2, 5, 10 or 15 micrograms/kg of fentanyl with induction of anaesthesia. Heart rate and blood pressure were measured before induction, after induction, and after intubation. The effects of fentanyl dose on both heart rate and mean arterial pressure (MAP) were evaluated in terms of both the mean and group responses. At all doses of fentanyl, mean heart rate increased after induction and rose further on intubation. The mean increase after induction was minimal at doses of 5 micrograms/kg and greater. The increase in heart rate after intubation was more difficult to block but with a fentanyl dose of 15 micrograms/kg, 87% of patients had heart rates below 100 bpm. As a group, the percentage of patients in whom the postintubation heart rate remained below 100 bpm increased progressively with the fentanyl dose. In contrast, mean MAP fell at all dose levels after induction, the mean fall being about 30 mmHg at 5 micrograms/kg and greater. Mean MAP exceeded pre-induction values after intubation with 0 and 2 micrograms/kg, and progressive attenuation of the MAP rise was found as the dose of fentanyl increased. The percentage of patients who did not exceed their preinduction MAP rose progressively with increasing dose of fentanyl with an ED50 of 3.7 micrograms/kg. If a minimal fall in mean MAP after induction with no rise above preinduction MAP is the sole criterion, a fentanyl dose of about 3 micrograms/kg is recommended. If heart rate is to be kept below 100 bpm, a dose of at least 10 micrograms/kg should be used.2+ dose or greater will cause the MAP to fall in some patients to less

Blood Pressure↗
PubMed1987

Hand grip force as an assessment of recovery from neuromuscular block.

A simple hydraulic hand dynamometer was used to assess the hand grip force before and after general anesthesia. Eight patients received a general anesthetic of nitrous oxide and oxygen and an inhalational agent without relexants (non-relaxant group). Ten patients received a similar anesthetic of nitrous oxide and oxygen and an inhalational agent with non-depolarizing relaxants (relaxant group). The patients in the nonrelaxant group showed a mild depression to 77% of initial hand grip force by the time they could hold up their heads for 5 seconds. Patients in the relaxant group had a mean of only 29% of initial hand grip force when they could lift their heads. One hour later, hand grip force increased to 76% of preoperative force in the relaxant group. Hand grip force appears to be a sensitive measurement of residual relaxant effect.

Anesthesia Recovery Period↗
PubMed1987

Effect of microfiltration on the histamine levels in stored human blood.

Plasma and whole blood histamine levels and white cell counts have been monitored over a 6-week period of storage in standard citrate-phosphate-dextrose supplemented with adenine (CPDA) blood packs, add-back blood packs, and also CPDA and add-back packs which were subjected to a microfiltration process at the time of collection. Our results indicate that the plasma histamine level rises and the white blood count falls progressively with time, the former being most marked after the 3rd week of blood storage. At 6 weeks, there was no significant difference between the plasma and whole blood histamine level, suggesting that the entire complement of histamine in blood was now in plasma. Microfiltration substantially reduced the white cell count in the packs, and this was reflected in a greatly reduced whole blood and (subsequently) plasma histamine concentration.

Blood Preservation↗
PubMed1986

Nifedipine for postoperative blood pressure control following coronary artery vein grafts.

The drug control of raised blood pressure following coronary artery bypass grafting was studied in 20 patients during the early postoperative period. On a random basis, 10 patients were given intranasal nifedipine and 10 other patients received intranasal saline. If the systolic pressure was raised, it was treated by an infusion of sodium nitroprusside. The systolic pressure abated in those treated with nifedipine so that 7 of the 10 did not require any other treatment in the first hour. The reduction in pressure was accomplished without an increase in heart rate. The requirement for sodium nitroprusside to control the pressure was much less in the first hour postoperatively in the nifedipine treated group and at 4 hours, the effect of nifedipine was still apparent. This study demonstrates that intranasal nifedipine is an effective adjunct for controlling raised blood pressure in the early postoperative period.

Blood Pressure↗
PubMed1985

Destruction of ristocetin cofactor by coagulation at 4 degrees C.

Ristocetin cofactor (VIIIR:RCo) and factor VIII-related antigen (VIIIR:Ag) were measured in anticoagulated and non-anticoagulated blood incubated at 4 degrees C, room temperature (RT) or 37 degrees C for 24 hours. A marked decrease in VIIIR:RCo, to almost undetectable levels, and a smaller decrease in VIIIR:Ag occurred when whole blood clotted at 4 degrees C. These changes were slight or absent when blood clotted at RT or 37 degrees C. VIIIR:RCo lost at 4 degrees C was not recoverable by further incubation at 37 degrees C but the less-marked loss of VIIIR:Ag was partially recovered. In blood which had clotted at 4 degrees C there was a change in the electrophoretic profile of VIIIR:Ag on crossed immunoelectrophoresis: there was more anodal migration of the VIIIR:Ag peak, consistent with a decrease in the mean molecular size. Further experiments showed that the decrease in VIIIR:RCo during coagulation at 4 degrees C preceded the decrease in fibrinogen levels. In cell-free plasma VIIIR:RCo also decreased markedly when coagulation occurred at 4 degrees C. The results show that loss of VIIIR:RCo occurs when blood is allowed to clot at 4 degrees C: this is not due to cryoprecipitation and does not require the presence of blood cells. The data suggest that it is probably caused by plasma proteases activated early in the coagulation pathway.

Antigens↗
PubMed1985

Platelet function in platelet concentrates and in whole blood.

Platelet function was studied in CPD whole blood stored at 4 degrees C for one and three days and in platelet concentrates stored at room temperature for the same periods of time. Comparisons were made of platelet shape, nucleotide content, beta-thromboglobulin (beta TG) liberated during storage, and platelet aggregation in response to ADP, collagen, sodium arachidonate and ristocetin. It was found that in whole blood the shape of the platelets was less discoid than in platelet concentrates. However, platelet aggregation in response to ADP, collagen, and sodium arachidonate was preserved better in whole blood than in platelet concentrates. Platelet nucleotides were the same in whole blood as in platelet concentrates, but the plasma levels of beta TG were less in whole blood. The results show that as judged by aggregation, beta TG release and nucleotide content, platelets from whole blood were at least as functional as those from platelet concentrates. However, platelets from whole blood had lost their discoid shape, which suggests that they would have a short survival in the circulation.

Adenosine Diphosphate↗
PubMed1985

Sonographic diagnosis of bicameral gallbladders: a report of three cases.

Three cases of bicameral gallbladder are reported; the fundal chamber could be visualized by oral cholecystography in only one of these cases. However, all structures were well visualized sonographically. Ultrasonography is thus regarded as essential for the diagnosis of bicameral gallbladders and for detecting any calculi within them.

Aged↗
PubMed1984

The effects of gallamine and a mixture of pancuronium and alcuronium on the pressor and plasma catecholamine responses to tracheal intubation.

Tracheal intubation can be accompanied by significant increases in arterial pressure, heart rate and the plasma levels of noradrenaline and adrenaline. The drugs used at induction can enhance or attenuate these responses. In nine patients who had received gallamine, intubation was associated with a 45% rise in mean arterial pressure, a twofold rise in plasma adrenaline and a 49% rise in plasma noradrenaline concentration. When a mixture of pancuronium and alcuronium (in a ratio of 4:10 by weight) was used in ten patients, blood pressure fell 24% after induction and rose 49% after intubation. A 24% rise in plasma noradrenaline in response to intubation was also observed. Compared with pancuronium alone, the use of the mixture attenuates the rise in blood pressure and noradrenaline concentration associated with intubation but does not abolish them. In addition, the mixture was associated with a significant fall in blood pressure between induction and intubation, whereas this was not found with gallamine.

Adult↗
PubMed1983

Slow-growing lung cancer in a fixed population sample. Radiologic assessments.

Radiographs generated during 20 years of biennial chest radiography of 107 patients with histologically proven lung cancers were reviewed for radiological evidence of slow-growing lesions. Twenty-nine of 37 solitary circumscribed peripheral masses which doubled in volume in five or more months prior to any therapy were considered slow growing. By these criteria, 7 (17%) of 41 squamous cell carcinomas were slow growing; whereas 22 (42%) of 52 adenocarcinomas grew slowly. There were no slow-growing tumors among the 14 anaplastic carcinomas or cancers of other histological type. The mean doubling time for the seven squamous cell carcinomas was 5.7 months; that for the 22 adenocarcinomas was 13.1 months. The cancers of females tended to grow more slowly than did those of males. There was no appreciable difference between the mean age of the 29 patients with slow-growing lesions and that of the remaining 78. Not only was the majority of cancer in the present study readily detectable by radiographic screening of the chest; patient survival correlated very well with the growth rates of the lesions, including those of seven resected tumors. The survivals of the seven patients with adenocarcinomas whose lesions were resected were no better than those of the remaining adenocarcinoma patients who had no surgical treatment. The results of this study proved that an appreciable percentage of lung cancers do develop slowly, especially adenocarcinomas.

Adenocarcinoma↗
PubMed1983

Effects of pancuronium and alcuronium on the changes in arterial pressure and plasma catecholamine concentrations during tracheal intubation.

The changes in the plasma concentrations of noradrenaline, adrenaline and dopamine, during tracheal intubation, were studied in 17 patients. Nine patients received pancuronium and eight alcuronium to produce neuromuscular blockade. In the patients receiving pancuronium, intubation of the trachea was accompanied by an increase in mean arterial pressure, and in the plasma concentrations of noradrenaline and adrenaline. In the alcuronium group, there were no significant changes in the plasma concentrations of any catecholamine, nor any change in mean arterial pressure in response to intubation of the trachea.

Adult↗