ABSTRACT
Twenty-three ASA physical status II-III patients scheduled for elective abdominal aortic surgery were studied preoperatively with multiple unit gated acquisition angiography (MUGA) scan to determine the resting left ventricular and right ventricular ejection fractions (LVEF and RVEF respectively). Intraoperatively pulmonary capillary wedge pressure (PCWP) and central venous pressure (CVP) were measured in each patient at five different time periods in the horizontal, 24 degrees head up, and 24 degrees head down table tilt positions. The correlation between absolute values and changes in PCWP and CVP, and the degree to which preoperative knowledge of LVEF and RVEF predicted these correlations were examined. Resting LVEF ranged from 0.1 to 0.84. Thirteen of the 23 patients failed to show significant correlation (p less than 0.05) between the absolute values of PCWP and CVP either before and/or after aortic crossclamp. When the correlation coefficients from this analysis were ranked against LVEF, there was a weak but significant correlation before aortic crossclamp (r = 0.41), but not after. The correlation between a change in PCWP and a change in CVP was significant for the 23 patients at all time intervals, before and after aortic crossclamp. However, the prediction of a change of PCWP value from a known change of CVP value ranged in accuracy from +/- 3 mmHg to +/- 12.5 mmHg. The study suggests that if the filling pressures of both ventricles need to be assessed during aortic surgery, then the PCWP and CVP must be independently measured.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Aorta, Abdominal/surgery , Central Venous Pressure , Pulmonary Wedge Pressure , Adult , Aged , Constriction , Female , Humans , Male , Middle AgedABSTRACT
The effect of the administration of fentanyl 50 micrograms/kg body weight on the established metabolic response to pelvic surgery was investigated. In comparison with a control group of patients in whom anaesthesia was supplemented with halothane, fentanyl was associated with a significant decrease in only blood lactate concentrations and heart rate. There were no significant differences in blood glucose, plasma non-esterified fatty acids, and plasma cortisol values between the two anaesthetic techniques. It is concluded that the administration of high-dose fentanyl has little effect on the established metabolic response to surgery, compared with the marked changes observed when the same dose is given before the onset of surgical stimulation.
Subject(s)
Anesthesia, Intravenous , Fallopian Tubes/surgery , Fentanyl/administration & dosage , Adult , Anesthesia, Inhalation , Blood Glucose/metabolism , Blood Pressure/drug effects , Female , Fentanyl/pharmacology , Halothane , Heart Rate/drug effects , Hematocrit , Humans , Hydrocortisone/blood , Lactates/blood , Lactic AcidABSTRACT
Pigment production by group B streptococci (GBS) is a useful test for identification of the organisms. The test is positive in 99.5% of beta-haemolytic strains. No false-positives are noted. Non-haemolytic strains do not produce pigment. Islam's media less agar can be used as a one-step broth detector of GBS in mixed cultures. This may have application for the detection of GBS in women in labour. When used as an identification system for GBS, serum-starch broth can be further modified by reduction of serum and starch concentrations by at least 80%.
Subject(s)
Pigments, Biological/biosynthesis , Streptococcus agalactiae/isolation & purification , Bacteriological Techniques , Culture Media , Streptococcus agalactiae/metabolismABSTRACT
A 44-year-old man sustained lacerations of the forearm as a result of a horsebite. His arm became swollen after primary closure of the wounds, and a roentgenogram showed gas in the tissues of the forearm. Streptococcus anginosus and S mutans were isolated from the wounds.
