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A A Bicker

Publications and source records attributed to A A Bicker.

5 recordsLinked to original sources

The effect of halothane on the amplitude and frequency characteristics of heart sounds in children.

UNLABELLED: Although continuous auscultation has been used during surgery as a monitor of cardiac function for many years, the effect of anesthetics on heart sounds has never been quantified. We determined the root mean squared amplitude and frequency characteristics (peak frequency, spectral edge, and power ratios) of the first (S1) and second (S2) heart sounds in 19 healthy children during induction of anesthesia with halothane. In all patients, halothane decreased the amplitude of S1 (R2 = 0.87 +/- 0.12) and S2 (R2 = 0.66 +/- 0.33) and the high-frequency components (>80 Hz) of these sounds. These changes were clearly audible and preceded decreases in heart rate and blood pressure. The spectral edge decreased for S1 in 18 patients (R2 = 0.73 +/- 0.24) and for S2 in 13 patients (R2 = 0.58 +/- 0.25). Peak frequency did not change. The rapidity with which myocardial depression and its associated changes in heart sound characteristics occurred confirms that continuous auscultation of heart sounds is a useful clinical tool for hemodynamic monitoring of anesthetized infants and children. IMPLICATIONS: Heart sound characteristics can be used to monitor cardiac function during halothane anesthesia in children. The changes occur rapidly and precede noticeable changes in heart rate and blood pressure.

Age Factors↗

An evolutionary solution to anesthesia automated record keeping.

In the course of five years the development of an automated anesthesia record keeper has evolved through nearly a dozen stages, each marked by new features and sophistication. Commodity PC hardware and software minimized development costs. Object oriented analysis, programming and design supported the process of change. In addition, we developed an evolutionary strategy that optimized motivation, risk management, and maximized return on investment. Besides providing record keeping services, the system supports educational and research activities and through a flexible plotting paradigm, supports each anesthesiologist's focus on physiological data during and after anesthesia.

Anesthesia↗

Follow-up of a cohort of alcoholic patients through 12 months of comprehensive biobehavioral treatment.

One hundred and eleven socially stable alcoholic patients were subjected to a comprehensive diagnostic and treatment protocol based on a biobehavioral model of alcoholism. Physical pathology, malnutrition, and toxicity were prevalent throughout the sample. After a period of inpatient care, subjects were treated for a period of 12 months with a combination of medical, nutritional, behavioral, and psychological support and care. At the end of the study period, 91 subjects (81.9%) remained in treatment contact. Sixty seven subjects (60.4%) were abstinent and physically stable at the 12-month date. Elevations of three scales of the MMPI were significantly predictive of treatment outcome.

Adult↗