PubMed Health⌕ Search

Biomedical subjects

B Geffin

Publications and source records attributed to B Geffin.

16 recordsLinked to original sources
PubMed1998

Sinus bradycardia and asystole during spinal and epidural anesthesia: a report of 13 cases.

STUDY OBJECTIVE: To characterize the clinical features that predispose to sinus bradycardia and cardiac arrest during spinal and epidural anesthesia. DESIGN: Retrospective clinical review. SETTING: University affiliated medical center. PATIENTS: 13 patients, aged 26 to 76 years, who suffered severe sinus bradycardia or asystole over a 5-year period, during which approximately 4,000 regional anesthetics were administered. MEASUREMENTS AND MAIN RESULTS: Case histories of 13 patients who developed severe sinus bradycardia or asystole during spinal or epidural anesthesia are summarized. Twelve cases occurred during spinal anesthesia, and the thirteenth, during epidural anesthesia. In all but one case, the acute event occurred 15 minutes or longer from the time of the anesthetic injection. Resuscitation was successful in all cases, with no postoperative sequelae. CONCLUSION: The clinical picture suggests a reflex cause, possibly associated with low right-sided cardiac filling pressure. No common precipitating cause or high-risk patient profile was noted.

Adult↗
PubMed1986

Flammability of endotracheal tubes during Nd-YAG laser application in the airway.

The effects of the neodymium-yttrium aluminum garnet (Nd-YAG) laser on several commonly used endotracheal tubes were examined. Six different types of tubes were tested for flammability. Three tubes were clear, transparent polyvinylchloride with black lettering on the surface. One was yellow-green silicone rubber with green lettering on the surface. One, which was opaque gray with no printing or marks on it, was designed specifically for use with the carbon dioxide (CO2) laser, and one was opaque red rubber with black letters printed on the surface. The latter was tested with and without a wrapping of reflective aluminum tape. On each tube a clear, unmarked area and an area with printing were tested. In each area the tube was impacted by the laser at three to five points. Pulsed and continuous patterns of laser impact were used. Power ranged from 20 to 50 W. The clear polyvinylchloride tubes were not damaged by a pulsed pattern of exposure in unmarked areas. Segments with black printing or marks were consistently damaged. Continuous laser exposure consistently damaged clear portions of the tube. In clear unmarked areas, silicone rubber tubes were damaged with the pulsed pattern when exposure reached 50 W for 1 s. Areas with green lettering were damaged at the lowest level of exposure. Continuous laser exposure at 30 W damaged clear portions of these tubes after 7 s. Opaque red rubber and opaque gray tubes were damaged at the lowest levels of exposure in both clear and marked areas with pulsed and continuous laser emission. A wrapping of reflective aluminum tape offered no protection.(ABSTRACT TRUNCATED AT 250 WORDS)

Color↗
PubMed1972

Ventilation with end-expiratory pressure in acute lung disease.

In 10 patients with severe, acute respiratory failure we studied the effects of positive end-expiratory pressure when intermittent positive pressure ventilation (IPPV) with inspired oxygen (F(IO2)) up to 0.5 failed to maintain arterial oxygen tension (P(aO2)) above 70 torr.Positive end-expiratory pressures (PEEP) of 0, 5, 10, and 15 cm H(2)O were applied for 30-min periods each and in random order. Blood gas exchange, lung volumes, compliance, and hemodynamics were studied at each level of PEEP. P(aO2) (F(IO2) = 1.0) rose linearly with elevation of PEEP, the mean increase being from 152 to 347 torr, or 13 torr/cm H(2)O PEEP. Mean functional residual capacity (FRC) was 1.48+/-0.78 liters at zero PEEP (i.e., IPPV) and the increase was essentially linear, reaching 2.37 liters at 15 cm H(2)O PEEP. P(aO2) and FRC showed a close correlation. Total and lung static compliance were greater during ventilation with high than with low levels of PEEP. The increase in P(aO2) correlated with the specific lung compliance. Dynamic lung compliance decreased progressively with rising levels of PEEP except for an increase with 5 and 10 cm H(2)O PEEP in patients with initial values of 0.06 liter/cm H(2)O or higher. Cardiac index fell in some patients and rose in others and there was no correlation of mean cardiac index, systemic blood pressure, or peripheral vascular resistance with level of PEEP. The most probable explanation for the effect of PEEP on P(aO2) and compliance is recruitment of gas exchange airspaces and prevention of terminal airway closure.

Acute Disease↗
PubMedDate not supplied

Anesthesia rebreathing bags: physical characteristics and use as portable oxygen reservoirs.

STUDY OBJECTIVE: To examine the physical characteristics of 3-liter anesthesia rebreathing bags and assess their use for oxygen (O2) storage and delivery during transport of patients from the operating room (OR) to the recovery area. SETTING: Anesthesia laboratory and pulmonary function laboratory. INTERVENTIONS: Five anesthesia rebreathing bags were inflated in 2-liter increments with 50 liters of air and then deflated in 2-liter increments. A sixth bag was inflated twice in 1-liter increments. Five bags were inflated with 60 liters of gas and allowed to deflate through a cannula functioning as a flow restrictor. Five bags were inflated with 100 liters of gas and checked for damage. MEASUREMENTS AND MAIN RESULTS: Pressure measurements done at 2-liter increments during inflation of the bags to 50 liters and deflation showed a consistent pattern of pressure-volume relationships. Assessment of gas flow during deflation through the cannula showed flow rates ranging from 3.1 to 3.8 L/min after 5 minutes of continuous flow and from 2.8 to 3.8 L/min after 10 minutes. No weakness or damage was apparent in bags inflated with 100 liters of gas. CONCLUSIONS: It is feasible for anesthesia rebreathing bags distended with O2 to serve as lightweight, inexpensive, and easily monitored alternatives to O2 tanks for O2 delivery during transport of patients from the OR to the recovery area.

Anesthesia Recovery Period↗