Biomedical subjects

B R Boggs

Publications and source records attributed to B R Boggs.

3 recordsLinked to original sources

PubMed1987

The superiority of cold oxygenated dilute blood cardioplegia.

It has been clearly shown, both in a laboratory model and in humans, that oxygenation of crystalloid cardioplegic solutions markedly enhances myocardial preservation. The addition of a small volume of red cells to a crystalloid perfusate improves capillary perfusion. Based on these results, we have changed our cardioplegic solution from cold crystalloid to cold oxygenated dilute blood. In the present study we retrospectively evaluate the results of 400 operative procedures to determine whether the addition of oxygenation and a small volume of blood to the cardioplegic solution enhances myocardial protection in the clinical setting. Two hundred consecutive patients who underwent operation with cardioplegic arrest using a cold crystalloid cardioplegic solution (group 1) were compared with a subsequent 200 patients who underwent operation with cold oxygenated dilute blood cardioplegia (group 2). Patients in group 2, who received cold oxygenated dilute blood cardioplegia, had a significantly reduced need for postoperative intraaortic balloon pump counterpulsation and for atrioventricular pacing. Also, patients in group 2 had a lower incidence of perioperative myocardial infarction and had improved early outcome. None of the 200 patients in group 2 had electrocardiographic evidence of perioperative infarction. We conclude that cold oxygenated dilute blood cardioplegia provides better preservation than does a nonoxygenated crystalloid solution during elective ischemic arrest, because a cold crystalloid solution is able to deliver oxygen and the red cells are able to enhance capillary perfusion.

Blood↗

PubMed1987

Optimal myocardial preservation with an acalcemic crystalloid cardioplegic solution.

The effect of the calcium and oxygen contents of a hyperkalemic glucose-containing cardioplegic solution on myocardial preservation was examined in the isolated working rat heart. The cardioplegic solution was delivered at 4 degrees C every 15 minutes during 2 hours of arrest, maintaining a myocardial temperature of 8 degrees +/- 2 degrees C. Hearts were reperfused in the Langendorff mode for 15 minutes and then resumed the working mode for a further 30 minutes. Groups of hearts were given the oxygenated cardioplegic solution containing an ionized calcium concentration of 0, 0.25, 0.75, or 1.25 mmol/L or the same solution nitrogenated to reduce the oxygen content and containing 0 or 0.75 mmol ionized calcium per liter. The myocardial adenosine triphosphate concentrations at the end of arrest in these six groups of hearts were 15.6 +/- 1.2, 9.5 +/- 0.5, 8.2 +/- 1.1, 4.9 +/- 1.8, 10.1 +/- 2.0, and 1.6 +/- 0.4 nmol/mg dry weight, respectively. At 5 minutes of working reperfusion, the percentages of prearrest aortic flow were 80 +/- 2, 62 +/- 4, 33 +/- 6, 37 +/- 5, 48 +/- 7 and 46 +/- 8, respectively. The differences among the groups in adenosine triphosphate concentrations and in functional recovery diminished during reperfusion. In hearts given the hypoxic calcium-containing solution, there was a marked increase in coronary vascular resistance during the administration of successive doses of cardioplegic solution, which was rapidly reversible upon reperfusion. These data indicate that hearts given the acalcemic oxygenated solution had better adenosine triphosphate preservation during arrest and better functional recovery than hearts in any other group. Addition of calcium to the oxygenated cardioplegic solution decreased adenosine triphosphate preservation and functional recovery. Oxygenation of the acalcemic solution increased adenosine triphosphate preservation and functional recovery. The lowest adenosine triphosphate levels at end arrest were observed in hearts given the hypoxic calcium-containing solution. In the setting of hypothermia and multidose administration, the addition of calcium to a cardioplegic solution resulted in increased energy depletion during arrest and depressed recovery.

Animals↗

PubMed1982

Five year experience with pancreatic pseudocysts.

Twenty-six patients with pancreatic pseudocysts underwent surgical intervention from 1975 through 1979. Chronic alcohol use was associated with pancreatic disease in 84.6 percent of these patients. The clinical findings are not specific, and ultrasonographic examination of the abdomen and computed tomographic scanning have been the most reliable diagnostic tests. External drainage is performed for infected or thin-walled cysts, and carries a complication rate of 72.7 percent in this series. Internal drainage was complicated 31 percent of the time. There were no deaths in this series.

Adolescent↗