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Biomedical subjects

C B Beckman

Publications and source records attributed to C B Beckman.

At least 19 recordsLinked to original sources
PubMed1983

Valve replacement for left-sided endocarditis in drug addicts.

Eighteen drug addicts with left-sided valvular endocarditis requiring operation are reviewed. Gram-positive bacteria were the most common organisms cultured (61%), with Staphylococcus aureus present in 7 of 11 patients. Gram-negative bacteria, exclusively Pseudomonas aeruginosa, were cultured in the remaining 39%. Indications for operation included sepsis (61%), heart failure (78%), and systemic emboli (22%). Abscesses formed in 6 of 11 patients with gram-positive endocarditis, while only one abscess was present with gram-negative endocarditis. Normal valves were infected in 17 of 18 patients (94%). Early surgical mortality (less than 30 days) was 11%. There were major complications in 79% of these patients, including persistent sepsis (50%), valvular dehiscence, prosthetic endocarditis or perivalvular leakage (37%), and mycotic aneurysms (22%). These complications were directly related to a late mortality of 44%, yielding an overall mortality of 50% in the first nine months after operation. Contrary to previous reports of acceptable surgical survival for valvular endocarditis, these data suggest that endocarditis involving the aortic or mitral valve in a drug addict is a highly lethal disease due to the virulence of the organisms, the severity of the complications encountered, and the predisposition to continued addiction.

Adolescent↗
PubMed1982

Influence of the salt moiety on the effectiveness of corticosteroid therapy in cardiogenic shock.

Using closed chest coronary artery microsphere embolization, myocardial infarction and subsequent shock were produced in healthy adult mongrel dogs. Following infarction animals were distributed among the following groups: (1) control; (2) methylprednisolone sodium succinate (MPSS); (3) methylprednisolone sodium phosphate (MPSP); (4) sodium phosphate (SP); and (5) sodium succinate (SS). Drug doses of equivalent anti-inflammatory activity were administered i.v. 15 min after infarction. Compared to control animals, only dogs treated with MPSS exhibited significant improvements in hemodynamic parameters and permanent survival. Survival in MPSS dogs was significantly (P = 0.02) better than that of either group treated with SP or SS and substantially (P = 0.02) better than that of either group treated with SP or SS and substantially (P = 0.065) better than the survival rate of dogs receiving MPSP. It appears that succinate is permissive, while phosphate is restrictive, with respect to efficacy of methylprednisolone in experimental cardiogenic shock. Possible explanations for these observations are discussed.

Adrenal Cortex Hormones↗
PubMed1981

Systemic effects of multidose hypothermic potassium cardioplegia.

The purpose of this study was to investigate the changes in serum and urine potassium before, during, and after the administration of potassium cardioplegia using a solution containing 28 mEq/L of potassium chloride in 20 consecutive patients with acquired heart disease. The data obtained suggest that the concentration of potassium administered does not result in inordinately elevated serum potassium levels (peak, 4.6 +/- 0.18 mEq/L at 2 hours of multidose hypothermic potassium cardioplegia) during or after infusion. Additionally, the urinary excretion of potassium increased during infusion and eventually exceeded the amount of potassium infused. While hypothermic potassium cardioplegia appears to be a safe and efficient method of myocardial protection, continued surveillance of postoperative potassium levels remains necessary to detect obligatory urinary potassium excretion following cardiopulmonary bypass and operation.

Adult↗
PubMed1981

Protective effects of epinephrine tolerance in experimental cardiogenic shock.

To evaluate the mechanism of protection of epinephrine tolerance in shock, we studied the hemodynamic and regional blood flow response to cardiogenic shock in dogs rendered tolerant to lethal doses of epinephrine. Shock was induced by coronary embolization. Regional organ perfusion was evaluated with radioactive microspheres. The survival of tolerant dogs following embolization was 8/12 (62%) compared to 5/31 (16%) in control dogs (P = 0.008). Heart and adrenal organ weights were significantly greater in the tolerant animals. Ventricular hypertrophy in the tolerant dogs was accompanied by greater myocardial blood flow and greater myocardial contractility both before and during cardiogenic shock. There was significantly greater regional flow to spleen, gastrointestinal tract, and pancreas during shock in the epinephrine-tolerant group.

Animals↗
PubMed1980

Risk factors for air embolization during cannulation of the ascending aorta.

Several techniques have evolved for the cannulation of the ascending aorta for cardiopulmonary bypass. Although the theoretical risk of air embolization related to cannulation of the aorta has been alluded to in the past, studies of this problem have not previously been reported. Using a mock circulatory circuit, we found that cannulation with an empty clamped cannula caused a mean embolization of 0.0435 cc of air per cannulation compared to 0.0142 cc with a saline filled cannula and 0.0045 cc with a vented cannula. The residual amount of air which embolized in the ideally vented cannula was caused by the air pocket found within the aorta above a tangentially applied excluding clamp and could be eliminated completely by not clamping the aorta.

Catheterization↗
PubMed1977

Results and complications of intraaortic balloon counterpulsation.

During the forty-month period ending July, 1976, intraaortic balloon counterpulsation was used as an adjunct to medical or surgical therapy in 273 patients. Thirty-seven developed complications. Limb ischemia occurred in 16; it resolved in 12, resulted in gangrene of the toes in 1 and leg gangrene in 2, and was the casue of death in 1 patient. Aortic dissection was confirmed in 7 patients and strongly suspected in another 4. Eight of the 11 patients with dissection underwent cardiac procedures with heparinization at two days to three months after balloon insertion with no untoward effects. Septicemia developed in 2 patients, 1 of whom died of cardiogenic shock. Localized groin sepsis occurred in 8 patients, 2 of whom required removal of infected Dacron graft material. Awareness of the complications of balloon insertion, proper attention to details of balloon management at the time of insertion and removal, and continuous monitoring through a central-lumen balloon should decrease the incidence of complications.

Adolescent↗
PubMed1975

Alternate pathways to pulmonary venous flow in left-sided obstructive anomalies.

In cardiac anomalies causing severe obstruction in the left side of the heart, such as aortic atresia, mitral atresia, or occasionally severe aortic stenosis, maintenance of circulation depends upon shunting of pulmonary venous blood into the right atrium. The usual pathway by which the shunt is achieved is across the atrial septum through the foramen ovale. When this route is closed or severely narrowed, alternate but less common pathways may exist. These involve either anomalous connections of pulmonary veins to systemic veins or communications with the coronary venous system. In the latter, as commonly occurs in aortic atresia, left ventricular myocardial sinusoids carry pulmonary venous blood from the left ventricular cavity and into the cardiac veins. In other instances of severe left-sided obstruction, a direct communication may exist between the left atrium and the coronary sinus.

Aortic Valve↗