Biomedical subjects

C C Bostek

Publications and source records attributed to C C Bostek.

4 recordsLinked to original sources

PubMed1992

Effective methods of in-line intravenous fluid warming at low to moderate infusion rates.

Three methods of warming intravenous (IV) fluids were examined. An in-line blood warmer was generally ineffective at flow rates of < 250 mL/hr but did produce temperatures of 30 to 31 degrees C at the catheter when the infusion rate was 500 to 1,000 mL/hr and the tubing was insulated. An in-line hot water bath produced temperatures of > or = 30 degrees C at flow rates of 200 to 1,000 mL/hr with uninsulated tubing. The addition of insulation maintained on infusate temperature of > or = 30 degrees C at a rate of 100 mL/hr. Application of a K-Thermia pad to the IV tubing close to the patient maintained an infusate temperature of > or = 30 degrees C at rates of 50 to 200 mL/hr. Warming at rates of 200 to 1,000 mL/hr is most effective with an in-line hot water bath. Warming at low infusion rates is best accomplished with a K-Thermia pad. The use of in-line blood warmers for routine fluid warming is ineffective.

Evaluation Studies as Topic↗

PubMed1992

Total intravenous anesthesia with a continuous propofol-alfentanil infusion.

A total intravenous anesthetic using propofol and alfentanil was evaluated to determine if it would provide a shorter recovery-room stay than a more traditional balanced anesthetic using isoflurane and alfentanil. Forty-three ASA I or II patients between 17 and 50 years of age undergoing major abdominal or orthopedic procedures were studied. The propofol group received alfentanil 50 mg/kg followed by propofol 1 mg/kg for anesthesia induction. Continuous propofol infusion was initiated at induction using 170 mg/kg/min for 10 minutes, followed by 130 mg/kg/min for 10 minutes, then maintained at 100 mg/kg/min until 10 minutes before the end of surgery. Ventilation was supported with an air-oxygen mixture. The group receiving balanced anesthesia received alfentanil 1 mg/kg, and anesthesia was induced with sodium thiopental 4 mg/kg. A 1% isoflurane inhalation with air-oxygen was initiated immediately upon induction. Both groups received a continuous infusion of alfentanil titrated to maintain heart rate within 10% of preinduction levels. Recovery from anesthesia was measured using a subjective pain assessment, a verbal fluency test, and a short-term memory test. No differences were detected in the rate of recovery at 30 minutes or 60 minutes postextubation. Hemodynamic stability during induction and intubation was slightly better in the propofol group than in the isoflurane group. One episode each of intraoperative awareness and delayed eye opening occurred in the propofol group. Total intravenous anesthesia using propofol and alfentanil is just as effective as a balanced inhalation anesthetic and provides equally rapid recovery. However, practitioners are cautioned to include an amnestic adjuvant when using propofol as the sole anesthetic agent.

Adolescent↗

PubMed1990

Avoiding unintentional hypothermia: anesthesia implications.

Maintaining normal thermal balance in the anesthetized patient remains a primary physiological consideration for the anesthetist. Because hypothermia occurs frequently during surgery and anesthesia, it is imperative that the anesthetist fully appreciate the variety of factors associated with unintentional hypothermia. This knowledged, coupled with an understanding of physiological ramifications and meaningful therapeutic interventions will enable the anesthetist to provide optimal care for patients, particularly those at risk for developing hypothermia intraoperatively. This survey article will trace current research as it applies to the principles underlying proper management of the hypothermic patient.

Anesthesia↗

PubMed1989

Oxygen toxicity: an introduction.

Although oxygen has been known to be toxic for more than 200 years, the clinical importance of oxygen toxicity was not appreciated until an epidemic of retrolental fibroplasia occurred in the early 1950s. Oxygen at high partial pressures is toxic to the respiratory, cardiovascular, nervous, and gastrointestinal systems. Toxicity results from the formation of oxygen-free radicals. These arise within mitochondria as oxygen is reduced to water, as byproducts of prostaglandin and thromboxane synthesis, and by the xanthine oxidase catalyzed reduction of xanthine or hypoxanthine. They are also produced by activated macrophages as part of the immune response. Superoxide anion is the radical most commonly produced. It dismutes to hydrogen peroxide, which is able to diffuse through lipid membranes. Hydrogen peroxide reacts with transition metals to produce the highly reactive hydroxyl radical which can initiate chain reactions of lipid peroxidation leading to cell rupture. Oxygen radical scavengers such as superoxide dismutase and catalase protect the body against normal levels of oxygen-free radicals. Oxygen toxicity can result from either reperfusion of ischemic tissue or prolonged exposure to high concentrations of oxygen. Limiting hyperoxia to maintain arterial oxygen percent saturation (SaO2) greater than or equal to 90% is recommended.

Animals↗