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Biomedical subjects

C Gillbe

Publications and source records attributed to C Gillbe.

15 recordsLinked to original sources
PubMed2006

The anaesthetist and the cardiac catheterisation laboratory.

Interventional cardiology is an innovative and expanding field. Anaesthetists are increasingly involved in managing complex congenital and acquired heart lesions in the cardiac catheterisation laboratory. This article provides an overview of common lesions encountered in the cardiac catheterisation laboratory, the anaesthetic management of patients with congenital and acquired heart lesions, the procedures performed and the complications encountered during such procedures.

Anesthesia↗
PubMed2003

Anaesthesia for lung volume reduction surgery.

Lung volume reduction surgery is a surgical treatment for severe emphysema that is increasing in popularity. The aim is to reverse the hyperexpansion of the lungs that leads to expiratory airflow limitation, compromises the diaphragm and chest wall mechanics, and tamponades the right ventricle. Optimal patient selection has not yet been established, but it has become clear that those patients with the most severe disease have an unacceptably high surgical mortality. The anaesthetic management of patients undergoing lung volume reduction surgery requires a good understanding of both the pathophysiology of the disease and the surgical procedure. It is important for the anaesthetist and the surgeon to work closely, supported by a large multidisciplinary team. Excellent analgesia is essential to a successful outcome; whether this is best provided by thoracic epidural is as yet unclear.

Analgesia↗
PubMed1995

The pharmacokinetics of alfentanil after normothermic and hypothermic cardiopulmonary bypass.

The pharmacokinetics of alfentanil were studied after two different methods of cardiopulmonary bypass (CPB) which used either a normothermic technique or a hypothermic technique with body temperatures below 30 degrees C. A group of surgical patients who did not undergo CPB were also studied. All patients (n = 36) received alfentanil 50 micrograms/kg as a rapid infusion over 10 min and plasma levels were measured for the following 8 h. The volume of distribution in steady state (Vdss) and the volume of central compartment (Vc) were significantly greater in the CPB groups (P = 0.009 and P = 0.04), compared to the nonbypass group. However, the elimination half-life of alfentanil (t1/2 beta) (mean, 95% confidence interval) did not differ significantly between the normothermic (134 min, range 104-172), hypothermic (143 min, range 111-184), and nonbypass (111 min, range 86-142) groups. Between the normothermic and hypothermic CPB groups no significant differences in Vdss, rate of clearance (Cl), or t1/2 beta were found. The pharmacokinetics of alfentanil showed fewer changes after CPB in this study than have been reported previously. Furthermore, different temperature management protocols during CPB did not influence alfentanil elimination.

Aged↗
PubMed1990

Comparative study of the effects of enoximone and dobutamine in patients with impaired left ventricular function undergoing cardiac surgery.

In the light of several incidences at Brompton Hospital in which enoximone brought about a striking improvement in cardiac index in patients with refractory left ventricular failure, a study was initiated to compare the effects of enoximone and dobutamine following cardiopulmonary bypass in patients with impaired left ventricular function (preoperative ejection fraction less than 0.5). In two groups of 10 patients, similar responses of haemodynamic variables were obtained with enoximone or dobutamine administration. In particular, mean cardiac index increased by 25% in the first 15 min and by 60% over the 24-hour study period after bypass. Mean systemic vascular resistance fell by approximately 10%. Mixed venous oxygen saturation increased marginally from a preoperative value of approximately 76% within 15 min of drug administration and then fell and stabilized at about 65% in the next 12 h during re-warming. Patients were weaned from enoximone, after 24 h, without event. Both drugs were shown to produce favourable haemodynamic profiles and to be well tolerated in this relatively high-risk cohort of patients.

Cardiac Surgical Procedures↗
PubMed1989

Slide tracheoplasty for congenital funnel-shaped tracheal stenosis.

Congenital funnel-shaped trachea is a serious condition, and the survival rate in infants is poor. A slide tracheoplasty is described, with a brief review of other methods of repair. Two cases that demonstrate the operability of congenital funnel-shaped trachea in infancy are reported.

Female↗
PubMed1985

Opitz-Frias syndrome. A case with potentially hazardous anaesthetic implications.

The anaesthetic management is described of a nine-month-old male for surgical palliation of the the functional abnormalities associated with Opitz-Frias syndrome. Features of this syndrome of interest to anaesthetists include recurrent pulmonary aspiration of intestinal contents, achalasia of the oesophagus, subglottic stenosis, hypertelorism, micrognathia and a high arched palate. No previous reports of anaesthesia for patients with this condition have been identified.

Abnormalities, Multiple↗
PubMed1981

Fixed performance oxygen masks. Hypoxic hazard of low-capacity drugs.

Four recently introduced low-capacity fixed performance oxygen therapy masks have been compared with the established Ventimask design. Under conditions of varying peak inspiratory flow rate the low-capacity devices all permit a variable amount of air admixture with a consequent fall in the inspired oxygen concentration. It is concluded that low-capacity venturi masks are not true fixed performance devices under all circumstances. The Ventimasks satisfy their specifications under all test conditions. A case is made for more rigorous assessment of new so-called "fixed performance" oxygen therapy devices before marketing is permitted.

Equipment Design↗