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Biomedical subjects

C J Westerholm

Publications and source records attributed to C J Westerholm.

18 recordsLinked to original sources
PubMed1979

Cardiovascular effects of neurolept anaesthesia in patients with coronary artery disease.

An anaesthetic technique comprising a combination of phenoperidine (0.1 mg . kg-1), diazepam (0.06 mg . kg-1) and pancuronium bromide (0.1 mg . kg-1) with controlled ventilation was evaluated in 12 patients with severe coronary artery disease. The heart rate, cardiac output and mean arterial blood pressure did not change significantly between the preinduction and postinduction measurements. The right atrial pressure and pulmonary capillary wedge pressure decreased significantly by 33% and 36%, respectively, probably due to the influence of positive-pressure ventilation. There was no depression of the left ventricular performance.

Adult↗
PubMed1979

Myocardial performance early after aorto-coronary bypass surgery and the influence of nitroprusside infusion.

The central and peripheral circulation were studied in 12 patients after aortocoronary bypass surgery. During the initial 5 h after termination of cardiopulmonary bypass, the oesophageal temperature rose from 36.5 degrees C to 39.4 degrees C, concomitant with cutaneous vasoconstriction and an increase in systemic vascular resistance (SVR) and mean arterial blood pressure (MABP). The oxygen uptake index (Vo2I) increased by 57% during the rewarming period. The cardiac index (CI), which was constant at 2.8 l.min-1.m-2, was too low to satisfy this oxygen demand and the arterio-venous oxygen content difference (AVDo2) increased to 3.0 mmol . l-1 by the 3rd hour. After 5 h, SVR had decreased and cutaneous vasodilation began. Vo2I and AVDo2 decreased. The postoperative myocardial function was moderately impaired and deteriorated after the cutaneous vasodilation. Twelve patients were given an infusion of sodium nitroprusside during the postoperative period (0.25--2.5 micrograms . kg-1 . min-1). The rewarming pattern was not influenced by this infusion, but the initial increases in MABP and SVR were eliminated. The myocardial performance was better in the nitroprusside group. CI was significantly higher than in the control group (3.5 l.min-1.m-2) and AVDo2 remained normal.

Adult↗
PubMed1977

Transcervical thymectomy with the aid of mediastinoscopy for myasthenia gravis: eight years' experience.

Fifty-eight patients with myasthenia gravis, including 12 children, underwent thymectomy. Eleven of them (19%) had total stable remission and 42 (72%) showed clinical improvement and were able to reduce their anticholinesterase medication. These two groups combined comprised 53 patients (91%). There was no operative or postoperative mortality. Histopathological examination of the resected thymuses revealed a tumor (benign thymoma) in 4 patients (7%), thymitis in 36(62%), and no pathological changes in 18(31%). Patients with few or no germinal centers tended to achieve remission more rapidly than those with numerous germinal centers.

Adolescent↗
PubMed1975

Central and peripheral circulation immediately after pulmonary surgery as related to sympathodrenal activity.

Catecholamine output and circulation were observed in connection with pulmonary surgery in one group of ten patients who were anaesthetized with halothane-N20-02-d-tubocurarine and who breathed spontaneously after operation. In another group of four patients who received a modified neurolept anaesthesia with phenoperidine-N2O-O2-d-tubocurarine and who were mechanically ventilated also after operation, catecholamine output and temperature were observed. In both patient groups, catecholamine output was normal during iperation. Adrenaline output increased by 400% the first postoperative hours, while noradrenaline output remained normal. Thereafter, noradrenaline output increased, while adrenaline output started to decrease. A subnormal body temperature was seen at the end of the operation. In two patients from the neurolept group, adrenaline output and temperature were recorded hour by hour; maximal adrenaline output concided with maximal temperature rise. In the patients from the halothane group, the pstoperative change in foot, calf and forearm blood flow correlated well with the change in catecholamine output. The central circulatory response to the symptahoadrenal stimulation was, however, found to be less pronounced than is ordinarily seen.

Adult↗