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Biomedical subjects

D Bouchier-Hayes

Publications and source records attributed to D Bouchier-Hayes.

At least 145 records · Page 8Linked to original sources
PubMed1988

Radionuclide ventriculography and two dimensional echocardiography as predictors of left ventricular performance during aortic vascular surgery.

Sixteen consecutive patients scheduled for elective aortic vascular surgery underwent preoperative LVEF determination employing two dimensional echocardiography (2DE) and radionuclide ventriculography (RNV). Measured and derived indices of cardiac function were recorded before and after induction of anaesthesia, aortic cross-clamping and aortic unclamping. Induction of anaesthesia was associated with significant decreases in mean arterial pressure (MAP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI) and with a highly significant decrease in left ventricular stroke work index (LVSWI). Aortic cross-clamping was associated with significant increases in MAP and systemic vascular resistance (SVR) whereas aortic unclamping was associated with a significant decrease in SVR. Preoperative LVEF, as measured by RNV and 2DE, were similar. Resting ejection fractions correlated poorly with both preoperative cardiac indices and with changes in indices of left ventricular performance seen intraoperatively. Preoperative ejection fraction determination did not predict intraoperative left ventricular performance. Preoperative exercise scanning may prove more informative.

Aged↗
PubMed1986

The association of impaired neutrophil chemotaxis with postoperative surgical sepsis.

Postoperative sepsis remains a major problem in current surgical practice. This study assesses the predictive role of neutrophil chemotaxis in the development of sepsis in surgical patients. Neutrophil chemotaxis was measured in 30 cancer patients undergoing gastrointestinal surgery and in 26 healthy age and sex-matched controls. Neutrophil chemotaxis was significantly reduced (P less than 0.02) in the patients (mean 79.2 micron +/- 2.7 s.e.m.) compared with the controls (mean 86.8 micron +/- 1.9 s.e.m.). In the entire patient group neutrophil chemotaxis did not change to any appreciable extent following surgery. However, in the seven patients who developed postoperative septic complications, chemotaxis, which was similar to control levels in the pre-operative stage, declined significantly following surgery. Pre-operative values for the septic group of patients are 92.4 micron +/- 4.02 s.e.m.. These declined to 73.4 micron +/- 3.15 s.e.m. (P less than 0.05) and to 68.2 micron +/- 2.89 s.e.m. (P less than 0.05), 5-8 days (early) and 10-14 days (late) postoperatively respectively. Neutrophil chemotaxis in the non-septic group of patients did not alter over this same period. The data suggest that the onset of postoperative sepsis in patients is accompanied by impairment of chemotactic properties in their neutrophils. However, it is also evident that measurement of this variable in patients before operation does not help to define an 'at risk' group for the development of postoperative sepsis.

Aged↗
PubMed1985

Ultrasound examination in the diagnosis of popliteal artery aneurysms.

Popliteal artery aneurysm is a potentially limb-threating lesion which is frequently difficult to diagnose by clinical examination or angiography. The risk of limb loss can best be reduced by early diagnosis. Over the past 5 years we have prospectively evaluated ultrasound examination of the popliteal space in screening patients with clinically suspected popliteal artery aneurysms. One hundred patients who were suspected clinically of having a popliteal artery aneurysm underwent bilateral ultrasound examination of their popliteal fossae. There were 21 patients who had abnormal scans. The problems identified were popliteal artery aneurysm in thirteen patients, popliteal artery ectasia in four patients, Baker's cyst in two patients, thrombosis in one patient and popliteal stenosis in one patient. Eight patients with eleven popliteal artery aneurysms by ultrasound also underwent angiography. Seven of the aneurysms were confirmed, four were missed. All eleven aneurysms were confirmed at operation. In addition, angiography did not demonstrate an aneurysm in any patient with a normal ultrasound. This study confirms that ultrasound examination is a quick, accurate, and non-invasive method of screening for popliteal artery aneurysms.

Adult↗
PubMed1985

Fibre-optic assessment of tracheal tube position. A comparison of tracheal tube position as estimated by fibre-optic bronchoscopy and by chest X-ray.

The distance between the tip of a tracheal tube and the carina was measured in twenty five patients who required tracheal intubation and artificial ventilation of the lungs. Two methods of evaluation of this distance--limited-optic bronchoscopy and chest X-ray--were compared. There was no significant difference between the distance measured by either method. The advantages of checking tracheal tube placement by fibre-optic bronchoscopy are discussed.

Adult↗