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Ethics, Medical↗
Biomedical subjects
D Buehler
Publications and source records attributed to D Buehler.
Computerized chaplaincy--today and tomorrow.
Health care chaplaincy is not an obvious setting for "high tech" methods and equipment. Yet computer technology is rapidly revolutionizing both medicine and ministry. DRGs (diagnosis-related groups) and other innovations in health care make it imperative that chaplains be both familiar and comfortable with computer technology. Obstacles to this goal include computer "block," clergy resistance, cost factors and the myth that pastoral care requires no technology. Chaplains are urged to explore new uses for computers in ministry, while being cautious about too rapidly embracing technology as an end in itself. Each chaplain must determine for herself/himself how best to utilize computers in chaplaincy.
Chaplaincy Service, Hospital↗
Prosthetic replacement of the aortic arch.
Four patients are reported in whom the aortic arch and variable portions of the ascending and descending aorta were replaced with a prosthesis. In three patients the preoperative diagnosis was dissecting aneurysm of the aortic arch and in one an arteriosclerotic aneurysm of the aortic arch was present. A combination of surface cooling and cardiopulmonary bypass was utilized to produce total body hypothermia. Arch replacement was carried out during a period of total circulatory arrest. Cardiopulmonary bypass was then utilized to warm the patient and resuscitate the heart. The average duration of cerebral ischemia was 43 minutes and the average duration of myocardial ischemia was 74 minutes. The average lowest esophageal temperature was 14 degrees C., and the average lowest rectal temperature was 18 degrees C. Three patients are alive and well 4 to 13 months following surgery. One patient died 4 days postoperatively of pulmonary insufficiency. This experience indicates that by utilizing total body hypothermia and circulatory arrest aortic arch replacement can be carried out with an acceptable mortality rate. Corrective surgery could be offered to patients with life-threatening enlarging aneurysms of the aortic arch.
Aortic Aneurysm↗