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Biomedical subjects

D C Finlayson

Publications and source records attributed to D C Finlayson.

At least 37 records · Page 2Linked to original sources
PubMed1980

Vasodilator therapy after cardiac surgery: a review of the efficacy and toxicity of nitroglycerin and nitroprusside.

Eight-five patients who required vasodilator therapy in the postoperative period after cardiac surgery were studied to compare the haemodynamic effects of nitroglycerin and nitroprusside, to evaluate local and systemic toxicity, and to develop long-range dosage recommendations. Ninety-one per cent of the patients received the vasodilators for postoperative hypertension, while nine per cent had low output syndromes. Both drugs significantly decreased blood pressure and central venous pressure, and increased heart rate. Nitroglycerin decreased both right and left ventricular filling pressures more than nitroprusside. No local toxicity or methaemoglobinaemia was found with either drug. Elevated thiocyanate levels were detected in 44 per cent of the nitroprusside group; however, none of the patients developed progressive metabolic acidosis. For prolonged infusions we found that nitroprusside at 1 microgram.kg-1.min-1 and nitroglycerin at 0.5 microgram.kg-1.min-1 were without significant toxicity.

Blood Pressure↗
PubMed1979

Intraoperative hemodialysis during cardiopulmonary bypass in chronic renal failure.

This report describes the features and the course of a patient on maintenance hemodialysis in whom infective endocarditis of the aortic valve ensued. The subsequent development of intractable congestive heart failure necessitated aortic valve replacement. Use of intraoperative hemodialysis, facilitating the intraoperative and postoperative management of the patient, is described. Following valve replacement the patient did well with no evidence of congestive heart failure.

Aortic Valve↗
PubMed1978

Dynamics of serum potassium change during acute respiratory alkalosis.

In summary, one should be aware that hyperventilation and hypokalaemia occur frequently in the operating room under ordinary clinical conditions. An awareness of the rapidity with which these changes occur, and their extent as well as their potential hazards, should cause consideration of more aggressive attempts to maintain normocarbia and to use supplemental potassium during anaesthesia, particularly in patients with cardiac disease.

Adolescent↗
PubMed1977

Effect of positive end-expiratory pressure on lung mechanics during anaesthesia in dogs.

We studied supine anaesthetized dogs to determine whether the use of positive end-expiratory pressure to increase functional residual capacity (FRC) could thereby prevent the small lung compliance values frequently reported during anaesthesia. We first made control measurements of FRC and of both static (CSTAT) and dynamic (CDYN) lung compliance. Continuous positive pressure ventilation (CPPV) with 5 cm H2O positive end-expiratory pressure was then commenced, and FRC and compliance measurements were repeated at 15-minute intervals during one hour of CPPV. We found that the positive end-expiratory pressure served to increase FRC to a level expected for unanaesthetized normally breathing dogs in the same posture (J. Appl. Physiol. 36: 93, 1974), and this FRC was well maintained during the one-hour observation period. Despite the volume preservation, we found a marked decline in lung compliance, equal in both CSTAT and CDYN; however, these changes were completely reversed to control values following hyperinflation of lung (artificial sighting). We conclude that diminution in lung compliance in our anaesthetized dogs was not dependent on low lung volume breathing but must have been due to another mechanism such as suppression of sighing or possibly regional hypoventilation. It might well be important to recognize that reversible reduction of compliance may occur despite increase of FRC in patients managed with positive end-expiratory pressure.

Anesthesia↗
PubMed1977

Open-heart surgery in Jehovah's Witnesses: experience in a Canadian hospital.

Jehovah's Witnesses have religious belief precluding the use of blood. Few centers have attempted open-heart surgery bound by such strictures; as a result, availability of therapy for such patients has been limited. Many groups that have extensive experience with hemodilution for cardiopulmonary bypass have noted that these procedures can often be done with little or no use of blood. Our experience with 21 adult patients is presented in this paper.

Adolescent↗