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Biomedical subjects

D Oxorn

Publications and source records attributed to D Oxorn.

30 records · Page 2Linked to original sources

Lobar bronchial blockade in bronchopleural fistula.

A 59-yr-old man with bullous lung disease developed a refractory bronchopleural fistula involving the right upper lobe. Despite independent lung and high-frequency jet ventilation, a large air leak persisted. Following the introduction of a bronchial blocker into the right upper lobe bronchus via the tracheal lumen of a left-sided endobronchial tube, oxygenation and ventilation improved, and the airleak was reduced by 90%. The presence of pneumonia led to an inexorably downhill course with death from overwhelming sepsis.

Bronchial Fistula↗

Traumatic rupture of the thoracic aorta: diagnosis on fibreoptic bronchoscopy.

The diagnosis of thoracic aortic rupture can be difficult, especially in the presence of other life-threatening injuries. We present a case in which the presence of major intraabdominal trauma shifted clinical attention away from the mediastinum. During bronchoscopy, which was performed to investigate high intraoperative airway pressures, unexpected tracheal and carinal compression were discovered. Thoracic aortography revealed aortic rupture distal to the left subclavian artery. Successful repair was subsequently achieved.

Aged↗

Bolus doses of esmolol for the prevention of perioperative hypertension and tachycardia.

The effectiveness of esmolol, an ultra short-acting cardioselective beta blocker, in the prevention and treatment of post-intubation haemodynamic perturbations, was investigated. Forty-eight ASA physical status I and II patients undergoing hysterectomy were randomly assigned to receive a single intravenous bolus of placebo, esmolol 100 mg, or esmolol 200 mg in a double-blind fashion. This was administered over 15 sec, and immediately followed by thiopentone 3-5 mg.kg-1, succinylcholine 1.5 mg.kg-1, and tracheal intubation 90 sec later. The heart rate following induction of anaesthesia was lower in the esmolol 200 mg group (P less than 0.01); following intubation, the increase in heart rate in the placebo group was greater than in the esmolol groups (P less than 0.05). The systolic blood pressure post-induction was lower in the esmolol 200 mg group (P less than 0.05); following intubation, however, no significant differences were seen among groups in systolic, diastolic, or mean blood pressures. Following tracheal intubation, the incidence of ventricular arrhythmias was lower in the esmolol groups (P less than 0.05). In summary, esmolol in 100 mg and 200 mg doses was effective in mitigating the haemodynamic response following tracheal intubation.

Adrenergic beta-Antagonists↗

Crico-tracheal disruption and common carotid artery occlusion: a case of blunt trauma.

A case of blunt trauma to the neck is presented. While driving an all terrain vehicle (ATV), a 20-yr-old male was struck across the anterior neck by a cord suspended between two poles. Initial findings were suggestive of an isolated laryngeal injury; 48 hours later, however, a dense left hemiplegia became manifest. A CT scan demonstrated a large right frontoparietal cerebral infarct, and an angiogram confirmed occlusion of the right common carotid artery. Intractable cerebral oedema developed, and the patient died five days after the initial insult. Such injuries should alert the clinician to the possibility of major vascular injury, and if suspected, angiography is warranted.

Adult↗