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D T Porembka

Publications and source records attributed to D T Porembka.

23 records · Page 2Linked to original sources
PubMed1989

The bone marrow as a source of laboratory studies.

The intraosseous route is an emergency alternative to the IV route for the administration of drugs and fluids. Another emergency function of intravascular access is obtaining blood samples for blood gases, laboratory studies, and blood cultures. One of the drawbacks to using the intraosseous route as an alternative to IV access has been the persistent need to establish IV access to obtain blood samples. We obtained bone marrow samples from ten healthy anesthetized dogs and analyzed the usefulness of the samples in providing meaningful laboratory studies when compared with simultaneous arterial and venous samples for blood electrolytes, blood chemistries, blood gases, and hemoglobin. There was no significant difference (P greater than .10) in blood electrolytes (sodium, potassium, chloride, and carbon dioxide) drawn from the intraosseous, arterial, and venous sites. The blood chemistries (blood urea nitrogen, creatinine, total protein, albumin, calcium, phosphorous, uric acid, total bilirubin, and SGOT) also were not significantly different (P greater than .10). Significant differences were obtained for glucose comparing intraosseous with arterial (P = .03), whereas intraosseous versus venous was only marginally significant (P = .06). Significant differences were also obtained for alkaline phosphatase when comparing intraosseous with arterial (P = .03), whereas comparison with venous was only marginally significant (P = .06): lactate dehydrogenase differences were marginally significant when comparing intraosseous with arterial (P = .09) and venous (P = .06) blood. Hemoglobin values were not significantly different when comparing results for the three sites (P greater than .25).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

The safety of intraosseous infusions: risks of fat and bone marrow emboli to the lungs.

The technique of intraosseous infusion is a life-saving emergency alternative when IV access is impossible or will be critically delayed. Concerns about its safety remain, especially concerning the risk of bone marrow and fat emboli to the lungs. We examined autopsy pulmonary specimens on two children who had received intraosseous infusions during resuscitation attempts and found an average of 0.23 to 0.71 bone marrow and fat emboli per mm2 of lung. We studied normotensive dogs with intraosseous infusions of emergency drugs and solutions into the distal femur. Three dogs were studied with each of the following emergency drugs or solutions: controls with normal saline (0.9% NaCl), epinephrine 0.01 mg/kg, NaHCO3 1 mEq/kg, CaCl 10 mg/kg, atropine 0.01 mg/kg, hydroxyethyl starch 6% in normal saline 10 mL/kg, 50% dextrose in water 0.25 g/kg, and lidocaine 1 mg/kg. Four hours after infusion, the animals were killed, and representative sections of the lung were examined with oil red-0 and hematoxylin and eosin stains for the presence of fat and bone marrow emboli. Fat and bone marrow emboli were found in all lung sections, varying from 0.11 to 4.48 emboli/mm2 lung (mean, 0.91 emboli/mm2 lung) for the emergency drugs and solutions and 0.06 to 0.53 emboli/mm2 (mean, 0.29 emboli/mm2 lung) for the controls. Analysis of variance revealed no significant difference (P = .07) in mean number of fat and bone marrow emboli per square millimeter of lung among the emergency drugs and compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Use of a pulmonary artery catheter in the management of the severe preeclamptic patient.

The perioperative management of the parturient with severe preeclampsia can be challenging with reference to fluid and antihypertensive therapy. A pulmonary artery catheter should be used when necessary to provide accurate information concerning the patient's hemodynamic status and to provide additional information regarding the effectiveness of the therapeutic modalities employed.

Adult↗