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D W Robins

Publications and source records attributed to D W Robins.

3 recordsLinked to original sources

Factors associated with survival and eventual cerebral status following cardiac arrest.

Cardiac arrests at two acute hospitals were investigated over a 5-month period. The outcome expressed as short-term and long-term survival was correlated with diagnosis, age, sex and technical details of the resuscitation. Survivors were followed up for 3 months to detect any remaining cerebral deficit. Of 108 patients who suffered cardiac arrest, 23 (21.3%) survived to be discharged from hospital, 58 (53.7%) died immediately and 27 (25%) survived for periods ranging from 1 hour to 30 days following cardiac arrest, before eventual death. Evidence of cerebral impairment was present initially in three patients (2.7%) at discharge from hospital. After 3 months however cerebral impairment was present in only one patient (0.9%). Survival was highest in patients suffering ventricular fibrillation following myocardial infarction where 16 out of 35 (47%) survived. Certain groups of patients were identified where the ultimate survival was predictably nil. Although some survived for short periods it was concluded that the attempted resuscitation in these patients was inappropriate and unjustified.

Adolescent↗

The anaesthetic management of patients undergoing free flap transfer.

The anaesthetic management of patients undergoing free flap transfer is discussed in the light of experience over a 4-year period. There is no single magical factor responsible for the success of this type of operation. But as the whole team has gained experience over the last 6 years, the incidence of vessel spasm and/or occlusion has been greatly reduced and at present is rare. It is therefore unusual for our patients to return to the operating theatre for re-exploration of the free flap that has developed ischaemia.

Adolescent↗

Closed system enflurane in oxygen.

A safe method of administering enflurane from a Goldman vaporizer in a closed system is described, using a fresh gas flow of 0.5 litres minute of oxygen. There was a drawback, in that, until the system was closed, insufficient concentration of enflurane was achieved in seven out of 20 patients, who then moved on surgical incision. When the system was closed, the concentration of enflurane increased so that satisfactory anaesthesia occurred. The maximum inspired concentration of enflurane in the system was 4.5% which occurred in one patient on the 3rd notch of the Goldman. A portable interference refractometer was used to measure the percentage of enflurane.

Adolescent↗