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E Sisillo

Publications and source records attributed to E Sisillo.

28 records · Page 2Linked to original sources
PubMed1987

Hemofiltration as short-term treatment for refractory congestive heart failure.

Hemofiltration has been suggested as a new therapeutic tool in refractory heart failure. In this study, 11 patients with primary or ischemic heart disease in New York Heart Association class IV, in whom there was no response to medical treatment, were subjected to hemofiltration. The pathophysiologic adjustments promoted by subtraction of plasma water were investigated, and guidelines for an appropriate use of this procedure in heart failure are provided. Fluid was removed from plasma at a rate of 500 ml/hour until either normalization of the right atrial pressure (which was increased in all cases) was achieved or the hematocrit exceeded 50 percent. According to these criteria, the duration of treatment ranged from four to six hours and the total amount of fluid removed was 2,000 to 3,000 ml. In each case, hemofiltration promoted relief of dyspnea and of clinical and radiographic evidence of lung congestion and pleural effusion, and substantially reduced the dependent edema and abdominal girth. These effects were paralleled by progressive decrease of the right (-70 percent) and left (-45 percent) ventricular filling pressures and of the pulmonary arterial pressure and arteriolar resistance, without significant variations in heart rate, aortic pressure, cardiac index, and systemic vascular resistance. Changes in the right atrial and wedge pulmonary pressures are interpreted as reflecting a combined effect of a decrease in pressure on the outside of the heart due to fluid reabsorption (from lung interstitial spaces and pericardial, pleural and abdominal cavities) and of intravascular volume subtraction. The arterial partial pressure of oxygen was raised, the partial pressure of carbon dioxide and pH were unchanged, and urinary output was substantially enhanced by the procedure. The study indicates that: hemofiltration may be a short-term treatment for refractory cardiac insufficiency with overhydration; a filtration rate of 500 ml/hour is effective and safe; and the central venous pressure may be a reliable guide to volume subtraction.

Aged↗
PubMed1976

Preliminary studies of nonvirion antigens associated with herpes simplex virus 1 and 2 (HSV1 - HSV2).

Biochemical and radioimmunological studies have indicated the presence of a nonvirion antigen associated with herpes virus. Guinea pig kidney cells were grown in culture and infected (I-cells) for 3h with herpes virus. Uninfected cells (N-cells) served as control. The cells were collected and sonicated to obtain, after centrifugation, "soluble extract" (SI, SN). The pellets were extracted with KCl (ISP, NSP). SN, SI were submitted to gel-filtration on Sephadex G-200. Extracts from I and N cells gave similar patterns. After labelling with 125I, greater resolution was obtained in a second gel-filtration with a much smaller load. ISP contained protein species not present in NSP. Polyacrylamide gel electrophoresis of peaks from SN and SI showed that SI contained some radioactive bands not found in SN. Labelled materials from SI and SN were incubated with sera from cancer patients and normal subjects. No differences in binding were seen with SN, but SI showed 14-30% more 125I binding with sera of cancer patients than with sera from normal subjects. No such difference was seen between ISP and NSP.

Animals↗
PubMedDate not supplied

[Hypertrophy of the lingual tonsil and difficulty in airway control. A clinical case].

A male patient suffering for exertional angina was scheduled for coronary bypass. Physical examination was unremarkable except for oropharynx classified as Mallampati II. After anesthetic induction with fentanyl 10 micrograms/kg, thiopental 5 mg/kg and muscle relaxation with succynilcoline 1 mg/kg, the patient was ventilated via a face mask. Laryngoscopy revealed a bulky mass arising from the rigth base of the tongue hiding the epiglottis and all the vocal apparatus (Cormack class 4); a failed intubation caused bleeding. Facial mask ventilation became more difficult therefore, considering the task on managing the airway, a n. 4 laryngeal mask was positioned by the senior anesthetist. Two intubation attempts failed while ventilation via laryngeal mask became more and more difficult. Surgery was therefore cancelled due to inability to airway management. The mass, biopsied by an otolaryngologist, resulted to be a lingual tonsillar hyperthrophy and therefore was not removed. The patients was re-scheduled for cardiac surgery. Maintaining spontaneous breathing during light sedation, with topical anesthesia, this patient was successfully intubated over an Olympus BF P 10 bronchoscope. The patient had an uneventful operation, was regularly extubated and was discharged on the sixth postoperative day free from airway complications. Although we followed only some of the guidelines for the management of the difficult airway: a senior anesthetist was immediately called when an anatomic alteration was evident; progressive difficulty in maintaining the airway prompted the positioning of a LMA, the restoration of the spontaneous breathing and the cancellation of the elective operation had been mandatory when a class 4 Cormack was found at laryngoscopy. This situation requires an alternative approach to intubation or with the retrograde technique or with the aid of a fiberscope both maintaining spontaneous breathing.

Anesthesia↗