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Biomedical subjects

G E Battit

Publications and source records attributed to G E Battit.

11 recordsLinked to original sources

Microbial examination of kidney lithotripter tub water and epidural anesthesia catheters.

Kidney lithotripsy patients frequently receive epidural anesthesia via indwelling epidural catheters. In our hospital, patients are immersed in a tub of warm, continuously-flowing tap water. The epidural catheter-entry site is covered by a transparent occlusive dressing. To determine the risk of microbial colonization of the epidural catheter during lithotripsy, we performed quantitative cultures of tub water and semiquantitative cultures of catheters in 63 lithotripsy procedures. Most of the tub water organisms were typical tap water and skin flora isolates. Total colony counts were generally low with no significant progression during the course of serial procedures. Forty-two epidural catheters were cultured; 34 (81%) were sterile, 8 (19%) were colonized with small numbers of flavobacteria or coagulase-negative staphylococci. Only four catheters had organisms present on catheter segments covered by the transparent occlusive dressing (in each case there was a single colony forming unit per semiquantitative plate) and these organisms were probable contaminants. We conclude that with our current lithotripsy procedures, the risk for the development of epidural catheter-associated infection seems to be low.

Anesthesia, Epidural

The role of surgery on ambulatory patients in one teaching hospital.

The development of a program of one-day surgery for ambulatory patients in one hospital was stimulated by overloaded operating room facilities and a long waiting list of patients for hospital admission. This concept has received enthusiastic reception by the surgical staff and the number of operations has increased to over 7,500 per year. All of the surgical specialty services use the surgical day care unit, although the number of cases suitable for ambulatory surgical treatment varies greatly on the various services. There have been no deaths and about 1% of patients have been admitted to the hospital from the surgical day care unit for a variety of reasons that are summarized.

Ambulatory Care

Transtracheal ventilation.

Effective percutaneous oxygenation and ventilation can be achieved through the use of transtracheal catheters. A graphic study of pressure-flow requirements through different-sized catheters can serve as a guide for the caliber and driving pressure requirement to obtain optimal oxygen flow.

Acute Disease

Effects of pentolinium on blood sugar and serum potassium concentrations during anaesthesia and surgery.

Blood surgar and serum potassium (K+) concentrations were measured before, during and 60 min after surgery in two groups of 10 non-diabetic patients during nitrous oxide/halothane/tubocurarine anaesthesia. In the control group the arterial pressure was maintained within the patients' normal ranges, while in the study group pentolinium was administered i.v. (average 22 mg per patient) to achieve and maintain a mean arterial pressure of 50 mm Hg (+/-10 SEM). In the normotensive group the blood sugar concentration increased markedly and significantly during surgery and in the early postoperative period while the serum K+ concentration was essentially unchanged. In the hypotensive group pentolinium produced a striking modification of the surgery-induced hyperglycaemic response (but not to hypoglycaemic values) as well as a small but significant decrease in serum K+ concentration. The observed increase in the blood sugar concentration may be part of the autonomic response to surgical stress. Two mechanisms can explain the reduction in serum K+ concentration: (1) decreased hepatic glycogenolysis and (2) attenuation of the suppressive effect of adrenaline on insulin release, both effects being secondary to the ganglion-blocking property of pentolinium. These results are in contrast to the widely held belief that ganglion-blocking drugs cause hypoglycaemia.

Adult