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Biomedical subjects

G Ramirez-Schon

Publications and source records attributed to G Ramirez-Schon.

8 recordsLinked to original sources
PubMed1988

Functioning hepatic cell mass and the hyperdynamic state in cirrhosis.

Seventeen patients with advanced hepatic cirrhosis underwent cardiopulmonary assessment by means of Swan-Ganz catheters combined with indocyanine green clearance studies to measure functioning hepatic cell mass. The indocyanine green clearance test was found to have a statistically significant linear correlation with such indicators of the hyperdynamic circulatory state as cardiac index and total peripheral resistance. Results from these studies also showed that the hyperdynamic state in cirrhosis is associated with limited oxygen consumption as compared with a control series of patients. Of the 14 patients who required operations, eight survived and six died. The mean indocyanine green clearance was a statistically significant predictor of death.

Adult↗
PubMed1985

Treatment of penetrating duodenal injuries: primary repair vs. repair with decompressive enterostomy/serosal patch.

We analyzed 60 patients with penetrating duodenal injuries (1972-1983) treated by two operative techniques: primary repair or anastomosis after debridement, and repair with decompressive enterostomy with or without serosal patch of jejunum. The two treatment groups were comparable in terms of severity of duodenal and associated injuries and clinical status of the patients. Morbidity was significantly higher (p less than 0.001) in the enterostomy/patch group and mortality was limited to that group. Our data suggest that debridement and primary repair of duodenal wounds is the treatment of choice and that the addition of decompressive enterostomy and/or serosal patch does not improve results and may contribute to morbidity and mortality.

Adolescent↗
PubMed1981

Emergency room thoracotomy for the resuscitation of patients with "fatal" penetrating injuries of the heart.

A total of 75 patients with penetrating cardiac injuries were treated at Lincoln Medical and Mental Health Center from January, 1974, to November, 1980. Twenty-two patients (29.3%) were unconscious on arrival and had no detectable vital signs, cardiac activity, or spontaneous respirations. Their last physical movement was observed in the ambulance. Immediate resuscitation of these patients employing intercostal or sternal splitting incisions in the emergency room revealed arrested hearts and permitted relief of tamponade, finger occlusion of the cardiac wound or wounds, and temporary suturing of the defect. Restoration of cardiac function was accomplished in 16 patients (72.7%). After transfer to the operating room for more definitive cardiorrhaphy and repair of other major wounds, 8 patients (36.4%) recovered without objective neurological disability. Our experience clearly supports the value of immediate emergency room thoracotomy in this group of patients.

Adolescent↗
PubMed1981

Myocardial function in acute pancreatitis.

Fifteen patients with acute pancreatitis had 68 physiologic cardiopulmonary assessments performed, and they were compared with 61 performed on normal postoperative patients, and 113 on 41 cirrhotics. It was found that the patients with pancreatitis have an elevated cardiac index (CI), which is not due to the hyperdynamic hemodynamic state found in cirrhotics. In spite of this, the Sarnoff curves demonstrated that pancreatitis was accompanied by a myocardial depression p less than 0.03, not found in hyperdynamic cirrhotics. Cirrhotics are unable to increase their oxygen consumption in response to an increase in CI, as do normal patients or those with acute pancreatitis. In cirrhotics the hemodynamic lesion occurs at the capillary level with the opening of arteriovenous shunts which rob the tissues of their nutritive blood supply, while the patient with acute pancreatitis has a primary myocardial depression and his peripheral vasculature reacts like that of a normal person.

Acute Disease↗
PubMed1980

The myocardial depressant factor (MDF) in acute hemorrhagic pancreatitis.

Myocardial depression (measured by ventricular function curves on response to a fluid load) has been shown in 10 patients with acute hemorrhagic pancreatitis. Significant inadequate responses were found on evaluation of both the left and right heart. The increased pulmonary vascular resistance associated with adult respiratory distress syndrome (ARDS) of this disease was shown to correlate inversely with pulmonary wedge pressure, thereby excluding myocardial failure and pulmonary edema as mechanisms for the production of the ARDS.

Acute Disease↗