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Biomedical subjects

G Solares

Publications and source records attributed to G Solares.

30 records · Page 2Linked to original sources
PubMedDate not supplied

[Changes in PCO2 and pH gradients in a canine model of experimental acute hemorrhage].

OBJECTIVE: To study changes in arterial-venous PCO2 pressures (Da-vPCO2) and in pH (Da-vpH) in an experimental dog model of acute bleeding. To emphasize the utility of monitoring these variables in situations of acute bleeding. ANIMALS AND METHOD: Eighteen dogs were anesthesized and monitored while being subjected to gradual bleeding. Gasometric and hemodynamic variables were recorded at the following moments: baseline, stage I (15% of volemic loss), stage Ib (20%), stage II (25%), stage IIb (30%) and stage III (35%). RESULTS: No significant differences in pH or PCO2 in either arterial or mixed venous blood were found. Bleeding induced a constant and progressive increase in Da-vPCO2 that correlated with changes in volume (r = -0.56, p < 0.001), SvO2 (r = 0.71; p < 0.001), Da-vO2 gradient (r = 0.62; p < 0.001) and cardiac output (r = 0.63; p < 0.001). CONCLUSIONS: Gradual bleeding caused a constant and significant increase of Da-vPCO2. Monitoring such changes in states of circulatory insufficiency may be useful for evaluating tissue ischemia.

Acute Disease↗
PubMedDate not supplied

[Study of thyroid function in the organ donor during brain death].

OBJECTIVE: To determine the thyroid function in organ donors undergoing cerebral death and evaluate the effects that these possible alterations may exert on the early function of renal graft. DEVELOPMENT: Prospective study. Hormonal analysis when: 1) the diagnosis of cerebral death was made and 2) before organ extraction. PATIENTS: Fifteen organ donors with cerebral death. Twenty-nine patients who received the kidneys of these donors. PLACE: Neurotraumatologic Unit at the University Hospital Marques de Valdecilla. Referring center. MEASUREMENTS AND RESULTS: All donors showed low T3 and T4 values. Values of T4 and IT4L were significantly lower during the second determination (p < 0.05). Eighty percent of donors showed increased T3r values. TSH was low in 73% of cases. Dopamine requirements in donors or the incidence of acute tubular necrosis in recipients were not significantly higher in donors with lowest T3 values. CONCLUSION: The hormonal picture observed in the donors of this study is more characteristic of a "ill euthyroid syndrome" than a real hypothyroidism. The low values of T3 in donors is not associated with higher requirements of inotropic agents, nor with a higher incidence of acute tubular necrosis in renal grafts.

Adolescent↗
PubMedDate not supplied

[Effect of isoflurane on gas exchange and systemic and pulmonary hemodynamics in man during single lung ventilation].

OBJECTIVE: We studied the effect of 1.5% isoflurane end expiratory fraction on arterial oxygenation and on systemic and pulmonary hemodynamics during nonsurgical single lung ventilation. MATERIAL AND METHODS: The study includes 6 patients undergoing surgical thoracotomy. In all cases a double lumen endotracheal tube was inserted and pulmonary ventilation was performed with a FiO2 = 1. Patients were placed on lateral decubitus position. The following variables were measured: mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP), central venous pressure (CVP), capillary pulmonary pressure (CPP), cardiac output (CO), and Qs/Qt. Measurements were taken at three different situations. The first was done under bilateral pulmonary ventilation and intravenous anesthesia with thiopental, fentanyl, and diazepam. The nondependent lung was collapsed by means of a selective ventilation of the dependent lung, and the second series of measurements was done 20 min after intravenous anesthesia. The third block of data was obtained after 15 min of respiratory ventilation with 1.5% isoflurane. RESULTS: Single lung ventilation induced a significant decrease of Pa O2 (379 +/- 96 mmHg vs 208 +/- 93 mmHg) and a significant increase in Qs/Qt (20 +/- 8% vs 30 +/- 10%). However, during isoflurane ventilation there were no significant changes in PaO2 (208 +/- 93 mmHg vs 204 +/- 94 mmHg) nor in Qs/Qt (30 +/- 10 vs 28 +/- 8). Isoflurane elicited a significant decrease of the CO, whereas MPAP, RVS, and PvO2 did not show significant variations. CONCLUSIONS: We conclude that 1.5% isoflurane end expiratory concentrations did not significantly affect pulmonary oxygenation during single lung ventilation.

Aged↗
PubMedDate not supplied

[Effect of changes in cardiac output on oxygenation and intrapulmonary short circuit (Qs/Qt) under inhalation anesthesia].

OBJECTIVES: To assess the relation between changes in pulmonary shunt and minute volume induced by blood loss, using an animal model with anesthetic maintenance by isoflurane CAM 1. MATERIAL AND METHODS: Eight dogs were given balanced anesthesia with pancuronium and isoflurane. Variables monitored were systemic and pulmonary arterial pressures, central venous and pulmonary capillary pressures and minute volume. Arterial and mixed venous blood gas measurements were taken from the pulmonary artery catheter, and blood samples were analyzed for hemoglobin in order to calculate pulmonary shunt (Qs/Qt). Two levels or stages of hypovolemia were studied: a) level I = loss of 20% blood volume and b) level II = loss of 30%. RESULTS: A significant decrease of 35% (139 +/- 43 to 90 +/- 24 ml/min-1/kg-1; p < 0.001) in minute volume was observed at the first level of hypovolemia; a 52% (139 +/- 43 to 69 +/- 23 ml/min-1/kg-1; p < 0.001) decrease was found at the second. This decrease was accompanied by similar drops in Qs/Qt of 34% (18.2 +/- 5% to 12.1 +/- 5%; p < 0.01) and 47% (18.2 +/- 5% to 9.2 +/- 5%; p < 0.01) at the first and second levels, respectively. Linear regression analysis showed a direct relation between changes in Qs/Qt with changes in minute volume. CONCLUSIONS: The data reported in this study indicate that changes in Qs/Qt are directly related to those of minute volume in the presence of isoflurane.

Anesthesia, Inhalation↗