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H H Dash

Publications and source records attributed to H H Dash.

31 records · Page 2Linked to original sources
PubMed1993

Airway pressure monitoring as an aid in the diagnosis of air embolism.

We designed a prospective study to compare the validity of airway pressure (AWP) monitoring with that of end-tidal CO2 (ETCO2) monitoring for early detection of air embolism. Subjects included 76 patients of both sexes who underwent neurosurgery in the sitting position. Anesthesia was maintained with O2, N2O, narcotics, pancuronium, and intermittent positive pressure ventilation (IPPV). Continuous monitoring was done of HR, ECG, intraarterial pressure, AWP, and ETCO2. A sudden and sustained decrease in ETCO2 during anesthesia in a hemodynamically stable patient was considered as a sign of air embolism. Concomitant changes in AWP and cardiovascular parameters were also recorded simultaneously. Onset time, stage of surgery, and duration of disturbances were recorded. At the same time, the chest was auscultated for any murmur. Aspiration of air through the CVP catheter was attempted for diagnosis and management of air embolism. ETCO2 monitoring detected 24 episodes (31.5%) of air embolism in 16 patients. We observed 10 episodes (13.1%) of tachycardia in nine patients and nine episodes (11.8%) of hypotension in eight of the 16 patients. Murmur was noted in four patients and air aspiration in six patients. Only six patients of the 16 had an increase in AWP along with the decrease in ETCO2. We conclude that AWP monitoring is neither a sensitive nor reliable indicator of air embolism.

Adolescent↗
PubMed1991

Comparative study on proper placement of central venous catheters with & without stillete.

Observing a standard protocol, central venous catheterization was performed, via the right basilic vein, in 100 patients. At random, 50 patients received a catheter with stillete and 50 without stillete. Catheter tip was localized on a chest radiograph; 78 per cent with stilletes and 80 per cent without stilletes were properly positioned (either in the right atrium or the superior vena cava). Most common aberrant placement was in the right ventricle (14% of each type of catheters), and this did not produce any ventricular arrhythmias. Eight per cent of catheters with stillete and 6 per cent without stilletes were malplaced into the ipsilateral internal jugular vein. The incidence of proper and improper placement was similar with the two types of catheters. Silent catheter migration into the right ventricle is very frequent than recognized when an estimated catheter length is inserted without radiologic control.

Catheterization, Central Venous↗
PubMed1990

Potassium homeostasis during & after cardiopulmonary bypass.

Potassium homeostasis was studied in 30 patients undergoing cardiac surgery by employing cardiopulmonary bypass (CPB) and moderate hypothermia, and using morphine, N2O, relaxant anaesthesia. There was a trend for hypokalemia, and for maintaining a K+ level of 4-4.5 mmol/l, K+ infusion was required during CPB (9.017 mmol/m2 BSA/h). K+ infusion required in the post-operative period was considerably less (1.532 mmol/m2 BSA/h). There was no significant difference in the K+ levels of patients receiving preoperative diuretic therapy, as compared to those not receiving such therapy. Potassium requirement was significantly higher in patients under-going CABG and valvular heart disease, as compared to congenital heart disease. The mean urinary loss of K+ during bypass was found to be 2.95 mmol/m2 BSA/h, which was only 32 per cent of that required to be infused (9.017 mmol/m2 BSA/h). The mean excretion of K+ in the post operative period was significantly higher (4.53 mmol/m2 BSA/h) than K+ required to be infused during this period (1.532 mmol/m2 BSA/h).

Cardiopulmonary Bypass↗
PubMed1990

End tidal carbon dioxide monitoring for detection of venous air embolism.

With the aim of defecting the potential hazard of air embolism, end tidal carbon dioxide (ETCO2) was monitored in 238 patients undergoing neurosurgery (in the sitting position), for early detection of venous air embolism (VAE). Fifty six episodes (26.3%) of significant fall in ETCO2 were observed in 41 patients (17.2%). Haemodynamic disturbances occurred in only 26 patients (10.9%) and were always preceded by a fall in ETCO2. Thirteen patients had positive air aspiration and cardiac murmurs were heard in only six. One patient suffered severe hypoxaemia (PaO2 = 55 mm Hg) whereas two had severe haemodynamic disturbances, but could be promptly resuscitated.

Adolescent↗
PubMed1983

Blunt trauma to the cervical portion of the trachea. A case report.

A case of closed injury to the cervical portion of the trachea, caused by a wheat-threshing machine, is reported. The patient presented with extensive subcutaneous emphysema, but without any respiratory distress. The unique problem faced during the management of an anterolateral tear of the trachea is highlighted.

Adult↗
PubMed1977

Chromium depletion in the pathogenesis of diabetes and atherosclerosis.

Dietary Cr deficiency may cause the aging-related Cr depletion observed in humans. Such depletion, when it occurs with excessive consumption of sugar and other carbohydrates, may result in glucose intolerance, glycosuria, hyperinsulinemia, and hyperlipidemia. These metabolic disorders could explain why athero-sclerotic diseases are endemic to most Western industrial societies. This review detailed significant current research and findings on the manifestations of Cr deficiency in humans and animal models.

Animals↗
PubMedDate not supplied

Effect of cerebrospinal fluid return on success rate of percutaneous retrogasserian glycerol rhizotomy.

BACKGROUND AND OBJECTIVE: Trigeminal neuralgia is a painful syndrome, which has been commonly treated with percutaneous retrogasserian glycerol rhizotomy (PRGR). This study was performed to evaluate the effect of cerebrospinal fluid (CSF) return on the success rate of PRGR. METHODS: In this retrospective, nonrandomized, observational case series, 100 cases underwent 140 PRGRs under fluoroscopic guidance and were followed up for 6 to 36 months. The results were compared in the presence or absence of CSF return before PRGR. RESULTS: The PRGR was successful in 115 procedures (82.1%). CSF return was present in 84 procedures (60%) and, among these, 76 PRGRs (90.5%) produced pain relief. More than 1 year of pain relief without medications was present in 60 of 84 procedures (71.4%). CSF return before PRGR was absent in 56 procedures (40%) and success resulted in 39 procedures (69.6%). Pain relief for more than 1 year without medications was present in 19 procedures (33.9%). The success rate and duration of pain relief was greater in the presence of CSF return compared with absence of CSF return (P < .005). The incidence of complications such as facial dysesthesia (40%), corneal anesthesia (2.8%), herpes simplex (3.5%), and nonbacterial meningitis (0.7%) was not significantly different in 2 groups ( P > .05). CONCLUSION: The presence of CSF is an important factor in determining the success rate and duration of pain relief of PRGR.

Adolescent↗