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Biomedical subjects

I J Gilmour

Publications and source records attributed to I J Gilmour.

10 recordsLinked to original sources
PubMed1992

Perioperative stroke.

Explore the source record for details and available documents.

Cerebrovascular Circulation↗
PubMed1991

Preoperative optimization of cardiovascular hemodynamics improves outcome in peripheral vascular surgery. A prospective, randomized clinical trial.

The hypothesis that optimizing hemodynamics using pulmonary artery (PA) catheter (preoperative 'tune-up') would improve outcome in patients undergoing limb-salvage arterial surgery was tested. Eighty-nine patients were randomized to preoperative tune-up either in the surgical intensive care unit (SICU) (group 1) or the preinduction room (group 2) or to control (group 3). The tune-up consisted of fluid loading, afterload reduction, and/or inotropic support to achieve predetermined endpoints. Patients with a PA catheter had significantly fewer adverse intraoperative events (p less than 0.05), less postoperative cardiac morbidity (p less than 0.05), and less early graft thrombosis (p less than 0.05) than the control group. The overall study mortality rate was 3.4%, with a mortality rate of 9.5% in the control group and 1.5% in the PA catheter groups. There were no differences in ICU length of stay (LOS), hospital LOS, or total hospital costs, although the percentage of cost from complications was higher in group 3 (p greater than 0.05). In this group of patients, preoperative cardiac assessment and optimization is associated with improved outcome.

Aged↗
PubMed1991

Effect of kidney dysfunction on lung volume in patients with diabetes.

OBJECTIVE: Over several years, one of the authors observed what appeared to be a relationship between a decrease in total lung capacity (TLC) and insulin-dependent diabetes mellitus (IDDM) in patients who were candidates for kidney transplantation. RESEARCH DESIGN AND METHODS: In an effort to define this potential relationship, pulmonary function tests (PFTs) were reviewed on all available kidney transplant candidates between 1983 and 1986. The patients were divided into two groups--those with kidney failure caused by IDDM (group 1) and those with kidney failure from other causes (group 2). A third group (control subjects) of volunteers with IDDM but without evidence of kidney failure was evaluated by PFTs in an attempt to determine whether IDDM without kidney failure was also associated with a decrease in TLC. RESULTS: Demographics of the two groups with kidney failure were similar. However, the duration of IDDM in the volunteers with IDDM was significantly shorter than in group 1 patients (19.6 vs. 25.9 yr). The TLC of group 1 patients was significantly smaller than the TLC of both the group 2 patients and the volunteers with IDDM. CONCLUSIONS: We believe that these data suggest that the association between IDDM and decreased TLC is the result of IDDM and not kidney failure. Because our volunteers with IDDM were significantly younger than the patients with IDDM and kidney failure, we can draw no conclusions about any separate contribution of kidney failure to changes in TLC in people with IDDM.

Adult↗
PubMed1976

Measurement of 'closing volume' initiated from functional residual capacity.

Comparison of the nitrogen method closing volume (CV) test, with oxygen inspiration initiated at residual volume (RV method) and functional residual capacity (FRC method), was made in 91 seated normal subjects. For RV and FRC methods, respectively CV%VC (mean+/-SD) was 14.4% (+/-6.2) and 17.5%(+/-7.5) (P=0.005); slope of Phase III of CV trace was 0.99% N2/1 (+/-0.76) and 1.66% N2/1(+/-1.07) (P=0.005); size of cardiogenic oscillations was 1.05% N2(+/-0.42) and 1.21% N2(+/-0.40) (P=0.001). These data confirm earlier predictions, based on a calculated increased lung top to bottom N2 gradient in the FRC method. Support for this mechanism was obtained in 5 additional normal subjects in whom the increased CV%VC, slope of Phase III and size of cardiogenic oscillations with the FRC method were eliminated when the top-to-bottom N2 gradient was reduced by breathing a reduced FIN2. Measurements made using the classical RV method cannot be directly compared to those using the FRC method.

Adult↗
PubMed1975

Nitrogen analyzer adaptation for use in the presence of halogenated anesthetics.

Interposition of activated carbon between a nitrogen analyzer needle valve and gas mixtures containing halothane, methoxyflurane, enflurane, or isoflurane eliminated the interfering effects of these agents, but added sampling delays. Placement of a carbon-filled Swinney adaptor in the sampling line between the needle valve and analyzer also eliminated the interference. Linearity of response (range 0 to 80 per cent N2) and sampling delay (40 msec) were unchanged. The 90 per cent fall time (step change 80 to 0 per cent N2) increased from 35 to 100 msec. This adaptation allows rapid analysis of nitrogen concentrations during general anesthesia.

Anesthesia, General↗