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Biomedical subjects

J A Pittman

Publications and source records attributed to J A Pittman.

At least 19 recordsLinked to original sources
PubMed2001

A comparison of two techniques for manual ventilation of the lungs by non-anaesthetists: the bag-valve-facemask and the cuffed oropharyngeal airway (COPA) apparatus.

In order to evaluate the possible role of the cuffed oropharyngeal airway during cardiopulmonary resuscitation, we compared its use by non-anaesthetists with the bag-valve-facemask technique of providing ventilation. A group of anaesthetic nurses and operating department practitioners were asked to manually ventilate the lungs of 40 patients undergoing elective surgery following the induction of general anaesthesia with neuromuscular blockade. Ventilation was first attempted using the bag-valve-facemask technique and then using the appropriate size cuffed oropharyngeal airway and self-inflating bag. Ventilation was clinically adequate in 32/40 (80%) patients using the bag-valve-facemask and in 38/40 (95%) patients using the cuffed oropharyngeal airway. Measured expired tidal volumes were greater using the cuffed oropharyngeal airway than with bag-valve-facemask ventilation in two-thirds of patients, despite a higher incidence of audible air leak. Successful ventilation was achieved using the cuffed oropharyngeal airway in seven of the eight patients in whom bag-valve-facemask ventilation was inadequate. The cuffed oropharyngeal airway may offer an effective method of providing ventilation during cardiopulmonary resuscitation by non-anaesthetic hospital staff, particularly when attempted ventilation using a bag-valve-facemask technique is proving ineffective.

Adolescent↗
PubMed2000

Glycinothorax: a new complication of transurethral surgery.

A 76-year-old woman sustained inadvertent perforation of her posterior bladder wall during transurethral resection of a bladder tumour. In the immediate postoperative period, she developed life-threatening respiratory failure following the formation of a large, unilateral pleural effusion. After therapeutic drainage, biochemical analysis of the effusion revealed that it had a high concentration of glycine. The fluid used for intra- and postoperative bladder irrigation had leaked from the perforated bladder and collected in the pleural cavity. This type of hydrothorax complicating endoscopic urological surgery has not been described previously.

Aged↗
PubMed1998

Reasons for withdrawing treatment in patients receiving intensive care.

We studied the frequency with which treatment was withdrawn in intensive care patients and the primary reason for reaching the decision. The medical records of patients having had active treatment withdrawn between August 1992 and February 1996 inclusive were reviewed. Patients were classified into an imminent death group consisting of those expected to die, a qualitative group who had treatment withdrawn on quality of life considerations and a lethal conditions group who had associated disease that precluded long-term survival. There were 1745 patients admitted, of whom 338 (19.4%) died in ICU. In 220 patients death followed the withdrawal of treatment (12.6% of all ICU admissions), 203 dying on ICU (60% of ICU deaths) and a further 17 soon after discharge to a ward. The primary reason for treatment withdrawal was imminent death in 45% of patients, qualitative considerations in 50% and lethal conditions in 5%. The reason varied significantly depending on the patient's age. Treatment is withdrawn commonly in ICU, the primary reason being quality of life considerations as often as because death is the expected outcome.

APACHE↗
PubMed1997

Spontaneous pneumomediastinum and Ecstasy abuse.

Ecstasy is an illegal recreationally used drug. A case of a young woman who had taken this drug and was found to have a spontaneous pneumomediastinum is reported. The association of spontaneous pneumomediastinum with drug abuse is discussed. The possible mechanism for this complication of Ecstasy, which has not been previously reported, is discussed.

Adolescent↗
PubMed1985

Blood transfusion complications: leukoagglutinin reactions.

Blood transfusions performed earlier in the 20th century were often accompanied by significant complications. Today, with an increased knowledge of blood type compatibility, the majority of risks have been eliminated. However, hazards still remain. The authors report on a potentially fatal pulmonary disorder caused by transfusions involving leukoagglutinins. This phenomenon apparently occurs with an increased risk in parous women and patients who have had multiple transfusions.

Adult↗