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Biomedical subjects

J J Radcliffe

Publications and source records attributed to J J Radcliffe.

9 recordsLinked to original sources
PubMed2001

A comparison of the intubating and standard laryngeal mask airways for airway management by inexperienced personnel.

Twenty-four inexperienced participants were timed inserting the intubating laryngeal mask airway and the laryngeal mask airway in 75 anaesthetised subjects. Adequacy of ventilation was assessed on a three-point scale. The pressure at which a leak first developed around the device's cuff was also measured. There was no significant difference in insertion time or the likelihood of achieving adequate ventilation between devices. However, the intubating laryngeal mask airway was better at providing adequate ventilation without audible leak (58/75 (77%) vs. 42/75 (56%); p = 0.009). The median (range [IQR]) pressure at which an audible leak developed was higher for the intubating laryngeal mask airway, 34.5 (14-40 [29-40]) cmH2O, than for the laryngeal mask airway, 27.5 (14-40 [22-33]) cmH2O (p < 0.001). The intubating laryngeal mask airway is worthy of further consideration as a tool for emergency airway management for inexperienced personnel.

Adolescent↗
PubMed2001

Fibreoptic views through the laryngeal mask and the intubating laryngeal mask.

BACKGROUND AND OBJECTIVE: The intubating laryngeal mask (intubating laryngeal mask airway) was designed to facilitate blind intubation. Its value as an adjunct to fibreoptic laryngoscopy has not been evaluated. This study compares the intubating laryngeal mask airway with the standard laryngeal mask airway as conduits for fibreoptic laryngoscopy. METHODS: The fibreoptic view of the laryngeal inlet was graded via both devices in 60 anaesthetized patients. The fibreoptic view through the intubating laryngeal mask airway was assessed after the central epiglottic elevator bar had been lifted out of the field of vision by an 8-mm Euromedical tracheal tube, which was inserted to a depth of 18 cm. The fibreoptic view from the aperture bars of the laryngeal mask was recorded. RESULTS: The vocal cords were viewed less frequently through the intubating laryngeal mask airway (52%) than through the laryngeal mask airway (92%) [difference = 40% (95% CI = 26% to 54%), P < 0.0001]. CONCLUSION: The view of the laryngeal inlet is better through the laryngeal mask airway than through a tracheal tube inserted to 18 cm in the intubating laryngeal mask.

Adolescent↗
PubMed2001

Neurofibromatosis: clinical presentations and anaesthetic implications.

The neurofibromatoses are autosomal dominant diseases that have widespread effects on ectodermal and mesodermal tissue. The commonest member of the group is neurofibromatosis type 1 (NF1) which varies in severity but which can affect all physiological systems. Neurofibromas are the characteristic lesions of the condition and not only occur in the neuraxis but may also be found in the oropharnyx and larynx; these may produce difficulties with laryngoscopy and tracheal intubation. Pulmonary pathology includes pulmonary fibrosis and cystic lung disease. The cardiovascular manifestations of NF1 include hypertension, which may be associated with phaeochromocytoma or renal artery stenosis. Neurofibromas may also affect the gastrointestinal tract and carcinoid tumours may be found in the duodenum. This review documents the aetiology and clinical manifestations of the neurofibromatoses and discusses their relevance to the anaesthetist.

Anesthesia↗
PubMed1998

The recognition of critical incidents: quantification of monitor effectiveness.

We have conducted a prospective analysis of all reported critical incidents which occurred during the period from admission to the anaesthetic room until discharge from the operating theatre complex over a 1-year. The aim was to identify which monitors were most effective for initial recognition of those incidents. All patients were monitored in accordance with the recommendations of the procedures gave rise to 338 recorded critical incidents, of which 27 were deemed to have caused, or been likely to cause, patient harm. We have shown that a combination of arterial blood pressure measurement (noninvasive), ECG, pulse oximetry and clinical observation detected 90% of all reported critical incidents, and all the incidents causing patient harm. We have also shown that blood pressure monitoring by itself, and combination with ECG and pulse oximetry, detected proportionately more critical incidents resulting in patient harm (incidents resulting in harm remaining incidents, for each monitor) than clinical observation alone (p < 0.05) and all other remaining forms of monitoring together (p < 0.01).

Blood Pressure Determination↗
PubMed1994

Performance of the Baxter disposable patient-controlled analgesia infusor under hyperbaric conditions.

Hyperbaric oxygen treatment may require the concurrent administration of drugs. A study was performed to assess the suitability of the infusor device from the Baxter Patient-Controlled Analgesia system, for drug delivery during hyperbaric therapy. Thirty infusor devices were used to deliver 5% dextrose, 50% dextrose or propofol solutions under conditions 1 and 2.3 atmospheres of pressure. The increased pressure caused an increase in flow of 4.27%, 1.79% and 9.84% for 5% dextrose, propofol and 50% dextrose respectively.

Analgesia, Patient-Controlled↗
PubMed1986

Immunity to cytomegalovirus in women with unexplained recurrent spontaneous abortion.

Humoral and cellular immunity to cytomegalovirus (CMV) has been assessed in women suffering unexplained recurrent spontaneous abortions (RSA). A significantly lower prevalence of serum anti-CMV antibodies was observed for RSA women compared with either their male partners or age-matched female controls, unlike for serum antibodies to Herpes simplex virus. In addition, there was a markedly impaired lymphocyte proliferative response to CMV for CMV-sero-positive RSA women compared with CMV-seropositive controls. These results indicate that women with unexplained RSA have difficulty in responding to CMV, and are of significance when considering leukocyte transfusion immunotherapy.

Abortion, Habitual↗
PubMedDate not supplied

The use of insulin pump therapy in adolescents.

Continuous subcutaneous insulin infusion (CSII) systems have been used in diabetes management since the mid-1970s. Investigators have reported encouraging results with CSII use in adult subjects with dramatically improved glucose control, reversal of some complications, and high acceptance and compliance rates. We have studied 10 adolescents and 3 young adults using CSII for diabetes management. Only the three young adults (ages 20, 24, 34 years) have had markedly improved metabolic control, sustained pump use, and made adequate psychological adjustment to CSII therapy. Adolescent subjects, (ages 9-17 years), experienced problems with peer acceptance of pumps, had difficulty with infusion needle insertion and skin care, were unable to perform home blood glucose monitoring consistently, made nonadvised manipulations of insulin dosage and reported mechanical problems with CSII devices more frequently than the young adult subjects. Mean duration of CSII use in adolescent subjects (6.1 months) was significantly less than mean use (30.6 months) among the young adults (p less than 0.01). Currently, adults appear to have greater success than adolescents in using CSII for diabetes management.

Adolescent↗