PubMed Health⌕ Search

Biomedical subjects

J S Britten

Publications and source records attributed to J S Britten.

At least 19 recordsLinked to original sources
PubMed1989

Are arterial blood gases of value in treatment decisions for carbon monoxide poisoning?

Traditionally, the carboxyhemoglobin (HbCO) level has been used to estimate the severity of carbon monoxide (CO) poisoning. Through extensive clinical experience, we have found this to be an inaccurate correlation; thus, other variables such as pHa or psychometric abnormalities have been assessed to determine severity from CO poisoning. In a 5-yr experience with 247 patients, on admission 114 had an arterial blood gas and HbCO determinations, and 88 also had psychometric testing. The data were evaluated to determine any relationship between pH and HbCO level; a weak correlation (r approximately equal to -0.3) was discovered. A comparison of psychometric testing with HbCO level showed a much stronger statistical relationship. The definition of HbCO poisoning severity may be better determined by psychometric testing than by the HbCO level because psychometric testing measures actual neurologic disability. The weak correlation between both psychometric testing and the HbCO level with pHa reinforces the clinical impression that patients with acidosis, alkalosis, or normal blood gases could have equally severe neurologic symptomatology at HbCO levels ranging from 1% to 62%.

Blood Gas Analysis↗
PubMed1985

Effects of hyperbaric treatment on carbon monoxide elimination in humans.

A theoretical model of carbon monoxide elimination from the acutely poisoned individual is presented. The model is derived from a one-compartment system with the rate-limiting step that of alveolar ventilation, assuming equilibration of carbon monoxide and oxygen between alveolar gas and pulmonary capillary blood and incorporates the effect of the carboxyhemoglobin-oxyhemoglobin equilibrium in the pulmonary capillary. The model is applied to groups of patients treated for carbon monoxide intoxication both by conventional means and by hyperbaric medicine and to some animal studies found in the literature with satisfactory fit of data to the model. Finally, a number of factors responsible for the variability of CO elimination are discussed in terms of the model.

Carbon Monoxide↗
PubMed1983

Short-stay study--utilization review.

During a 6-month period approximately 20% of the 589 patients admitted to the Maryland Institute for Emergency Medical Services Systems (MIEMSS), and who did not die, stayed less than 48 hours. About two thirds of these short-stay admissions (13% of the total number of admissions during the study period) were judged inappropriate on clinical grounds. This percentage is lower than the inappropriate rate (20%) experienced at areawide trauma centers in Maryland and may approximate the lower limit of the rate of inappropriate admissions due to unavoidable errors in triage. The inappropriately admitted patients did not impose a large fiscal or service drain on MIEMSS and did not interfere with the care of patients with more serious problems.

Humans↗
PubMed1982

Blood ethanol and serum osmolality in the trauma patient.

The relationships between blood alcohol concentrations and both "osmolar difference" (measured serum osmolality minus expected serum osmolality calculated from serum sodium, serum potassium, blood urea, and blood glucose concentrations) and total serum osmolality have been investigated in severely traumatized patients. Osmolar difference was found to be more strongly correlated to blood alcohol concentration than serum osmolality; however, the error in the slopes of the regression lines was essentially identical (approximately 17%). Consequently, indirect estimations of blood alcohol concentrations by calculating osmolar difference do not improve the accuracy obtained by the estimation by measurement of serum osmolality alone. It appears that the production of unidentified osmoles in traumatized patients significantly influences all indirect calculation of blood alcohol by osmometry. A direct determination of blood alcohol should be made whenever possible.

Alcoholic Intoxication↗
PubMed1981

Calculator/computer-assisted calibration and use of the IL-182 CO-Oximeter.

Of the many techniques and methods available for measuring carbon monoxide in blood, one of the easiest involves the use of the IL-182 CO-Oximeter, a specialized triple-wavelength spectrophotometer. Although easy to use, the calibration procedure can be lengthy and impractical if performed routinely to ensure accuracy. A method is described for an equivalent calibration by using a programmable calculator or minicomputer. The new method allows rapid and easy calibration as well as the analysis of unknown blood samples. Three anticoagulated blood samples, each containing as little as 2 ml, are required to calibrate. One sample is chemically reduced, one is tonometered in pure oxygen, and the third is tonometered in pure carbon monoxide. The optical densities of these three known calibration samples, determined at each of the three specific wavelengths used by the IL-182, allow one to derive the constants used in the equations needed to solve for an unknown sample.

Calibration↗
PubMed1979

Hypothermia: quantitative aspects of therapy.

Quantitative aspects of various methods of warming are presented comparing the peripheral method of warm bath immersion to the central method of ventilation with heated water-saturated air, infusion of warmed intravenous solutions, peritoneal lavage with warmed solutions, and hemodialysis or cardiopulmonary bypass. The need to convert arterial blood gas results for body temperature is emphasized. Two cases demonstrate combined use of peripheral warming using warming mattress and blankets and central warming with ventilation and infusion.

Adolescent↗
PubMed1976

Adsorption of albumin on rabbit sperm membranes.

When mammalian sperm cells are exposed to solutions of albumin there are changes in the membranes of some species that resemble those that normally occur in the uterus prior to fertilization. We have shown that albumin molecules absorb on to the membranes of ejaculated rabbit sperm cells, and that the equilibrium binding constant, K, (1) varies inversely with the albumin concentration, (2) is independent of the sperm cell concentration in the range of 10(6)--10(7) per ml, (3) is independent of the time of exposure of the sperm cells to the albumin solution, and (4) decreases in the presence of Ca++ and Mg++ ions. An unusual aspect of the adsorption is that if the albumin concentration is given the symbol [A], K[A] is a constant in our measurements. This means that for virtually the entire range of [A] studied, the sperm cells bind albumin so that half of the available surface is coated and half remains uncoated. This situation is rather remarkable and it suggests a role that adsorption could play in the physical processes preceding fertilization. In purely physical systems, the optimum for the bridging and flocculation of particles that are coated with adsorbed macromolecular films occurs when half of the available surface is covered. The sperm cell appears to provide the optimal situation for interacting with itself or with another surface.

Adsorption↗