Biomedical subjects

Keith J Anderson

Publications and source records attributed to Keith J Anderson.

3 recordsLinked to original sources

PubMed2005

Normobaric hyperoxia reduces cardiac index in patients after coronary artery bypass surgery.

OBJECTIVE: The purpose of this study was to assess the hemodynamic changes in response to normobaric hyperoxia in patients immediately after coronary artery bypass surgery. DESIGN: Observational study. SETTING: Single-center university hospital. PARTICIPANTS: Patients immediately after coronary artery bypass surgery. INTERVENTION: Change of fractional inspired oxygen concentration from baseline (< or =0.60) to 1.0 and return to baseline. MEASUREMENTS AND MAIN RESULTS: Cardiovascular changes were assessed with a lithium dilution technique. Cardiac index decreased from 2.82 to 2.52 L/min/m2 (10.6%). Heart rate decreased from 85.9 to 82.5 beats/min (4.0%), and the systemic vascular resistance index increased from 1,858 to 2,304 dyne/s/cm5/m2 (24.1%). Stroke index or mean arterial pressure did not change significantly. On reducing the FIO2 from 1.0 to the baseline FIO2 , there was significant reversal of the previous changes in heart rate and systemic vascular resistance. Heart rate increased from 82.5 to 84.0 beats/min (1.8%), and the systemic vascular index decreased from 2304 to 1932 dyne/s/cm5/m2 (16.1%). The cardiac output did not return to baseline, and the mean arterial pressure decreased from 69.6 to 64.4 mmHg (7.6%). CONCLUSIONS: Exposing patients after coronary artery surgery to hyperoxia induces significant hemodynamic changes.

Aged↗

PubMed2004

QTc dispersion is prolonged in patients with early postoperative adverse cardiovascular events and those with silent myocardial ischemia.

OBJECTIVE: To determine if increased QT interval dispersion (corrected and not corrected for heart rate) is associated with perioperative silent myocardial ischemia or postoperative adverse cardiovascular events. DESIGN: Blinded retrospective observational study. SETTING: University hospital. PARTICIPANTS: One hundred eighty-one perioperative patients receiving general anesthesia for elective major vascular or orthopedic surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: QT dispersion, corrected and uncorrected for heart rate, was prolonged in patients suffering significant myocardial ischemia up to 48 hours assessed by Holter ECG monitoring, for early cardiac morbidity and all early cardiac events (including mortality) up to 1 month postoperatively. There were no significant changes in patients showing early cardiovascular mortality or late cardiac morbidity or mortality between 1 and 12 months postoperatively. Morbidity and mortality were determined from clinical notes, laboratory investigations, and autopsy when available. QT dispersion performed poorly as a screening test to identify those who subsequently developed early adverse cardiovascular outcomes. CONCLUSIONS: QT dispersion is prolonged in those at risk of early adverse cardiovascular events but is a poor screening tool.

Adult↗

PubMed2002

Reversible coma in children after improper baclofen pump insertion.

We report the occurrence of delayed postoperative coma in five of nine consecutive children following surgery for insertion of baclofen infusion pumps. We suspect that improper technique resulted in an inadvertent administration of an intrathecal baclofen bolus. We suggest ways to minimize this risk.

Analgesics, Opioid↗