TRACHEOTOME TRACHEOSTOMY.
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Biomedical subjects
Publications and source records attributed to L D MACLEAN.
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The single apparent and potential benefit of hyperbaric oxygen is the great increase in the blood content of dissolved oxygen achieved when pure oxygen is breathed at increased pressure. The design of an economical chamber for this purpose is presented. A large number of physiological measurements (cardiac output, electroencephalogram, electrocardiogram, etc.) can be performed on patients or experimental animals within the chamber by use of unique electronic connections in the chamber wall which permits all recording equipment to remain outside. Expected arterial blood oxygen tensions have been achieved in patients studied at 2, 3, and 4 atmospheres. Safety features are emphasized. No complication has resulted in 113 dives over the period January to June 1964, one-half of which were for treatment of patients. The chamber has been used clinically as an adjunct to treatment of shock, certain forms of malignancy, anaerobic infections, coronary occlusion, and problems of ischemia, and for preservation of organs for transplantation.
Four renal homotransplants were carried out between cadaver donors and four recipients, all of whom were in terminal chronic renal failure. Immune suppression was attempted with azathioprine (Imuran), actinomycin C and prednisone; no radiation was used, nor were the recipient's kidneys, spleen or thymus removed. One patient died with disseminated histoplasmosis at two weeks; another with irreversible homograft rejection at 30 days; a third patient died of septicemia after 9(1/2) weeks with stable renal function. The fourth patient, whose transplant had been ischemic for 190 minutes and had not functioned for 2(1/2) weeks thereafter, eventually achieved good function which remained unchanged to 7(1/2) months. Changes in urinary enzyme excretion and in the I(131) renogram and meralluride scan were of value in assessing homograft rejection.
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