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Biomedical subjects

M A Branthwaite

Publications and source records attributed to M A Branthwaite.

At least 55 records · Page 3Linked to original sources
PubMed1983

Respiratory failure after thoracoplasty: treatment by intermittent negative-pressure ventilation.

Ten patients with severe respiratory failure secondary to extensive pulmonary tuberculosis and thoracoplasty have been treated with intermittent negative-pressure ventilation. All recovered and have been followed up for from six months to eight years. Two have died from unrelated causes and six have used some form of breathing aid at home. Negative-pressure ventilation, which is a non-invasive form of respiratory support, offers important benefits in selected cases.

Adult↗
PubMed1982

Severe acute asthma: a comparison of three methods of inhaling salbutamol.

The effects of salbutamol inhaled by three different methods were compared in groups of adult patients with severe acute asthma. 2 x 400 micrograms Rotacaps was the optimum dose of dry powder but about 40% of patients failed to respond to it. 5 mg salbutamol nebulized with IPPB resulted in a significant increase in peak expiratory flow rate when given before or after either Rotacaps or salbutamol nebulized without IPPB, whereas neither the dry powder nor the nebulized drug without IPPB resulted in significant change when given after salbutamol nebulized with IPPB. The extra benefit derived with IPPB is only slight and requires a device of appropriate characteristics. Occasional patients fail to respond to salbutamol inhaled by any means, generally those with the most severe airflow limitation.

Acute Disease↗
PubMed1981

Respiratory mass spectrometry during general anaesthesia.

The performance of a respiratory mass spectrometer, modified commercially for use during general anaesthesia, has been evaluated. Stability and linearity proved satisfactory for monitoring respiratory gases and accurate measurement was possible when the inspired concentration of all gases was less than 80%. The system has been installed centrally in a three-room operating theatre suite and the selection of long sampling probes which permit an adequate response time for all gases is discussed.

Anesthesia, General↗
PubMed1981

Non-invasive measurement of cardiac output during anaesthesia. An evaluation of the soluble gas uptake method.

A technique for measuring cardiac output which depends on the uptake of an inert soluble gas from the lungs has been evaluated during anesthesia. A respiratory mass spectrometer has been used to follow the concentrations of argon and freon-22 during passive rebreathing in anaesthetized patients before cardiopulmonary bypass. Values for cardiac output obtained with this technique are reproducible, but lower than those recorded using the direct Fick technique before and after the rebreathing manoeuvre. A reduction in cardiac output caused by vigorous rebreathing is the most likely explanation for the discrepancy and, although serial measurements of oxygen consumption may permit application of a correction factor, a method of measurement which causes significant haemodynamic disturbance cannot be recommended for widespread use.

Adult↗
PubMed1981

End-tidal carbon dioxide during thoracotomy. Its relation to blood level in adults and children.

The concentration of carbon dioxide in end-tidal gas was compared with the tension in arterial or superior vena caval blood during thoracotomy in twelve patients. In six adults requiring pulmonary resection, one-lung anaesthesia did not change the difference between the two measurements. In six children in whom a systemic to pulmonary arterial anastomosis was being created to improve pulmonary blood flow impaired by cyanotic congenital heart disease, occlusion of the pulmonary artery caused in increase in the blood-end-tidal carbon dioxide gradient. This change was particularly marked in two neonates and was of sufficient magnitude to render end-tidal monitoring unreliable in these circumstances.

Adult↗
PubMed1980

Complement activation during cardiopulmonary bypass.

Conversion of C3, the third component of complement, has been studied using a two-dimensional immunoelectrophoretic method. Evidence of C3 conversion has been obtained in stored donor blood, in patients during and after cardiac surgery involving cardiopulmonary bypass, and occasionally during thoractomy for pulmonary resection. It is suggested that complement activation is one factor contributing to tissue injury after cardiopulmonary bypass.

Adult↗
PubMed1980

Mechanical ventilation for pulmonary disease. A six year survey.

Between 1972 and 1977, 91 patients received mechanical ventilation for pulmonary disorders. Forty-nine (53.8%) left hospital and 35 of these survived for at least 1 year. Nineteen of 23 asthmatic patients survived. Cerebral damage following cardiorespiratory arrest precluded successful outcome in three of the four who died. In those with chronic lung diseases, patients with chronic bronchitis fared best; outcome was poor in those with emphysema, bronchiectasis and pulmonary fibrosis often despite trivial precipitating causes of respiratory failure. Mortality was high in patients with pneumonia even if immunologically normal.

Acute Disease↗
PubMed1980

Metabolic indices of pulmonary damage. Changes in angiotensin converting enzyme and alpha 1 anti-trypsin activity after cardiopulmonary bypass.

The activity of angiotensin-converting enzyme was measured in patients undergoing cardiopulmonary bypass and in a control group requiring thoracotomy for pulmonary surgery. The activity of the enzyme was higher in patients with cardiac disease, fell during operations involving cardiopulmonary bypass, but did not change during thoracotomy for pulmonary surgery. Possible reasons for these differences are discussed. The activity of another enzyme, alpha 1 anti-trypsin, did not change during cardiopulmonary bypass and no arteriovenous difference could be detected during or after operation.

Adolescent↗
PubMed1980

Applications of respiratory mass spectrometry to intensive care.

A monitoring and research system based on a respiratory mass spectrometer controlled by a microprocessor has been installed in a paediatric intensive care unit. It provides an opportunity to study up to twelve patients simultaneously at distances up to 30 m from the instrument, can operate for prolonged periods without intervention, and includes a routine for regular calibration checks. There is an automatic sensitivity control which compensates for minor variations in probe patency or in water vapour pressure. Information derived from the system can be displayed centrally or at the bedside and data can be conserved for up to 24 hours; past events can be recalled and displayed for either the previous hour or previous 24 hours. The system can be used to measure respired gas tensions, metabolic gas exchange, lung volume, pulmonary blood flow and pulmonary tissue volume. The clinical value and limitations of the system are discussed.

Carbon Dioxide↗
PubMed1980

Pulmonary blood flow and tissue volume. Assessment of a non-invasive technique of measurement.

Pulmonary blood flow and tissue have been measured by a rebreathing technique in which the disappearance of soluble and insoluble gases from an inhaled mixture is followed continuously using a respiratory mass spectrometer. Although measurements made with diethyl ether are more reproducible than those made with freon-22, they are inaccurate because ether (the more soluble gas) is taken up by the tissues surrounding the respiratory dead space. Experiments carried out on four normal subjects demonstrate that measurements of both pulmonary blood flow and tissue volume are influenced by the volume of gas in the lungs during the manoeuvre. Possible reasons for this are discussed and an exponential relationship between the two variables and lung volume is suggested.

Adult↗
PubMed1980

Pulmonary function after prolonged mechanical ventilation with high concentrations of oxygen.

The mortality and morbidity resulting from mechanical ventilation with high concentrations of inspired oxygen has been investigated in two groups of patients. Ninety-one patients requiring mechanical ventilation for pulmonary disease included six (group 1) in whom death was attributed directly to respiratory failure but only three in whom oxygen toxicity might have been relevant. Review of the clinical and postmortem findings suggests that oxygen was probably not a contributory factor in two of these three. A second group of 16 patients who survived prolonged mechanical ventilation with oxygen in excess of 40% (average 14.5 days) included five who had been ventilated with 75% oxygen or more for an average of 38 hours. Lung function studies carried out on this second group of patients approximately one year later demonstrated that all but three had significant defects in either ventilation, gas transfer, or both. Oxygen toxicity was thought to be a likely cause in one and a possible contributory factor in three more. It is suggested that the adverse effects of oxygen on the alveolar epithelium are rarely of practical importance in hypoxaemic patients requiring mechanical ventilation but disturbance to the pulmonary defences against infection may well be of greater importance. The fear of inducing oxygen toxicity should not be allowed to interfere with the relief of arterial hypoxaemia in ventilated patients.

Adolescent↗
PubMed1979

Cardiac pacemaker insertion: a study of the anaesthetic and postoperative complications.

One hundred and three patients undergoing pacing procedures have been studied, the majority requiring the insertion of an epicardial system under general anaesthesia. The main findings were of an elderly group of patients with a high incidence of associated disease, who suffered predominantly from pulmonary and renal complications. Methods of reducing these complications, particularly in relation to general anaesthesia are discussed.

Adolescent↗