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M Baysinger

Publications and source records attributed to M Baysinger.

6 recordsLinked to original sources

A trajectory approach for education of the child/adolescent with cancer.

Survival in childhood cancer has improved, but the child's learning capability and psychosocial adjustment are affected by intense therapy, the side effects, and psychosocial issues. The resulting problems of school attendance and performance need to be addressed by pediatric oncology nurses. This article describes an education intervention program that is based on a treatment trajectory with interventions that occur from diagnosis through long-term survival and are directed toward the patient/parent, school personnel, and classmates. Both anecdotal and empirical evaluations of the program are being completed. This program provides pediatric oncology nurses with a model for program development and resource materials.

Adolescent↗

Effects of halothane and morphine sulfate on myocardial compliance following total cardiopulmonary bypass.

We evaluated the effect on diastolic myocardial compliance of halothane and morphine sulfate using 15 swine placed on total cardiopulmonary and right heart bypass with controlled aortic pressure, heart rate, and left ventricular preload. The animals were divided into three equal groups: (I) regional block anesthesia, (II) morphine sulfate (10 mg/kg), and (III) halothane anesthesia at 0.5%. Myocardial performance was evaluated on right heart bypass following a 30 minute period of total cardiopulmonary bypass before and after administration of the anesthetic agent by measuring stroke volume, left ventricular end-diastolic pressure, and left ventricular end-diastolic volume. All perfusions were at normothermia, at a hematocrit level of 30%, and at a normal arterial Po2. PCO2, and pH. Neither regional block nor morphine sulfate anesthesia significantly depressed the myocardium or changed diastolic compliance. Halothane, however, significantly decreased diastolic compliance so that stroke volume was less at a given left ventricular end-diastolic pressure, but not at a given left ventricular end-diastolic volume. The depression of stroke volume with halothane following cardiopulmonary bypass at equal filling pressures appears to be due primarily to a change in compliance rather than to a change in contractility.

Anesthesia↗

Extending the limits of hemodilution on cardiopulmonary bypass using stroma-free hemoglobin solution.

Ten swine were subjected to exchange transfusion to a hematocrit level of 5% with either stroma-free hemoglobin solution (SFHS) or 7% albumin solution. Myocardial performance, oxygen kinetics, and myocardial metabolism were subsequently examined using a perfused, in situ, right heart bypass, swine heart model with control of preload, afterload, and heart rate. Animals were tested during a control period (hematocrit = 30%) and following exchange transfusion with either solution to a hematocrit level of 5%. We found that myocardial performance following albumin solution exchange could not be sustained on right heart bypass, and these animals had a stroke volume of zero at a left ventricular end-diastolic pressure of 14 torr. SFHS animals had a significant drop in stroke volume at 14 torr following exchange (20 +/- 3 versus 10 +/- 4, p < 0.025), but this 50% performance level could be sustained. Coronary blood flow rose and myocardial oxygen consumption fell in both groups, although the statistically nonsignificant mean differences were less with SFHS. Arterial-coronary sinus oxygen difference fell significantly (p < 0.05) with albumin solution (7.3 +/- 0.8 versus 2.2 +/- 0.2) and nonsignificantly with SFHS (5.6 +/- 0.4 versus 4.1 +/- 0.7). Lactate production occurred in both groups, but was greater with albumin (34% +/- 6%) than with SFHS (3% +/- 16%). No changes in myocardial tissue gasses were noted in either group. Although myocardial performance decreased and some lactate production occurred with SFHS, we believe these comparative results provide promise in the eventual utilization of an oxygen-carrying agent such as SFHS to extend the limits of hemodilution to a hematocrit value of 5% or less.

Animals↗