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M R Parker

Publications and source records attributed to M R Parker.

7 recordsLinked to original sources

A pilot study to investigate the effects of an infusion of aminophylline on renal function following major abdominal surgery.

Acute renal failure is a frequent complication of critical illness and optimal preventive therapy remains elusive. There is increasing evidence from animal models and some human studies that adenosine receptor antagonism by aminophylline may reduce the severity of renal impairment caused by a variety of aetiologies. We studied the renal effects of intravenous aminophylline in an unblinded, within-patient study of 20 patients admitted to a general intensive care unit following major surgery. We demonstrated that there were no adverse cardiovascular complications related to aminophylline therapy. Renal sodium and osmolar clearance increased with a non-significant trend towards increased diuresis during treatment. Creatinine clearance, however, was unchanged but the study was not designed and did not have the power to test whether aminophylline increased renal blood flow or glomerular filtration rate. We suggest the renal actions of aminophylline in critical illness merit further investigation.

Abdomen↗

Visible and occult blood contamination of laryngeal mask airways and tracheal tubes used in adult anaesthesia.

The purpose of this study was to compare visible and occult blood contamination of 50 laryngeal mask airways and 50 tracheal tubes following routine anaesthesia for procedures not involving the oropharyngeal or nasal cavities. All airway devices were examined visually for the presence of blood before washing in 100 ml of water. A semiquantitative dipstick was used to test for the presence of blood in the washings. Laryngeal mask airways were examined visually by both authors to test agreement. The results show that occult blood contamination occurred in 78% of tracheal tubes and 76% of laryngeal mask airways, while visible blood contamination was 16% and 12%, respectively. Other studies reporting visible blood contamination of airway devices probably underestimate the true incidence of blood contamination. Oral secretions following the use of these devices should be considered as high risk for transmission of blood-born viruses. Anaesthetic and recovery staff should be protected against the risks of occupational exposure to oral secretions following the use of airway devices.

Adult↗

The use of protective gloves, the incidence of ampoule injury and the prevalence of hand laceration amongst anaesthetic personnel.

In a study of 97 anaesthetic sessions, the incidence of hand laceration secondary to opening glass ampoules was 6% and the prevalence of visible old hand laceration 26%. The wearing of gloves for procedures likely to cause contamination by human secretions ranged from 35-86%. Overall there was no statistically significant difference in glove wearing habits of trainees and consultants. In the presence of a visible laceration, glove wearing by trainees increased and was significantly higher than that practiced by consultants. There were at least 90 procedures performed in 97 sessions during which an anaesthetist risked contaminating a visible laceration. It appears that the occupational risk of contracting a blood-borne viral infection is still unnecessarily increased by anaesthetists not wearing protective gloves for all procedures in which contamination may occur.

Anesthesiology↗