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Biomedical subjects

M Rebenson-Piano

Publications and source records attributed to M Rebenson-Piano.

6 recordsLinked to original sources
PubMed1990

Electrocardiographic response to ice water ingestion.

To determine the necessity of restricting ice water for patients with acute myocardial infarction (MI) we performed studies in 89 patients who had been admitted to a coronary care unit with a diagnosis of acute MI or "rule out MI." Using a split-plot factorial repeated-measures design, we randomly assigned patients to position and sequence of volume. A Marquette Augmented Cardiograph was used to obtain 12-lead electrocardiogram (ECGs) at baseline and at 3, 10, and 25 minutes after ingestion of 200 or 400 ml ice water. Multivariate analysis of variance (MANOVA) was used to assess the significance of each factor alone and in interaction for both ST segments and T waves for 11 leads. The preliminary analysis of variance showed significant difference (p less than 0.10) in ST segments for position in several leads and in T waves for disease in several leads. Differences did not continue to be significant when they were considered across the four time periods (MANOVA); then time and volume were the significant variables for most leads. Mean change scores for ST segment (0.01 to 0.05) and T wave amplitude (0.01 to 0.88) were not clinically significant; however, a few patients had significant changes in ST segment of greater than 1 mm and T wave amplitude of greater than 10 mm. A few patients exhibited T wave inversion, suggesting a third level of significance: clinically detectable differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

The physiologic changes that occur with aging.

The elderly critically ill patient requires more intense consideration and observation, because his or her system has become less capable of adapting to external stresses. Table 2 summarizes the major changes in the various systems and considerations for care in the critical care unit. The use of various diagnostic tests to establish organ function is required in the elderly population before medication or treatment regimes are instituted. Tests typically performed on a routine basis include tests of renal function, gastrointestinal motility, and respiratory and cardiac function. Judicious use of these studies is required, including evaluation of the patient's ability to cooperate and comprehend instructions. Clinicians also must consider the impact of past and recent life-style patterns on the aging process. Health care professionals need to develop ways to promote what Rowe and Kahn have termed, "successful aging," and improve their understanding of factors, psychosocial or physiologic, that facilitate resistance to disease and maintenance of autonomy in the elderly population.

Aged↗
PubMedDate not supplied

An evaluation of two indirect methods of blood pressure measurement in ill patients.

Direct (intraarterial) and two indirect (using a mercury sphygmomanometer [MS] and an automatic [auscultatory] device) methods of blood pressure measurement were compared in intensive care patients (N = 32). One trained observer blind to both automatic and direct measurements obtained all indirect MS measurements. All direct and indirect measurements were made on the same arm. Direct measurements were obtained from 10-second strip chart recordings. In normotensive patients both indirect measurements of systolic blood pressure (SBP) underestimated the direct SBP; however, only the SBP value obtained with the automatic device (106 mm Hg) was significantly different, p less than .05, from the direct SBP value (120 mm Hg). No significant difference was noted between methods in measurement of normotensive diastolic blood pressure. In hypertensive patients direct SBP was significantly greater, p less than .05, from both values obtained by indirect measurement. In patients without hypotension the automatic device may be substituted for the MS and direct blood pressure methods. The automatic device may offer the advantage of decreasing observer bias and variability in blood pressure measurement.

Adult↗
PubMedDate not supplied

Mean arterial pressure readings: variations with positions and transducer level.

The purpose of this study was to examine the relationship between mean arterial pressure (MAP) readings, measured at two reference points, the right atrium (RA) and the catheter site (CS), and in two body positions, supine and semi-Fowler's. Four MAP readings were taken on 29 CCU patients, 17 males and 12 females, with ages ranging from 33 to 93 (mean = 57.8; SD = 14.3). MAPs were obtained in the semi-Fowler's position-RA reference point (mean = 82.6), semi-Fowler's-CS reference point (mean = 90.3), supine-RA reference point (means = 82.2), and supine-CS reference point (mean = 84.03). All r values for pairs of readings were greater than .90 (p less than .001); therefore the readings are extremely comparable. However, when the comparability of readings is taken into account with MANOVA, the Hotelling's T2 is 58.06; the associated F is 17.97 (df = 3,26) with p less than .001. Therefore, in stable patients, MAP readings are comparable, but use of RA as the reference point for either position is the most preferable. A patient would not have to be lowered to the supine position for each MAP reading. However, in patients who are not stable, the significant differences among MAPs must be considered. The same position and the RA is preferable for all MAPs on these patients.

Adult↗