Biomedical subjects
M V Chapman
Publications and source records attributed to M V Chapman.
The effect of hypothermia on calculated values using saline and automated air tonometry.
OBJECTIVE: To quantify in vitro the effect of hypothermia on results obtained when performing automated air tonometry (Tonocap, Datex-Ohmeda, Instrumentarium Corp, Helsinki, Finland) and saline tonometry. DESIGN: In vitro validation study. SETTING: University hospital research laboratory. INTERVENTIONS: Two TRIP sigmoid catheters, one connected to the Tonocap device and the other instilled with 2.5 mL of 0.9% saline, were placed in a saline bath at 30.3 degrees C (mean) through which 5% carbon dioxide (CO(2)) was bubbled. MEASUREMENTS AND MAIN RESULTS: A total of 50 paired measurements were taken at 30-minute equilibration times of saline bath CO(2) tension and saline tonometry and air tonometry readings. Saline samples were analyzed at 37 degrees C and corrected for temperature. Bias and precision of each technique as a percentage of predicted CO(2) values were calculated. The Tonocap device had bias and precision values of -2.6% and +/-1.4%. Measurement of CO(2) is in the gaseous phase so that temperature correction is not required. Saline tonometry readings processed at 37 degrees C exhibited a large positive bias of 23.06% (precision +/- 7.02%). Correction for temperature improved bias to -10.98 % with a similar precision profile of +/-5.78%. CONCLUSION: When using gastrointestinal tonometry during hypothermic cardiopulmonary bypass, saline tonometry samples should be temperature corrected. The Tonocap device proved the most accurate and precise measurement technique independent of the need for temperature correction.
Report from the meeting: Gastrointestinal Tonometry: State of the Art. 22nd-23rd May 1998, London, UK.
Gastrointestinal (GI) tonometry, the only clinically available method for the accurate diagnosis of compromised GI blood flow, has been shown to be a sensitive predictor of increased morbidity, mortality and prolonged hospitalization. The recent introduction of the Tonocap, as a means of performing automated air tonometry, has simplified the application of GI tonometry in the clinical setting. Despite this the utility of GI tonometry remains controversial. The GI Tonometry: State of the Art meeting brought together a group of clinicians with a proven track record of research, clinical interest and expertise in this field. The aim of the meeting was to come to a consensus regarding certain issues such as the past and future roles of GI tonometry and standards for its correct usage and interpretation. Finally suggestions as to further research and clinical evaluation were made within a broader discussion regarding the complexities of applying the principles of evidence-based medicine to the introduction of a new piece of medical technology.
Early clinical experience with a newly formulated hydroxyethyl starch--Hextend.
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Recognizing the impact of marital discord and parental depression on children. A family-centered approach.
The American family is changing. Pediatricians are increasingly aware of treating children within a family systems context. Patients present with a variety of biopsychosocial problems, and pediatrics must continue to adjust to fit the changing needs of children and their families. Pediatricians must view themselves as members of a community of caretakers for families and children. The pediatrician faces increasing responsibility in responding to the increased stress experienced by children and their families. Family-focused pediatrics is becoming an increasingly accepted part of pediatric practice. The authors have sought to provide strategies for assessing and intervening with families in which depression and marital discord are impairing children's well-being and development. The pediatrician's role as a trusted family consultant creates a unique situation in which problems that often go unnoticed and unattended can be recognized and addressed early. In this way, children can be spared the consequences of exposure to parental conflict and the decreased functioning of a depressed parent.