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Biomedical subjects

P Casthely

Publications and source records attributed to P Casthely.

5 recordsLinked to original sources
PubMed1981

Decreases in electric thoracic impedance during transurethral resection of the prostate: an index of early water intoxication.

Thoracic impedance of 18 patients undergoing transurethral resection of the prostate was measured 15 minutes preoperatively, and 30 and 60 minutes after the start of the operation. Impedance variations were compared to variation in 1) cardiac output, 2) serum sodium osmolality and 3) alveolar-arterial oxygen tension difference. Thoracic impedance, initially 24.6 plus or minus 0.3, decreased to 23.8 plus or minus 0.5, 30 minutes after the onset of the operation (p less than 0.0005) and 22.9 plus or minus 0.5, 30 minutes later (p less than 0.01 from previous reading and 0.0005 from control). Patients in whom impedance had decreased 10 per cent or more from control values received 10 mg. furosemide intravenously 60 minutes after the onset of the operation. This therapy permitted the restoration of impedance values, cardiac output, alveolar-arterial oxygen tension difference and serum sodium osmolality to values statistically similar to those found in the 10 patients who had not sustained such precipitous decreases in impedance within 60 minutes. We believe that the measurement of thoracic impedance during transurethral prostatic surgery offers the most sensitive index of early water intoxication. Measurements can be obtained without delay in the operating room and, thus, permit immediate correction of the condition.

Aged↗
PubMed1980

Tracheobronchial cytologic changes during prolonged cannulation.

The tracheobronchial cytology of eighteen patients undergoing prolonged mechanical ventilation were examined for the type of cell population present, together with the morphologic integrity of the ciliated epithelial cells 1, 3, 5,10, and 20 days after tracheal cannulation. Smears obtained from patients recovering from cardiac surgery were different from all others in that: (1) they contained fewer epithelial cells (ciliated and squamous) which disappeared earlier; (2) they initially had more pus cells which appeared earlier; (3) they originally contained more histocytes but these were not found after the 5th day after cannulation; and (4) their ciliated epithelial cells displayed more cytomorphologic changes. Differences in cytology were attributed to impaired cardiac output in these patients. The reduced perfusion pressure of the vasculature of their tracheobronchial tree was presumably unable to sustain the lateral wall pressure of tube cuffs pressure, which further impaired tracheal perfusion. Less reparative processes (squamous metaplasia and early appearance of histiocytes) were also found in patients following cardiac surgery, together with early invasion of smears by pus cells indicating premature lowered resistance to bacterial infection.

Adolescent↗
PubMed1978

Prevention of nitroprusside-induced cyanide toxicity with hydroxocobalamin.

To investigate hydroxocobalamin's role in preventing cyanide intoxication from sodium nitroprusside, we studied two groups of patients. One group received nitroprusside alone, and the other received nitroprusside and hydroxocobalamin. Red-cell and plasma cyanide levels were 83.44 +/- 23.12 and 3.51 +/- 1.01 microgram per 100 ml after nitroprusside alone and were 33.18 +/- 17.29 and 2.18 +/- 0.65 microgram per 100 ml after nitroprusside plus hydroxocobalamin. Acidosis developed in patients with red-cell cyanide levels higher than 75 microgram per 100 ml. When hydroxocobalamin infusion was stopped before sodium nitroprusside infusion was discontinued, blood cyanide levels and base deficit increased in a manner similar to that in the untreated group. The dose of nitroprusside used in each group did not differ statistically. These data show that hydroxocobalamin prevents cyanide transfer from red cells and plasma to tissue after nitroprusside metabolism, and thereby prevents cyanide toxicity from large intravenous doses of the drug.

Adult↗