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Biomedical subjects

P Cubillos

Publications and source records attributed to P Cubillos.

4 recordsLinked to original sources
PubMed1999

Cerebrospinal fluid spinal lumbar drainage: indications, technical tips, and pitfalls.

Since the publication by F. Vourc'h in 1963 [Br J Anaesth (1963) 35:118-120] describing the use of a plastic catheter inserted percutaneously for the drainage of lumbar cerebrospinal fluid (CSF) the indications for spinal drainage are numerous, but not very well systematized. The bibliographical review shows few recent papers concerning the techniques, indications, complications and pitfalls. The authors considered it interesting to analyze nine papers, in particular those dedicated to the use of spinal drainage in skull base surgery and in the prevention and/or treatment of CSF fistulas. Two papers describe for the first time pachymeningeal gadolinium enhancement associated with orthostatic headaches, owing to CSF hypotension mimicking an inflammatory or infiltrative disease. The results of the treatment of CSF fistulas are good with a high success rate, avoiding direct surgical repair. The use of a specially designed subarachnoid catheter is clearly superior to the epidural catheter, with good flow of CSF and minimal complications. The main problems are deficient flow and infections. Overdrainage is potentially dangerous, with acute pneumocephalus, brain collapse and neurological deterioration. Infrequent but possible is Chiari II-like syndrome with vocal cord paralysis and life-threatening aspiration, or temporal downward herniation with kinking of the posterior cerebral artery and acute brain infarct. The key to success lies in a rigid protocol, intermittent CSF drainage with a closed circuit, and daily biochemical and microbiological monitoring. Highly qualified medical and nursing staff are essential.

Journal Article↗
PubMed1984

Phenytoin improves hemodynamic tolerance and survival after severe hypoxia.

Three groups of 12 rabbits each, anesthetized with ketamine (30 mg/kg, intramuscularly) and spontaneously breathing N2O-O2, were given intravenous injections of either placebo (group 1), thiopental (TP) (40 mg/kg, intravenously; group 2), or phenytoin (PNT) (15 mg/kg, intravenously; group 3). Four minutes later, succinylcholine was given and, while ventilation was controlled with N2O alone, changes in systolic blood pressure (SBP) and heart rate (HR) were measured. Tachycardia (greater than 210 beats/min) occurred in groups 1, 2, and 3-111, 107, and 151 sec later, respectively. SBP decreased below 100 torr at 189, 192, and 362 sec, respectively, and below 30 torr 245, 216, and 433 sec after the onset of hypoxia (P less than 0.05), respectively. Bradycardia (less than 30 beats/min) appeared 248, 219, and 439 sec (P less than 0.05), respectively. The onset of severe bradycardia and hypotension was significantly (P less than 0.05) delayed by PNT but not by TP. All rabbits in the placebo group died, while 3 and 8 of the animals given TP and PNT, respectively, survived; survival rate was significantly (P less than 0.05) increased by PNT but not by TP. Phenytoin appears to sustain cardiovascular function during hypoxia better than thiopental does, but phenytoin may not be more effective than thiopental in increasing survival.

Anesthesia, General↗
PubMed1981

Humidity and temperature changes during low flow and closed system anaesthesia.

Water humidity and temperature were measured in the proximal end of the inspiratory limb in anaesthetic circuits used to anaesthetize three groups of adult patietnts using various fresh gas flows (FGF). Humidity increased as FGF's were lowered, with 98% water humidification achieved when FGF's of less than 0.51/min were administered. Temperature at the same site changed about 1-2.5 degrees C in inverse proportion to the volume of FGF. This advantage of closed system and low flow anaesthesia is a further reason for their wide-spread utilization.

Adult↗