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Biomedical subjects

P J Strube

Publications and source records attributed to P J Strube.

5 recordsLinked to original sources

Serum fluoride levels in morbidly obese patients: enflurane compared with isoflurane anaesthesia.

Obese patients are known to metabolise anaesthetic agents more than patients of normal weight. The extent of this was investigated by the measurement of serum fluoride concentrations in 10 morbidly obese patients undergoing gastroplasty. Five were allocated to receive enflurane and five to receive isoflurane supplemented anaesthesia. The mean peak serum fluoride concentrations after enflurane anaesthesia were greater (22.7 mumol/litre, SE 2.9) than after isoflurane anaesthesia (6.5 mumol/litre, SE 0.6). The mechanisms and implications of this finding are discussed.

Adult

Ketamine by continuous infusion in status asthmaticus.

A 13-year-old girl was admitted to the intensive care unit with status asthmaticus. Conventional bronchodilator therapy failed to relieve her bronchospasm. In order to try and avoid artificial ventilation, a continuous intravenous infusion of ketamine was used with success. The total dose rate was 40 micrograms/kg minute for a period of 8 hours; this was given at a decreasing rate. She regained consciousness 30 minutes after the end of the infusion and became well orientated after one hour. Ketamine is a useful drug in the intensive treatment of status asthmaticus and should be tried before a decision is taken to start mechanical ventilation.

Adolescent

Thyroid storm during beta blockade.

A thyrotoxic patient who had received beta-adrenoceptor blockers pre-operatively suffered an episode of severe heart failure immediately following thyroidectomy and required artificial ventilation of the lungs for six hours. The possible causes are discussed and the likelihood of thyroid storm unmitigated by beta adrenergic blockade suggested.

Humans