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Biomedical subjects

P M Bailey

Publications and source records attributed to P M Bailey.

At least 19 recordsLinked to original sources
PubMed1999

Efficacy and safety of the laryngeal mask airway vs Guedel airway following tracheal extubation.

PURPOSE: To compare the safety and efficacy of the laryngeal mask airway (LMA) with the Guedel airway during the recovery period. METHODS: In a prospective randomised trial in the Post Anesthesia Care Unit (PACU), 52 patients (ASA 1 and 2) were randomised to receive either a laryngeal mask airway (LMA: n = 26) or a Guedel airway (n = 26) during the recovery period after middle ear surgery. Ease of airway maintenance was graded and the presence of coughing was noted. Peripheral arterial oxygen saturation (SpO2) was measured continuously by pulse oximetry in the PACU. Readings were taken on arrival (time 0) and for five minutes afterwards. RESULTS: There was no difference in sex, age, weight or incidence of smoking between the two groups. In the LMA group 25 patients required no airway manipulation and only one patient required repositioning of the LMA. In the Guedel group severe difficulty maintaining the airway was experienced in two patients, moderate difficulty in five patients and mild difficulty in 12 patients. Seven patients required no airway manipulation. The LMA group showed higher ease of airway maintenance scores, (P = < 0.0001) and less coughing (P = 0.0496). At time 0 and at one minute the LMA group had higher median SpO2 (97% and 97%) than the Guedel group (95% and 96%), (P = 0.0002 and 0.0362). There was no further difference in SpO2. CONCLUSIONS: The LMA provides easier airway maintenance, less coughing and initially higher median SpO2 when compared with the Guedel airway in the recovery period.

Adult↗
PubMed1995

Comparison of the reinforced laryngeal mask airway and tracheal intubation for nasal surgery.

Airway maintenance and protection during anaesthesia and recovery provided by the reinforced laryngeal mask airway was compared with the sequential use of a tracheal tube followed by the Guedel airway in 66 patients having anaesthesia for nasal surgery. One patient was withdrawn from the laryngeal mask group because the airway was difficult to position. All patients had an oropharyngeal pack inserted and Moffett's solution instilled into the nasal cavities. At the end of surgery the nasal cavities were packed. During operation airway maintenance was good and airway protection was equally effective in both groups. Contamination of the lower airway occurred in only five patients. During recovery from anaesthesia the laryngeal mask and Guedel airway were well tolerated by most patients, but only the mask laryngeal provided an unobstructed airway in all patients. The laryngeal mask protects the larynx from contamination during and after operation until the return of the patient's own protective reflexes.

Adult↗
PubMed1993

Comparison of the reinforced laryngeal mask airway and tracheal intubation for adenotonsillectomy.

One-hundred and four patients were allocated randomly to receive anaesthesia for adenotonsillectomy via either a reinforced laryngeal mask airway or tracheal tube. Airway maintenance and protection were assessed during and after operation. The reinforced laryngeal mask did not interfere with surgical access; it resisted compression and protected the lower airway from contamination with blood. Four patients were withdrawn from the laryngeal mask airway group: two because difficulty with placement, and two because the laryngeal mask was obstructed distally when the Boyle Davis gag was opened fully. In children, recovery was less eventful in the laryngeal mask airway group, with less airway obstruction (P < 0.001) and better airway acceptance (P < 0.05). The reinforced laryngeal mask airway provided a clear, secure airway until recovery of protective reflexes.

Adenoidectomy↗
PubMed1990

Effect of propranolol on nitrogen and energy metabolism in sepsis.

Pharmacologic therapy designed to block adrenergic activity or alter hormonal milieu may modulate energy and protein metabolism in stress. The metabolic effects of propranolol (beta adrenergic receptor blocker) in sepsis was investigated in 22 well-nourished rats that underwent superior vena caval cannulation, cecal ligation, and puncture. Animals were randomly assigned to receive either a continuous infusion of 0.7 mg/day of propranolol combined with parenteral nutrition (n = 11) or parenteral nutrition alone (n = 11). Both groups received isocaloric, isonitrogenous, isovolemic, parenteral nutrition post-operatively for 24 hr. Nitrogen balance was better for the propranolol group than for the control group (+743 +/- 84 mg/kg/day versus +300 +/- 63 mg/kg/day, respectively, P less than 0.05). A significant difference between the pharmacologic therapy and control groups was noted for urinary 3-methylhistidine excretion versus control (0.99 +/- 0.08 micrograms/kg/day versus 7.5 +/- 0.37 micrograms/kg/day, respectively, P less than 0.01). Measured energy expenditure was similar for both pharmacologic therapy and control groups (149 +/- 20 kcal/kg/day versus 134 +/- 11 kcal/kg/day, respectively, P = N.S.). No statistically significant difference was demonstrated for 24-hr survival between propranolol and control groups (73 and 64%, respectively). Continuous, low-dose propranolol promotes nitrogen retention and decreases 3-methylhistidine excretion without altering energy expenditure in parenterally fed septic rats.

Animals↗
PubMed1986

Alterations in exogenous substrate metabolism in sepsis.

Metabolic rates and substrate utilization patterns were evaluated by using a rate cecal ligation and perforation model. Animals that survived for 48 hours after the induction of sepsis were hypermetabolic and responded appropriately to varying exogenous substrate infusions. In contrast, animals that did not survive to 48 hours were premorbidly hypometabolic and failed to adjust their oxidation patterns in response to the exogenous substrate supply. These findings suggest the benefit of individually tailoring the supply of exogenous nutrients in critically ill patients with sepsis and of frequent reassessment of metabolic parameters, including the resting energy expenditure and respiratory quotient.

Animals↗