Biomedical subjects

R B Indech

Publications and source records attributed to R B Indech.

6 recordsLinked to original sources

PubMed1983

Predicting success in limb salvage.

While success in revascularization procedures for severe arterial insufficiency--limb salvage--demands a technically correct operation, the adequacy of the outflow system is equally important. An outflow index (phi), the percentage drop in femoral artery pressure following an intra-arterial injection of papaverine, was developed. The predictive value of this index was demonstrated in a prospective study of 44 limbs in which an aortoiliac procedure with profundoplasty was done for multilevel disease. In the operations considered completely successful (n = 27), the mean value of phi was 37 +/- 8 per cent; this was significantly greater (P less than 0.001) than the mean value of 16 +/- 9 per cent found for those operations (n = 17) deemed to have been unsuccessful on the basis of rigorous postoperative criteria. This finding not only proves the efficacy of the index, but emphasizes the importance of an outflow system with the ability to accept more blood.

Arterial Occlusive Diseases↗

PubMed1980

Hyperemic response for accurate diagnosis of arterial insufficiency.

Monitoring of calf (or ankle) blood pressure during reactive hyperemia after thigh arterial occlusion allows differentiation of normal from abnormal responses and of distal (femoropopliteal [FP] system) disease from proximal (aortoiliac [AI] disease. The hyperemic response of 106 lower extremities representing three disease states--FP (N = 19), AI (N = 15), and combined (AI plus FP)(N = 16)--were compared with each other and with 20 normal subjects and 36 asymptomatic diabetics. Not only were the three disease states readily distinguished from the very similar normal subjects and asymptomatic diabetics, but there was a highly significant difference between FP disease and AI disease up to 150 s. This is a simple, inexpensive, and reliable test that can be used at the bedside to determine levels of severe disease, especially in the claudicator, who may not have a critical stenosis under resting conditions.

Adult↗

PubMed1980

Calibrated impedance plethysmograph.

The accuracy of quantitative pulse-volume measurement with a calibrated electrical impedance plethysmograph was determined on a laboratory limb-segment model. Changes in electrical impedance detected via a tetraprolar electode configuration were related to pulse-volume changes by the parallel-impedance model described by Nyboer et al. (The Impedance Plethysmograph: An Electrical Volume Recorder. Natl. Res. Council, Comm. Aviation Med. 149, 1943). The instrument employed in this study calculated pulse volume assuming two standard conditions: distance between voltage electrodes, l, is 15 cm, and resistivitiy of blood, rho b, is 150 omega x cm. The effects of varying tissue and blood resistivity, pulse frequency, and electrode distance were investigated. Measurements under three ionically distinct conditions gave an overall accuracy of 96.6% with correlation coefficients of 0.99 for each condition. Measurement accuracy was maintained with a pulse-frequency variation in the range of 15-150 pulses/min and with application of correction factors for electrode distance and blood resistivity other than the standard values.

Electric Conductivity↗

PubMed1980

Which deep breathing device should the postoperative patient use?

A study was undertaken to compare the use of three types of deep-breathing devices in patients undergoing upper-abdominal operations. Seventy-nine patients were divided into three groups, each receiving preoperative bedside testing of pulmonary function and instruction in the use of one of three randomly assigned deep-breathing devices thought to be representative of those currently available (Triflo II, Bartlett-Edwards Incentive Spirometer, or Spirocare). Repeat testing and instruction were provided daily during each of the first five postoperative days. There were few statistically significant differences in pulmonary function, vital signs and white blood cell count, and no difference in length of postoperative stay. No device was uniformly acceptable to patients, and none was used as frequently as recommended. When left at the bedside and only one daily reinforcement of instructions, the three devices showed no clinically important differences.

Adult↗

PubMedDate not supplied

The calibrated impendance plethysmograph: laboratory and clinical studies.

By careful experimental studies a calibrated impedance plethysmograph has been shown to be highly accurate (standard error = 3.8%). Its ability to measure the rate of pulsatile volume change has been extremely useful in the diagnosis of arterial insufficiency of the lower extremities. By helping in the objective definition and documentation of arterial perfusion, this instrument can greatly improve our selectivity of patients for angiography and subsequent revascularization.

Arterial Occlusive Diseases↗

PubMedDate not supplied

Noninvasive assessment of vascular disease in the lower limbs of diabetics.

One hundred and fifty seven limbs of diabetic patients free of any symptoms or signs of arterial insufficiency, were studied using noninvasive techniques to determine vascular distensibility in the lower extremities. A relationship between these values and the classification of the diabetic in terms of age, duration of diabetes and control of diabetes was sought. The results revealed a distinct inverse relationship between vascular distensibility and age of the diabetic subject, analogous to the trend found in a normal, non-diabetic group of volunteers. Furthermore, comparison of distensibility in normal and diabetic subjects within the same age group showed lowered values among the diabetics. However, the study revealed little or no apparent relationship to either duration or control of diabetes.

Adult↗