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Biomedical subjects

R D Latimer

Publications and source records attributed to R D Latimer.

18 recordsLinked to original sources
PubMed1990

Management of donors for heart and heart-lung transplantation.

The quality of donor organs will determine the quality of life for the recipient and the importance of optimal management of the multi-organ donor is that the organs may benefit up to five, critically ill, patients. The basic principle is to maintain sufficient preload to minimise the need for inotropic support and it is recommended that all multiple organ donors should have central venous and arterial pressure monitoring in addition to adequate venous access. The importance of the choice of fluid for volume expansion and the management of the hormonal disturbances which follow brain death are considered.

Brain Death↗
PubMed1990

Management of low cardiac output syndrome after cardiac surgery using enoximone.

This case report describes the use of enoximone, a potent phosphodiesterase F-IV inhibitor with inotropic and vasodilator actions, to treat low output syndrome after cardiac surgery. The reduced cardiac output was unresponsive to a combination of inotropic drugs and intra-aortic balloon counterpulsation was contraindicated. Cardiac output was increased dramatically by enoximone, but systemic vascular resistance and perfusion pressure remained low until the addition of metaraminol.

Aged↗
PubMed1990

Effects of intravenous enoximone following coronary artery bypass surgery.

The effects of intravenous enoximone were investigated in patients with reduced left ventricular ejection fraction following coronary artery bypass graft surgery. Pulmonary capillary wedge pressure was maintained at its original level during therapy. Results showed an improvement in cardiac index of approximately 35% and a reduction of systemic vascular resistance of approximately 30% in 10 out of 16 patients. In an attempt to explain the failure of 6 patients to respond to enoximone therapy, preliminary studies revealed that a repeat dose of enoximone may elicit a response. It is further suggested that postsurgical trauma may change the behaviour of the heart in response to this agent, perhaps due to a reduction in high-energy phosphate levels.

Cardiotonic Agents↗
PubMed1988

Dopexamine hydrochloride, a beta 2 adrenergic and dopaminergic agonist; haemodynamic effects following cardiac surgery.

Twelve patients recovering from open heart surgery received an intravenous infusion of dopexamine hydrochloride, a novel beta 2 adrenergic and dopamine receptor agonist. The mean cardiac index increased from 2.58 to a maximum of 3.64 1 min-1 m-2 (P less than 0.001) and the systemic vascular resistance (SVR) decreased from 1527 to 1116 dyne s cm-5 (P less than 0.001) at a dose of 3 micrograms kg-1 min-1. Heart rate increased with dose from 85 beats min-1 to a maximum of 119 beats min-1 (P less than 0.001). There was no significant change in the pulmonary vascular resistance (PVR) with treatment in the group as a whole. However, PVR decreased (P less than 0.05) in patients who had aortic-valve replacement (AVR) only, whereas in patients who had mitral-valve replacement (MVR) the PVR increased (P less than 0.05). We conclude that dopexamine hydrochloride was well tolerated in patients following cardiac surgery. It produced a significant increase in cardiac output with evidence of afterload reduction and, although the increase in heart rate may limit its use in some patients, dopexamine hydrochloride is potentially of value in the treatment of low cardiac output state following cardiac surgery.

Adrenergic beta-Agonists↗
PubMed1986

A comparison of five heat and moisture exchangers.

Five heat and moisture exchangers were investigated to compare their efficiency of humidification, their ability to filter bacterial spores and their various physical properties. The results are presented and the various mechanisms of heat and moisture exchange are reviewed. The Pall Ultipor BB50, because of its hydrophobic properties, has a slightly different action from heat and moisture exchangers already in use, The place of the Pall Ultipor BB50 in clinical practice is discussed.

Filtration↗
PubMed1979

Carbon dioxide equilibration in canine lungs during rebreathing and acute alkalosis.

1. The left lower lobe of the lungs of six anaesthetized dogs were isolated by the introduction of a bronchial cannula at thoracotomy. Catheters were introduced into the main pulmonary artery and a vein draining the isolated lobe. 2. Blood-gas pressures and pH were measured across the isolated lobe and compared with gas pressures in alveolar samples from the lobe. 3. When the isolated lobe was allowed to reach gaseous equilibrium with pulmonary arterial blood for 30 min, there was no significant difference between alveolar and pulmonary venous PCO2. Mean values of whole-blood base excess were similar in pulmonary arterial and pulmonary venous blood. 4. After injection of 20 ml of 8.4% sodium bicarbonate solution into a peripheral vein, PCO2, pH and plasma bicarbonate concentrations rose in the mixed venous blood. There was no change of whole-blood base excess across the lung, indicating that HCO3-, as distinct from dissolved CO2, did not enter lung tissue in measurable amounts. 5. No systematic alveolar-pulmonary venous PCO2 differences were demonstrated in this preparation other than those explicable by maldistribution of lobar blood flow.

Acid-Base Equilibrium↗
PubMed1976

A safety block for scavenging systems.

A safety block is described which protects the patient from expiratory obstruction when using scavenging systems, and provides the anaesthetist with a visual and auditory check on the functioning of the system.

Anesthesia, Inhalation↗
PubMed1975

Arterial oxygen tensions during the induction of ether and air anaesthesia with spontaneous respiration.

Arterial oxygen tensions were measured during the induction of ether and air anaesthesia with the EMO Inhaler and spontaneous respiration. Severe degrees of anoxia were demonstrated; these were often associated with normal or above normal minute volumes. The danger of anoxia can be alleviated either by supplying oxygen or by the use of relaxants and positive pressure ventilation or both. A choice of priorities has often to be made by those in authority in developing countries where resources of material and manpower are limited and logistic support erratic. Every effort should be made to encourage a supply of oxygen in such circumstances. The training of anaesthetic staff is of paramount importance and it is a great pity that the equivocal attitude of the professions, both medical and nursing, in Britain towards the training of nurses and paramedical personnel in anaesthesia does little to encourage such training in developing countries.

Adolescent↗