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Biomedical subjects

R F Salamonsen

Publications and source records attributed to R F Salamonsen.

13 recordsLinked to original sources
PubMed1992

Effectiveness of nursing involvement in bedside monitoring and control of coagulation status after cardiac surgery.

OBJECTIVE: This study explores: (1) the feasibility of involvement of nursing staff in routine bedside testing of activated clotting time and (2) joint implementation with resident medical staff of a preformulated plan for management of mediastinal bleeding after cardiac surgery. DESIGN: Patients were divided randomly into two groups, an experimental group (n = 108) subjected to ACT testing and management by protocol, and a control group (n = 146) treated by independent medical decisions. RESULTS: Bleeding, volume of blood replaced, abnormal coagulation profiles and reoperations to control bleeding and its consequences were all reduced in the study group. CONCLUSION: We concluded that bedside measurement of activated clotting time by nursing staff, associated with therapy based on a flow diagram, enhanced the overall management of early mediastinal bleeding after cardiac surgery as compared with independent management decisions by resident medical staff. In addition, the method provided a sensitive and reliable means of detecting and correcting rebound heparinization in the early postoperative period.

Blood Transfusion↗
PubMed1991

Initial clinical experience with the Haemopump left ventricular assist device.

The Haemopump is an intra-arterial, axial flow, temporary left ventricular assist device. The intra-cardiac pump assembly is connected by a flexible drive shaft to a high speed motor and a drive console. The pump is placed in the left ventricle via the femoral artery, iliac artery or abdominal aorta. Blood is withdrawn from the left ventricle and pumped in a continuous, non-pulsatile fashion into the descending thoracic aorta. We report the use of the Haemopump to provide circulatory assistance in 2 patients with severe graft dysfunction following cardiac transplantation. Both patients were successfully weaned from the Haemopump after 6 and 3 days of support. The first patient subsequently died of overwhelming fungal sepsis and the other remains well 3 months after transplantation with normal left ventricular function. The Haemopump is an effective temporary cardiac assist device for application in severe left ventricular failure.

Equipment Design↗
PubMed1986

Adaptation of the quadrupole mass spectrometer to multipatient anaesthesia gas monitoring.

A series of modifications designed to increase the suitability of the quadrupole mass spectrometer for multipatient gas monitoring in the operating suite are presented and evaluated. The adaptations include a pressure-stabilised long capillary inlet system and computer control of the quadrupole filter together with tuning, calibration and subsequent multitheatre analysis and display of clinical information. A pilot study of three months clinical monitoring provided documentation of contributions towards the safety and effectiveness of anaesthesia. These included indication of equipment malfunction, and fluctuations in gas exchange associated with inappropriate ventilation, haemodynamic instability and variations in body temperature. Limited accuracy for carbon dioxide and a low signal-to-noise ratio together with rapid ageing of electron multipliers were identified as problems still only partially solved.

Anesthesia, Inhalation↗
PubMed1985

Inhalation of carbon dioxide mixtures for sensorineural deafness. Evaluation of a rebreathing method.

A laboratory study in 11 healthy subjects was conducted to evaluate the performance of a rebreathing device as a means of raising the effective carbon dioxide level in the inspiratory mixture. In all subjects, there was a sustained rise in end-tidal carbon dioxide levels and a transient rise in end-tidal nitrogen tensions associated with an equivalent fall in end-tidal oxygen levels. Although the rise in end-tidal carbon dioxide tensions was variable, the mean elevation for the 11 subjects (from 36 to 43 mm Hg) was not equivalent to elevations reported to follow inhalation of 5% carbon dioxide mixtures. Nevertheless, the volume of the device was sufficient to cause a marked depression of the end-tidal oxygen level (to 67 mm Hg) in one subject. Despite the simplicity and cost-effectiveness of the rebreathing method, it cannot be recommended in the treatment of sudden or fluctuant sensorineural deafness.

Carbon Dioxide↗
PubMed1978

Simultaneous trace analysis of nitrous oxide and halothane in air.

A gas chromatographic method for the simultaneous analysis of halothane and nitrous oxide in operating theatre atmospheres has been developed and evaluated. The flame ionization detector is suitable for the quantitative analysis of halothane in concentrations approaching one part per million. The frequency-modulated electron capture detector is highly sensitive to nitrous oxide but we have found it to be non-linear over the range 25--1000 p.p.m. The overall reproducibility of the gas chromatographic method based on the dynamic technique of standard preparation is approximately 4%. Effective exposure of personnel to pollutant anaesthetics is assessed by the analysis of end-expired gas.

Air Pollutants, Occupational↗
PubMed1978

A vaporizing system for programmed anaesthesia.

A vaporizing system for closed circuit "programmed" anaesthesia is described. Despite its location within the circuit, the vaporizer controls directly the input of volatile anaesthetic agents irrespective of fluctuations in ventilation of the anaesthetized subject. It is interfaced easily with electronic controllers and has an accuracy approaching 1.0% under laboratory conditions. During experimental anaesthesia, it maintained stable end-tidial concentrations of halothane at 1.2 MAC (the intended value) despite wide variations in ventilation.

Anesthesia, Inhalation↗
PubMed1977

Effect of polarity on the response of the flame ionization detector to halothane.

Prepared standards of halothane in oxygen were analysed using a Pye Series 104 gas chromatograph equipped with a heated head flame ionization detector and gas sampling valve. The adoption of a positive jet voltage expanded the linear dynamic range of the detector to cover the 0.5-9.0% by volume range, provided that a small (0.5-ml) sample loop was used.

Chromatography, Gas↗
PubMed1976

An approach to programmed anaesthesia.

This approach to programmed anaesthesia uses a pharmakokinetic model to predict the rate at which halothane must be administered to achieve and maintain a preselected tension within the brain. 'In-course' corrections are also applied to this predictive regime on the basis of variations in the respired minute volume which is taken as an indicator of the depth of anaesthesia. Experimental data on the accuracy of the model and the performance of the corrective control unit are presented.

Anesthesia↗
PubMed1975

A method for the gas chromatographic analysis of inhalation anaesthetics in whole blood by direct injection into a simple precolumn device.

A simple heated precolumn device constructed from standard gas chromatographic components is described and evaluated. The device permits the analysis of concentrations of anaesthetic agents by direct injection of whole blood containing a suitable internal standard. A method is described for the analysis of halothane, chloroform, trichloroethylene, and methoxyflurane. The procedure is rapid and of acceptable accuracy.

Anesthetics↗
PubMed1975

Isolation, characterization and quantitation of chloral hydrate as a transient metabolite of trichloroethylene in man using electron capture gas chromatography and mass fragmentography.

A method for the quantitative determination of plasma concentrations of chloral hydrate by electron capture gas chromatography is described. Characterization by multiple ion monitoring confirms, for the first time, that chloral hydrate exists as a transient metabolite of trichloroethylene in man.

Anesthesia↗
PubMed1970

Hyperventilation.

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Arrhythmias, Cardiac↗