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Biomedical subjects

R H Gunawardana

Publications and source records attributed to R H Gunawardana.

11 recordsLinked to original sources
PubMed1997

Intensive care utilisation following attempted suicide through self-poisoning.

OBJECTIVE: To evaluate intensive care utilisation following attempted suicide through self-poisoning. DESIGN: Retrospective analysis of clinical records. SETTING: Intensive Care Unit, Teaching Hospital, Peradeniya. PATIENTS: All patients admitted over the period 1991-1995. RESULTS: 292 patients were admitted after a suicide attempt by ingestion of a poisonous substance or drug in overdose. 52% were mechanically ventilated. The mean stay was 6 days. Daily intensive care cost averaged Rs. 8000 for a ventilated patient. Fifty three patients died. The 292 patients constituted 10.2% of the total admissions to the unit. CONCLUSIONS: Suicide as a medical emergency imposes pressure on the limited resources and facilities available in intensive care units. Concrete preventive measures are mandatory to prevent loss of life and health care resources.

Adolescent↗
PubMed1996

Difficult laryngoscopy in cleft lip and palate surgery.

We studied prospectively 800 paediatric patients undergoing repair of cleft lip and palate to determine the predictors of difficult laryngoscopy. The incidence of difficult laryngoscopy (Cormack and Lehane grade III and IV) was 2.95% in patients with unilateral cleft lip, 45.76% in bilateral cleft lip and 34.61% in patients with retrognathia. Tracheal intubation was successful in 99% of patients in whom laryngoscopy was difficult. There was a significant association between age and laryngoscopic view (P < 0.01).

Age Factors↗
PubMed1992

Experience with tracheostomy in medical intensive care patients.

Thirty-four intensive care patients who received elective tracheostomies were studied to determine the incidence and nature of complications associated with tracheostomies. Indication for tracheostomy was long-term ventilation. Adverse consequences occurred in 47% of the patients. The most frequent problem was pneumonia. There were no intraoperative complications. Two deaths occurred due to delayed haemorrhage. Some complications of tracheostomy were influenced by the preceding period of endotracheal intubation. In patients requiring prolonged mechanical ventilation, tracheostomy carries a considerable risk. Optimal airway care only will reduce the incidence of complications.

Adolescent↗
PubMed1992

Intensive care experience in Guillain-Barre syndrome.

In a retrospective study of 34 patients with acute Guillain-Barre syndrome admitted to an intensive care unit (ICU) during a six year period from January 1984 to December 1989, for bulbar paresis or impending respiratory failure, 4 required endotracheal intubation to protect the airway, and 27 required mechanical ventilation. A high incidence of respiratory complications was noted. Two patients died of cardiovascular instability. Close monitoring of respiratory and cardiovascular status is essential to ensure survival.

Adolescent↗
PubMed1991

Rate-pressure product and arterial oxygen saturation during electroconvulsive therapy.

The arterial oxygen saturation, heart rate and systolic blood pressure were measured in 100 patients undergoing electroconvulsive therapy under general anaesthesia. All patients were anaesthetised using thiopentone and suxamethonium. In spite of ventilation with oxygen during the procedure a marked degree of hypoxaemia occurred during the convulsion in 80% of the patients. This was associated with a highly significant rise in heart rate and blood pressure (p less than 0.001). During electroconvulsive therapy there is an imbalance between myocardial oxygen supply and consumption.

Adolescent↗
PubMedDate not supplied

Anesthesia and surgery in pediatric patients with low hemoglobin values.

A low preoperative hemoglobin (Hb) concentration creates a dilemma for the anesthetist to proceed or not. The authors prospectively studied the perioperative morbidity of 200 healthy infants and children (age range 3 mon-5 years) with preoperative Hb values > or = 7 g/dl, undergoing cleft lip and palate surgery under general anesthesia. The patients were later categorized according to preoperative Hb level group A: Hb 7-10 g/dl and group B: Hb > 10 g/dl and the results were compared. One or more episodes of hypoxemia (SpO2 < 91%) were recorded in 8 patients in group A and 6 in group B during airway management. All patients had stable cardiovascular parameters except for transient bradycardia during desaturations. Recovery was similar and rapid. There were no differences in perioperative morbidity between the two groups. However, the safety of general anesthesia in infants and children with difficult airways is questionable when the oxygen reserve is reduced in anemia.

Anemia↗