Pulmonary artery catheter occlusion.
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Biomedical subjects
Publications and source records attributed to R H Marsh.
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The rate of paracetamol absorption following oral administration has been used as a model of drug absorption and as an indirect estimate of the rate of gastric emptying before and after elective or emergency surgery in 13 adult patients. The rates of paracetamol absorption before and after surgery were not significantly different and compared well with results obtained previously in normal volunteers. This suggests that preoperative anxiety and pain did not delay gastric emptying in this group of patients.
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A case of general anaesthesia for removal of carcinoid metastases is presented. Evidence of serotonin hypersecretion was shown by raised levels of 5-hydroxyindoleacetic acid, hypertension and tachycardia. The rarity of osteoblastic carcinoid metastases is discussed.
The rate at which paralysis from pancuronium could be reversed by neostigmine was monitored in two groups of patients, one elderly and the other young adults. Some patients were found to have prolonged recovery times, and this slow reversal occurred more frequently in the older group of patients. Possible reasons for this are discussed.
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We have studied the responses of human arterial chemoreceptors to various patterns of quick change of stimulation. (i) Transient abolition of hypercapnia lowers VE after 2 breaths (chemoreceptor latency) only if PAO2 is low, therefore hypoxia is necessary for an arterial chemoreceptor response to CO2. (ii) Alternate breaths of euoxia and hypoxia, and of eucapnia and hypercapnia, separately and combined, have no special effect on mean V. However, oscillating CO2 commonly causes breath-by-breath alternation of V, but only if hypoxia is present; oscillating only the low O2 seldom causes oscillation of V. Concluded (a) that chemoreceptor responses to delta-CO2 are quicker than to delta-O2; (b) that, above CO2 threshold, response to rising CO2 is equal and opposite to response to falling CO2. (iii) Three time patterns of PACO2 within single respiratory cycles have been compared in hypoxia. At a single mean arterial PCO2, a small sharp fall of PACO2 early in inspiration depresses mean V, while a smaller sharp fall of PACO2 late in inspiration increases mean V. Concluded that human respiratory system distinguishes between these rather similar patterns presumably through arterial chemoreceptor pathway since the phenomenon depends on the presence of hypoxia. The importance of exact timing is emphasised.
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