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Biomedical subjects

R L Berger

Publications and source records attributed to R L Berger.

At least 109 records · Page 6Linked to original sources
PubMed1976

Autologous blood transfusion during cardiopulmonary bypass.

Immediately prior to cardiopulmonary bypass, two units of blood were removed from each of 25 patients undergoing open-heart surgery, and the autologous blood was reinfused after cessation of support with the pump oxygenator. Pertinent data on blood balance and hematologic measurements were compared to a matched group of control subjects. There were no significant differences in the amount of operative or postoperative bleeding, the requirements for homologous blood and blood products, or the amount of protamine needed for neutralization of heparin.

Adult↗
PubMed1975

Clinical applications of thermodilution cardiac output determinations.

The pulmonary arterial catheter was shown to be safe and easily positioned in a group of 200 patients. Thermodilution cardiac output measurement was shown to be simple, rapid, and safe. The technic was as accurate as the simultaneously measured indocyanine green cardiac output, and more reproducible, particularly at high and low flows. The construction of myocardial performance curves during a fluid challenge is described. The value of these curves is guiding fluid, drug, and respirator therapy is illustrated by case presentations.

Aged↗
PubMed1975

Intracavitary cardiac extension of hepatoma.

Acute right atrial obstruction in a 62-year-old man was demonstrated angiographically to be due to a tumor, which was later proved to be metastatic hepatoma. Resection of the tumor resulted in total symptomatic relief.

Bile↗
PubMed1975

Nutrient myocardial blood flow in experimental myocardial ischemia. Effects of intraaortic balloon counterpulsation and coronary reperfusion.

This experimental study was designed to evaluate the effect of intraaortic balloon pumping (IABP) upon nutrient myocardial blood flow (NMBF) following acute myocardial ischemia in dogs, but also to determine whether IABP improves NMBF following revascularization. Localized myocardial ischemia was produced by ligation of one or two small branches of the circumflex coronary artery combined with a three hour snare occlusion of the left anterior descending coronary artery distal to the first septal branch. NMBF was measured by NaI131 washout at three points corresponding to the peripheral, intermediate, and central zones of the infarct. Occlusion of the coronary arteries reduced NMBF. Release of occlusion after three hours, or the equivalent of coronary artery revascularization, increased NMBF but did not restore it to control levels. The increase in flow was more marked in the peripheral zones of ischemia. IABP increased NMBF significantly both during and after release of occlusion. The effect was sustained after cessation of IABP only when the latter was maintained during the period of reperfusion. The results indicate that NMBF, defined by washout of a locally injected tracer, was improved by both IABP and reperfusion. The beneficial effect was maximal when the two techniques were combined.

Animals↗
PubMed1975

Improved myocardial performance following high 2-3 diphosphoglycerate red cell transfusions.

Twenty-two matched coronary bypass surgery (CABS) patients were randomly divided into two groups; 11 patients in the control group received CPD-stored or fresh blood (mean age, 5.5 days) containing 70 percent of normal 2-3 diphosphoglycerate (2-3 DPG) and 11 patients received 2-3 DPG-enriched previously frozen, washed, concentrated red cells (2-3 DPG 150 percent of normal). Coming off cardiopulmonary bypass, when given a volume load, the high 2-3 DPG patients had a significant increase in cardiac index (2.95 L. per minute vs. 2.18 L. per minute, p smaller than 0.001) at similar filling pressures. At this time body oxygen consumption, in vivo P50, red cell 2-3 DPG, and arterial-venous oxygen content difference were all increased, but P minus vo2 was normal. Improved oxygen delivery occurred without decreasing mixed venous oxygen tension. The results suggest that, with volume loading, function in the heart with coronary artery disease is limited in part by available oxygen. By decreasing oxygen affinity for hemoglobin by altering red blood cells biochemically, myocardial performance can be improved safely.

Blood Transfusion↗
PubMed1975

Mitral valve replacement with a turtleneck-disc prosthesis.

A 5 year experience in 100 patients with a turtleneck-cuff (Magovern) disc valve (Harken) is presented. The prosthesis was inserted into the atrioventricular position by a continuous suture technique. The operative mortality rate was 7 per cent and the late mortality rate, 8 per cent. Age, functional classification, multiple valve replacement, pulmonary hypertension, and reoperation did not influence the operative mortality rate. However, the incidence of late death was much higher among patients in Class IV than in Class III and was also greater when more than one valve was replaced. The incidence of combined early and late thromboembolic complications was 7 per cent. Peribasilar leaks or valve dehiscences were not encountered.

Adult↗
PubMed1975

Continuous determination of the oxygen dissociation curve for whole blood.

We report here the development of a new method that allows continuous determination of the oxygen dissociation curve for microsamples (600 mul) of whole blood under conditions of pH, pCO2, methemoglobin concentration, and 2,3-diphosphoglycerate content closely approaching those found in the circulatory system. The method consists of gradually oxygenating a blood sample by adding H2O2 in the presence of catalase (EC 1.11.1.6), to produce the reaction H2O2 leads to H2O + 1/2 O2. Because the total oxygen content of blood can be derived from the known rate of H202 addition and the pO2 is determined in the liquid phase by an oxygen electrode, the two functions (total O2 content) and (% oxygen saturation) vs. pO2 are simple to calculate. pCO2 and pH are controlled by adding base simultaneously with the gradual oxygenation of blood. The method described thus avoids the direct measurement of oxygen saturation of whole blood.

Autoanalysis↗