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Biomedical subjects

R Lapin

Publications and source records attributed to R Lapin.

15 recordsLinked to original sources
PubMed1987

Total hip replacement in Jehovah's Witnesses under spinal anesthesia without transfusion.

Ninety patients who were Jehovah's Witnesses underwent 107 total hip replacements without transfusion; all procedures were performed under spinal anesthesia. Of these 90, 87 had not previously undergone hip replacement surgery. They sustained an average intraoperative blood loss of 300 mL, which was a significant reduction compared with that in controlled groups of patients reported by other authors. Factors other than spinal anesthesia that aided in reducing blood loss were posterior surgical exposure of the hip without capsulectomy or removal of the greater trochanter, hemostasis without electrocauterization, and rapidly performed surgery. There were three operative complications and one death, none of which were related to spinal anesthesia.

Adolescent↗
PubMed1985

The use of an integral tissue expander for primary breast reconstruction.

The authors emphasize the recent advances in breast reconstruction provided by use of the skin expander device. A Silastic percutaneous skin expander developed by the authors and the Dow Corning Corporation has been used by them in breast reconstruction for the past 7 years with satisfactory results. Important design differences in the device suggested by the authors include the use of a reinforced backing which consists of Dacron Silastic sheeting extending beyond the inflatable tear-drop-shaped envelope for approximately 3/8 of an inch, thus adding strength and rigidity to the envelope and the rim, and making it possible for the rim of the expander implant to be sutured in an appropriate orientation.

Adult↗
PubMed1984

Fluorocarbons and the microcirculation.

A short discussion of oxygen transport and delivery by fluorocarbon containing blood substitutes is presented. Those physical properties of the preparations that would tend to cause improvement in oxygenation in areas of damaged or impeded microcirculation are also discussed. A number of studies carried out at the Erasmus University, Rotterdam have demonstrated certain important characteristics of fluorocarbons with respect to tissue oxygenation. In the first instance, it has been demonstrated that extracorporal perfusion with Fluosol-DA 20% can maintain oxygenation and viability of isolated extremities for periods of up to 48 hours. Secondly it has been shown that the preparation can indeed penetrate compromised capillary beds, its low viscosity enabling it to travel along collateral perfusion pathways and to provide oxygenation of areas of ischaemic hypoxia. The low particle of the emulsion may, in combination with the low viscosity of the product, contribute to the re-establishment of perfusion in areas of circulatory arrest. The clinical implications of the above findings are numerous and wide spread. The importance of Fluosol in maintaining and improving micro-circulatory oxygenation should not be underestimated.

Animals↗
PubMed1982

The preoperative treatment of severely anemic patients with a perfluorochemical oxygen-transport fluid, Fluosol-DA.

We gave a perfluorochemical oxygen-transport fluid and plasma expander, Fluosol-DA, to seven severely anemic patients before surgery to determine its effectiveness in supplementing oxygen transport. The dose of Fluosol in the five patients completing the study was 20 ml per kilogram of body weight. When the patients breathed low levels of supplemental oxygen (mean partial pressure of arterial oxygen +/- S.D., 101 +/- 25 torr), the perfluorochemical carried a small amount of oxygen, but when they received pure oxygen (arterial oxygen pressure, 361 +/- 65 torr) it carried approximately 0.8 per cent of oxygen (by volume). This increase accounted for 7 +/- 3 per cent of the patients' arterial oxygen content and 24 +/- 7 per cent of their oxygen consumption. The cardiac index and left ventricular stroke-work index decreased, whereas the oxygen delivery increased, although these changes were not statistically significant. Significant changes included a 22 per cent increase in oxygen consumption, a 59 per cent increase in mixed venous oxygen tension, and an increase in mixed venous hemoglobin saturation to 90 +/- 6 per cent. We conclude that at ambient oxygen tensions fluosol acts primarily as a volume expander, whereas at higher tensions (greater than 300 torr) it contributes substantially to the oxygen-delivery system.

Adult↗
PubMed1980

Hemodynamic and oxygen transport effects of a perfluorochemical blood substitute, fluosol-DA (20%).

Cardiorespiratory measurements were made in a severely anemic patient (hemoglobin concentration of 3.5 g/dl) who was preoperatively given the perfluorochemical blood substitute (Fluosol-DA, 20%). Hemodynamic and oxygen transport variables were monitored, including arterial and mixed venous oxygen content (CaO2 and CVO2) before, during, and after infusion of 1000 ml of Fluosol as well as throughout the intraoperative period. Blood samples revealed a maximum of 2.7% of the perfluorochemical. The CaO2 increased 37% above the CaO2 calculated without Fluosol; i.e., 5.8 +/- 0.1 to 8.1 +/- 0.6 ml/dl, p < 0.01. The cardiac index (CI) decreased from 7.2 +/- 0.2 to 5.9 +/- 0.8 L/min . M2 and the left ventricular stroke work decreased from 67 +/- 6 to 58 +/- 13 g . M/M2, while the oxygen delivery increased, and the total body oxygen consumption (VO2) remained essentially unchanged.l Intraoperatively, 27% of the O2 delivery and 51% of the VO2 were transported by Fluosol. No adverse effects of the fluosol were noted.

Adult↗