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Biomedical subjects

S Jakobson

Publications and source records attributed to S Jakobson.

25 records · Page 2Linked to original sources
PubMed1980

Effects of intercostal nerve blocks on pulmonary mechanics in healthy men.

Bilateral block of the 5th through the 11th intercostal nerves was induced in 16 healthy men. In eight of the men, bupivacaine 0.25% was used and in the other eight, etidocaine 0.5%. Before and after induction of the block flow/volume curves, maximal airway pressures, and pulmonary compliance, were recorded, and helium spirometry and multiple and single breath nitrogen wash-outs were performed. There were no differences between the results in the two groups, and the material was therefore pooled. Total lung capacity was decreased by 4%. There was no increase in residual volume, though the maximal expiratory airway pressure decreased by 7%. There was an 8% decrease in functional residual capacity. Pulmonary recoil appeared to be unchanged, as also did the effort-independent peak expiratory flow rates. According to the pulmonary nitrogen clearance index, the overall pulmonary time constant did not alter, while the slope of the alveolar plateau in the single breath nitrogen wash-out test increased by 9%. The significance of the latter finding is unclear, but it is concluded that the nerve block had no obvious effects on pulmonary mechanics, the changes observed rather being attributable to effects on the chest wall.

Adult↗
PubMed1977

Effects of intercostal nerve blocks (bupivacaine 0.25% and etidocaine 0.5%) on chest wall mechanics in healthy men.

Bilateral blockade of the 5th to 11th intercostal nerves, inclusive, was produced in 14 healthy subjects. In seven, bupivacaine 0.25% was used, and in the other seven, etidocaine 0.5%. The latter has been found to have a stronger motor-blocking action than the former. Before and after the blockade, the vital capacity (VC), peak expiratory flow rate (PEF), tidal volumes, respiratory variations in rib cage and abdominal circumferences and in oesophageal and intragastric pressures were recorded. By transthoracic electrical impedance pneumography, measures indicating changes in the functional residual capacity (FRC) were obtained. Although it was considered that changes in the parameters investigated mainly demonstrated changes in motor function, no differences were found between the drugs. With this form of blockade they seem to have equivalent effects in this respect. Thus, VC decreased by an average of 7% and PEF by 6%. Signs of a reduction of FRC after the blockade were also observed. The blockade had no effect on the partitioning of costal and abdominal breathing at rest. Analysis of the relations between the fractions of costal and abdominal breathing and the corresponding variations in intragastric pressure gave support to the view that in normal individuals both intercostal and abdominal muscles remain passive during respiration at rest. This is thus achieved by the diaphragm alone.

Acetanilides↗
PubMed1976

The concordance of respiratory fluctuations in oesophageal and central venous pressures.

Respiratory fluctuations in oesophageal and central venous pressures were recorded in 13 healthy subjects and compared with respect to phase and amplitude concordance. An average divergence in phase of nearly 180 degrees was obtained, with large inter-individual variations. Disregarding phase the amplitude of the respiratory central venous pressure was found to be, on the average, a good 1/4 of that of the oesophageal pressure in the supine posture, and a good 2/3 while the subjects were sitting. These figures also varied considerably. It is suggested that the findings might be referred to competition between a central venous pressure raising effect of inspiration enhanced venous return, and a central venous pressure depressing effect of the inspiratory fall in intrathoracic pressure. The partitioning of costal and abdomino-diaphragmatic breathing is considered of great significance to the outcome of this competition. It is concluded that the oesophageal balloon catheter technique for estimation of transpulmonary pressure cannot simply be replaced by the central venous catheter technique in healthy subjects. Its application in patients with certain pulmonary disorders, however, might be more successful.

Adult↗
PubMed1975

The use of 125I-labelled fibrinogen for determination of fibrin trapping in the lungs in patients developing the microembolism syndrome.

The microembolism syndrome occurred in four patients out of a series of 15 patients with multiple injuries who were considered to run a risk of developing this syndrome. These four patients showed signs of fibrin trapping in the lungs, as demonstrated by the use of 125I-labelled fibrinogen and external detection over the lungs. It is, therefore, considered that this method can be used for diagnosing the microembolism syndrome. The fibrin trapping occurred at the onset of the progressive respiratory insufficiency. The time relation between the uptake of fibrin and the onset of the progressive respiratory insufficiency supports the theory of a causal connection between fibrin and pulmonary damage. Measurements of different coagulation and fibrinolysis factors in the blood were not able to discriminate between patients who developed the microembolism syndrome and those who did not.

Adolescent↗