Biomedical subjects

S Leavey

Publications and source records attributed to S Leavey.

3 recordsLinked to original sources

PubMed1994

Post-myocardial infarction ventricular septal defect: an angiographic study.

Clinical and angiographic findings are reported in a consecutive series of nineteen patients with post infarction ventricular septal defect (PIVSD). In all patients PIVSD complicated a first myocardial infarct and none had a history of angina pectoris prior to presentation. In over 50% of the patients PIVSD occurred within three days of infarction. The mean patient age was 65 years. Single vessel disease was noted in 63% of the patients. The mean left ventricular ejection fraction was 27%. Contrast left ventriculography localised the defect in all patients. Although a comprehensive cardiac ultrasound examination will generally confirm the diagnosis of PIVSD, preoperative coronary angiography is essential for the selection of those patients most likely to benefit from concomitant coronary artery bypass grafting at the time of surgical repair of the interventricular septum.

Aged↗

PubMed1993

How much heparin? A simple in vitro test.

A simple in vitro test to calculate the dose of heparin required to achieve optimal in vivo anticoagulation during surgery has been assessed in 15 patients who subsequently underwent vascular surgery. Heparin was added to four aliquots of patients blood in vitro to give five solutions with heparin concentrations ranging from 0-0.8 units/ml of plasma. The activated partial thromboblastic times (APTT) of each of these samples was then measured and the natural log (ln) of the APTT calculated. The natural log of the APTT in vitro was then plotted against the in vitro heparin concentration. From this linear correlation the concentration of heparin required to achieve an APTT 2.5 times the normal in vitro (Hc) for the 15 different patients was calculated and ranged from 0.4-0.75 units/ml (median 0.47). Based on an estimate of the plasma volume (PV), the bolus dose of heparin given intravenously to each patient to produce an equivalent anticoagulant response in vivo was calculated (Hc x PB). Heparin boli administered ranged from 1000-2000 units (median 1500). The mean in vivo APTT achieved was 77% of the predicted value (range 62%-123%). Such an estimation of an in vivo response, by means of an in vitro test, should help to more accurately predict the effects of heparin in vivo and individualise anticoagulation dosage.

Aged↗

PubMedDate not supplied

The rapid reversal of profound hypothermia using peritoneal dialysis.

Severe hypothermia is associated with serious patient morbidity and mortality. The groups most frequently affected are the elderly, the very young and substance abusers. We describe three such cases which were successfully treated using warmed peritoneal dialysis. Two patients recovered completely and were left with no long term deficits. The third patient recovered from the acute event, but succumbed later to an underlying medical condition. Warmed peritoneal lavage is an efficient, cost effective approach which is easily performed without specialist equipment, and involves minimal risk to the patient.

Adult↗