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Biomedical subjects

S P Pietak

Publications and source records attributed to S P Pietak.

6 recordsLinked to original sources
PubMed1983

The anaesthetic ventilator.

A summary of functional characteristics of some commonly used anaesthetic ventilators is included in Table I. This information was obtained from manufacturers' specifications.

Anesthesiology↗
PubMed1979

Hemodynamic monitoring and care of the patient of high risk for anesthesia.

Hemodynamic monitoring and care of the patient at high risk for anesthesia require a careful and systematic approach. During preoperative evaluation the patient at increased risk must be identified and correctable problems must be solved. The patient's current medications must be reviewed because they may influence the choice of anesthetic approach and may alter the physiologic response to the stresses commonly associated with anesthesia. In addition to conventional clinical and electrocardiographic monitoring, perioperative hemodynamic monitoring may be desirable for patients at special risk, who are likely to have significant associated medical problems or to undergo complicated surgical procedures. No ideal induction agent exists, and hypotension secondary to peripheral vasodilation or myocardial depression, or both, is a potential problem. Patients with an inordinately high risk may benefit from mechanical circulatory assistance prior to induction of anesthesia. Attention to oxygenation, blood volume replacement and the prevention of hypertensive episodes are particularly important during anesthesia so that optimal cardiac performance is ensured and ischemia avoided. The stresses during emergence from anesthesia contribute to lability of the cardiovascular status and hypoxemia. The period of risk does not conclude with immediate recovery from anesthesia but extends through the postoperative phase. Careful monitoring and attention to the control of pain, prevention of hypotension and hypertension, adequate oxygenation, early mobilization and resumption of the administration of cardiac medications are important factors in a successful outcome.

Aged↗
PubMed1976

Airway obstruction following smoke inhalation.

Respiratory distress with episodes of cyanosis, intercostal retraction and sibilant rhonchi occurred in a 2-year-old boy over a 48-hour period following serious smoke inhalation. Worsening of the child's condition accompanied these findings, culminating in sudden loss of air entry, severe respiratory distress and loss of consciousness, which necessitated endotracheal intubation for resuscitation. Pronounced improvement followed removal of two pseudomembranous bronchial casts from the airway by suctioning, and thereafter recovery was uneventful.

Airway Obstruction↗
PubMed1976

Prolongation of anesthetic action by BNPP (bis-[p-nitrophenyl] phosphate).

Bis-[p-nitrophenyl] phosphate, BNPP, an enzyme inhibitor of the organophosphate class, has been used to inhibit the enzyme, carboxylic ester hydrolase EC 3.1.1.1. Esterases play a major role in the rapid metabolism of propanidid in vivo; in fact, the short duration of action of this intravenous anesthetic agent is due to this rapid hydrolysis. The duration of anesthesia with propanidid alone in healthy mongrel dogs was 10.1 +/- 2.1 (SEM) minutes. When the dogs were pretreated with BNPP, propanidid anesthesia time was prolonged to 38.2 +/- 7.9 (SEM) minutes. Measurements of serum propanidid concentration demonstrated that prolonged high levels of propanidid were associated with the extended anesthesia time. Therefore, BNPP can significantly alter the anesthetic action of propanidid by inhibition of the enzyme system responsible for the rapid hydrolysis of the agent. The experimental model used in the present study provides a means for investigation of effects of certain drugs when their metabolism is impaired.

Anesthesia, Intravenous↗