Biomedical subjects
Publications and source records attributed to T Blanco.
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The haemodynamic changes produced by laparoscopic surgery in children have been evaluated. A transesophageal echocardiographic study on 13 patients (7 males and 6 females, 10.8 +/- 2.7 years old) has been performed before, during and after peritoneal CO2 gas insufflation. A change on the Doppler waves pattern of the infradiaphragmatic veins along with an increase in blood flow velocity were observed. Pulmonary veins suffered minimal changes showing an increase on either the systolic pressure and on atrial contraction. Diastolic retrograde flow in aorta reflected an increase in peripheral vascular resistance. Cardiac output increased minimally. All haemodynamic changes returned to basal after gas peritoneal desufflation. These data show that laparoscopic surgery could produce important cardiac derangements in children with ventricular dysfunction or in patients presenting left ventricular outlet obstruction. In these patients laparoscopic surgery might be precluded.
The laryngeal mask is a new method in the control of the airway. In this study we assess the haemodynamic response during the insertion of the laryngeal mask, incidence of complications and recovery from anaesthesia after its use. We also check if the laryngeal mask is easy to place into the patient airway and its versatility in pediatric patients. We have obtain that the use of the laryngeal mask airway is a safe technique, with few complications, easy to learn and with a short recovery time.
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The relative roles of endogenously released histamine and the sympathetic nervous system in septic shock were indirectly studied by blocking each one separately. Antihistamines in doses of 3-10 mg/kg prevented severe blood pressure drops and improved urinary output in groups treated before and after shock. Release of histamine seems to be important at least in the pathogenesis of early septic shock, although analysis of blood pressure pattern and survival implicates additional factors in late shock. Epidural block in combination with E. coli injection was detrimental, producing severe hypotension and even immediate death. Neural sympathetic tone is essential to survival in shock.