Biomedical subjects

T H Hendershott

Publications and source records attributed to T H Hendershott.

3 recordsLinked to original sources

PubMed1993

Evaluation of right ventricular function during aortic operations.

The simultaneous measurements of mixed venous oxygen saturation (SvO2) and right ventricular ejection fraction (RVEF) have now made it possible to precisely define and correlate the various hemodynamic changes that occur during abdominal aortic operations. Twenty-five patients undergoing infrarenal abdominal aortic aneurysm repair were examined with a pulmonary artery catheter capable of continuously measuring SvO2 and RVEF. With aortic clamping, significant reductions in cardiac index, stroke volume index, and right ventricular end-diastolic volume index (RVEDVI) were noted, while RVEF remained unchanged. Following unclamping of the aorta, a significant reduction in SvO2 occurred, accompanied by an increase in mean pulmonary artery pressure and in pulmonary vascular resistance. Despite the increase in afterload, RVEDVI and RVEF did not change after unclamping. These preliminary data suggest that right ventricular function is preserved during abdominal aortic aneurysm repair.

Aged↗

PubMed1993

Hospitalized teens. Ambulatory care utilization patterns.

Twelve- to eighteen-year-olds enrolled in a federally qualified HMO in Central Massachusetts who had an admission to a hospital with a diagnosis of trauma or mental health problems were identified. Routine and episodic health care utilization for a 24-month period of each study case was determined and compared with the same for a comparison group matched for age, sex and length of enrollment. Although information on health habits and lifestyle was often missing from the charts, it was determined that the study cases were less likely to be in school and living with their parents and used episodic care more frequently, especially in the 6 months prior to admission. Both hospitalized and non-hospitalized youth had a higher average number of visits to office-based providers than their national counterparts. The study suggests that (1) greater awareness of morbidity and health care utilization patterns and risk behaviors may enhance prevention efforts; (2) use of instruments to capture more information on health habits and lifestyle may facilitate preventive interventions; (3) collaborations among pediatric primary care providers, the Information Services (IS) and Quality Management (QM) departments may facilitate this type of research in a managed care setting.

Adolescent↗

PubMed1993

A modified, angioscopically assisted technique for in situ saphenous vein bypass: impact on patency, complications, and length of stay.

PURPOSE: The impact of preoperative saphenous vein mapping and intraoperative angioscopy on the results of in situ saphenous vein bypass is analyzed in this study. METHODS: A new technique developed for in situ saphenous vein bypass (ISVB) was used in 26 patients (group I) and consisted of (1) preoperative duplex scanning and mapping of the saphenous vein and its tributaries, (2) small incisions for dissecting the proximal and distal arteries and veins, (3) ligation of marked tributaries through small incisions, (4) angioscopically directed incision of venous valves with a flexible-tipped valvulotome, and (5) femoral and distal anastomoses. The results were compared with those of 14 patients (group II) in whom the technique was similar except that venous tributaries were identified angioscopically and then ligated and 24 patients (group III) who underwent standard "open" ISVB through one long incision without angioscopy or vein mapping and in whom valvulotomy was carried out with a rigid valvulotome passed through tributaries. RESULTS: In comparing the results of groups I and III, significant reductions in operative intravenous fluid requirements (1930 ml vs 2675 ml; p = 0.04), postoperative length of stay (4.4 days vs 9.1 days; p < 0.001), and wound complications (1 vs 9; p = 0.01) were observed. Angioscopic irrigation fluid volume in group I was less than that in group II (360 ml vs 1014 ml; p < 0.001). At 12 months, the primary graft patency rate in all 64 patients was 91% for femoropopliteal and 89% for femoral-infrapopliteal ISBV and 84% for the 40 patients in groups I and II. CONCLUSIONS: This report demonstrates the effectiveness of our modified technique for ISVB, which helped reduce wound complications and length of stay while satisfactory early graft patency was also maintained.

Aged↗