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T J Coady

Publications and source records attributed to T J Coady.

14 recordsLinked to original sources

Pattern of breathing during upper gastrointestinal endoscopy: implications for administration of supplemental oxygen.

Cardiopulmonary complications account for half the deaths associated with upper gastrointestinal endoscopy. The incidence of hypoxia at the time of upper gastrointestinal endoscopy can be greatly reduced by the administration of supplemental oxygen via nasal cannulae. Using dual thermistors in the mouth and nostrils of patients undergoing upper gastrointestinal endoscopy, the present study demonstrates that most patients breathe predominantly via the oral, rather than the nasal, route following intubation of the oesophagus. The implication from the study is that, if supplemental oxygen is to be used in 'at risk' patients, it would be logical to employ an oral, rather than nasal, route of administration.

Endoscopy, Gastrointestinal

Determination of the optimum dose of subcutaneous salbutamol in asthmatic patients.

Saline and salbutamol (250 mug, 500 mug, 750 mug, and 1000 mug) injections were administered under double-blind conditions to seven chronic stable asthmatic patients. The response on the respiratory system (FEV1, FVC) and cardiovascular system (pulse rate, blood pressure and ECG) was monitored for 3 hours. Increasing the dose of salbutamol increased the peak and weighted average effects of FEV1 and pulse rate. The optimum dose, a titration of desired increases in FEV1 and undesirable increases in pulse rate, is 500 mug but doses up to 1000 mug may be administered if necessary.

Adult

Evaluation of a breath actuated pressurized aerosol.

Preliminary investigation suggests that some asthmatic patients find it difficult to synchronize the release of a metered dose from a pressurized aerosol with the correct phase of inspiration. An automatic device has been developed to overcome this problem. Information is presented outlining the physical characteristics of the unit and the methods used to establish its performance in patients. It is suggested that the device may have a place in the management of asthma.

Aerosols

Upper gastrointestinal endoscopy: a prospective randomized study comparing continuous supplemental oxygen via the nasal or oral route.

We have examined the efficacy of supplemental oxygen in preventing episodes of significant arterial desaturation (SpO2 less than 90%) during upper gastrointestinal endoscopy. We have compared the effects of 2 liters.min-1 of oxygen given orally via the bite-guard with the same flow rate via nasal cannulas and have also examined the effects of pre-oxygenation. Results of this study at a flow rate of 2 liters.min-1 have been compared with previously published results at a flow rate of 3 liters.min-1. Although in this study fewer episodes of desaturation were seen in the orally supplemented group compared with the nasal group, the difference observed was not statistically significant. Pre-oxygenation significantly reduced episodes of desaturation (SpO2 less than 90%, p less than 0.01) and prevented SpO2 falls below 85% in all patients studied. Supplemental oxygen given at a rate of 2 liters.min-1 was as effective as that given at a rate of 3 liters.min-1 in preventing significant desaturation, as previously defined, during the procedure. We therefore recommend the use of supplemental oxygen at a flow rate of 2 liters.min-1 in all high risk patients and conclude that the oral route has practical advantages and is at least as effective as nasal cannulas.

Endoscopy, Gastrointestinal