Heparin dose for accurate anticoagulation in cardiac surgery.

A simplified technique relating individual heparin dose to desired anticoagulant effect was used in 152 patients during cardiac surgery. Activated clotting time (act) was measured by semi-automated technique (Hemochron) before and after heparin, 200 U/kg I.V.

Serratia marcescens bacteremia from contaminated pressure transducers.

Primary Serratia marcescens bacteremia developed in 17 patients in an intensive care unit after exposure to pressure monitoring devices. A study showed that all of the transducer heads were contaminated with S marcescens, and prospective culturing of 110 pressure monitoring lines disclosed a 24% rate of contamination with the same organism. Hand contamination occurs at the time the equipment is initially assembled; in five of eight trials, transmission was shown experimentally to occur by direct inoculation of open ports.

Comparison of hemodynamic, pulmonary, and renal effects of use of three types of fluids after major surgical procedures on the abdominal aorta.

Hemodynamic, pulmonary, and renal variables were measured in 24 patients scheduled for major abdominal aortic operations. Control values were obtained before preoperative medications were given. All patients received 5% dextrose in Lactated Ringer's solution intraoperatively.

Management of Reye's syndrome. A rational approach to a complex problem.

Five patients suffering from progressive Reye's syndrome were aggressively treated in our ICU. Our protocol consisted of endotracheal intubation, curarization, mechanical ventilation, hypothermia to 31 degrees C, and fluid restriction. Intracranial pressure (ICP) was monitored and remained below 10-20 torr in all patients except one in whom ICP rose only once (for a few minutes) to 27 torr.

Algorithm for management of pulmonary complications in burn patients.

An algorithm for management of pulmonary complications in burn patients on the same basis as in patients with adult respiratory distress syndrome is outline. Pao2 of less than 60 torr (F(I)O2 0.21-0.

An evaluation of hypocarbia and hypercarbia during carotid endarterectomy.

One hundred consecutive patients were randomly given hypocarbic (PaCO2 less than 25 torr) or hypercarbic (PaCO2 greater than 60 torr) general anesthesia during carotid endarterectomy to test the effect of the two regimens upon the incidence of postoperative neurological deficit. An indwelling shunt was not used. One patient died, two have permanent neurological deficits and two have temporary neurological deficits.

Cardiovascular and respiratory changes in response to change of posture in the very obese.

Circulatory and respiratory effects of change of posture from sitting to supine were studied in 11 obese patients scheduled for gastric bypass operations. Patients were studied on the morning of operation before any medication was given. Average weight was 138.

Management of carbon monoxide poisoning in the absence of hyperbaric oxygenation chamber.

Manifestations of carbon monoxide poisoning are mostly attributable to acute hypoxic insult. In the absence of immediately available hyperbaric oxygen chamber, 100% oxygen should be delivered to the patient until carboxyhemoglobin levels in the blood are less than 5%. Presence of abnormal motor activity or prolonged abnormal consciousness are indications for proceeding with hypothermia and mechanical ventilation.

A method for measuring oxygen consumption and cardiac output in intensive care units.

A simplified measurement of oxygen consumption was investigated in 15 spontaneously ventilating and 11 apnoeic patients in the intensive care unit following open-heart surgery, using a Godart Pulmonet type 11e. Three consecutive measurements were performed on each patient to define the reproducibility of the method. The coefficient of variation of VO2 was plus or minus 3.

Pleistocene shoreline sediments in coastal georgia: deposition and modification.

New evidence invalidates the former concept that Pleistocene shorelines are "terrace" cut and fill structures. Comparison of Pleistocene and Holocene sediments with morpholo gy of the shoreline indicates that Pleisto cene deposits accumulated in barrier island environments and that the "ter races" are former lagoon-salt marshes. Stratigraphic evidence supports six ma jor Pleistocene shorelines below an elevation of 100 feet (30 meters).

Algal Cultures: Ability To Reduce Turbulent Friction in Flow.

Liquid cultures of several freshwater and marine algae required less pressure to flow through a pipe at a given rate than the pure liquid medium before algal growth. This increased ease of flow can be attributed to long-chain polysaccharides produced in the medium during growth. Measurements of friction were used to estimate the molecular weight of an algal polysaccharide and to show the effect of bacterial action on the polymer.