Publications by authors named "Richard Downes"
Article Synopsis
- Global tissue oxygenation assessments during cardiopulmonary bypass (CPB) may not accurately represent regional oxygenation, potentially leading to organ injury, but near-infrared spectroscopy (NIRS) provides a noninvasive way to measure regional tissue oxygenation and could enhance treatment strategies.
- The PASPORT trial aims to evaluate whether incorporating NIRS monitoring into CPB management can lead to better cognitive outcomes, less organ injury, fewer unnecessary blood transfusions, and lower healthcare costs during heart valve surgeries.
- The study involves randomly assigning adults undergoing specific heart surgeries to either a standard treatment approach or one that integrates NIRS monitoring, with rigorous methods used to minimize bias and improve the reliability of results.
Propofol cardioplegia: A single-center, placebo-controlled, randomized controlled trial.
J Thorac Cardiovasc Surg
December 2015
Objectives: Cardiac surgery with cardiopulmonary bypass and cardioplegic arrest is an effective treatment for coronary artery and aortic valve diseases. However, the myocardium sustains reperfusion injury after ischemic cardioplegic arrest. Our objective was to assess the benefits of supplementing cardioplegia solution with the general anesthetic propofol in patients undergoing either coronary artery bypass grafting (CABG) or aortic valve replacement (AVR).
View Article and Find Full Text PDFBackground: Despite improved myocardial protection strategies, cardioplegic arrest and ischemia still result in reperfusion injury. We have previously published a study describing the effects of propofol (an anesthetic agent commonly used in cardiac surgery) on metabolic stress, cardiac function, and injury in a clinically relevant animal model. We concluded that cardioplegia supplementation with propofol at a concentration relevant to the human clinical setting resulted in improved hemodynamic function, reduced oxidative stress, and reduced reperfusion injury when compared to standard cardioplegia.
View Article and Find Full Text PDFPurpose: A retrospective case note review was undertaken to elucidate any differences in the cosmetic results and rate of serious complications between hydroxyapatite (HA) and porous polyethylene (PP) orbital implants.
Methods: Patients who had undergone orbital implant surgery during the period 1993 to 1997 by a single surgeon were identified. Twenty-six patients had an HA implant and twenty-six had received a PP implant.
Introduction: The aim of this paper is to highlight the use of the Holmium YAG laser in the endoscopic placement of Lester Jones tubes in patients with a blocked canaliculus or failed lacrimal pump function.
Materials And Methods: Sixteen cases with a non-functional canaliculus were included over a one-year period. Following caruncle excision, a 19 G needle is inserted through the medial canthal tissues into the nasal space.
Intraoperative fluorouracil in endonasal laser dacryocystorhinostomy.
Arch Otolaryngol Head Neck Surg
February 2003
Background: Although endonasal laser dacryocystorhinostomy (ELDCR) offers many advantages compared with conventional techniques, postoperative scarring leading to occlusion of the rhinostomy is more common with ELDCR.
Objective: To investigate whether fluorouracil applied to the rhinostomy site intraoperatively has an effect on the outcome.
Participants: We randomly allocated 155 consecutive patients (201 procedures) to a control group and a fluorouracil group.