Solomon N. Albert

Ventilation With an Oxygen Injector for Suspension Laryngoscopy Under General Anesthesia

HE anesthesiologist must adjust and T modify anesthesiologic methods to meet the requirements of new surgical technics. Suspension laryngoscopy and operative procedures on the vocal cords under direct vision, by necessity, require that the neck and oropharyngeal muscles be relaxed to introduce the laryngoscope and obtain adequate exposure of the glottic entrance. Ventilation under these circumstances is a challenge.

Pitfalls in blood volume measurement.

OST OF THE earlier work published on M blood volume measurement has demonstrated the value of such measurement in the management of the surgical patient.1-8 However, in recent years, with new improvements in the technic, and with the advent of automation, we suddenly seem to be confronted with new problems.9, l o Some investigators now claim that blood volume measurements are meaningless and that the results do not correlate with the clinical picture.ll. 12

The Distribution Between the lntravascular and Interstitial Compartments of Commonly Utilized Replacement Fluids

INCE THE initial observations by Shires S and associates1 of a disproportionate loss of extracellular fluid (ECF) following hemorrhage and trauma, there has been a rash of reports on massive fluid replacement to correct fluid-volume deficits. Some authors have advocated specific regimens for replacing blood loss with a variety of parenteral solutions2~3 Precalculated volume replacement of fluid based on an estimated blood loss has also been suggested as a rational method of therapy. In an editorial, Moore and Shires4 advocated proper restitution of physiologic functions and replacement of elements in deficit rather than treatment by inundation. Albert and associates5 and Roth and coworkerse have shown that crystalloid infusions disperse rapidly into the interstitial fluid (ISF) space and only a small fraction of the volume of fluid administered remains in the intravascular fluid (IVF) compartment.

A waste gas scavenging valve for pediatric systems.

Thirty separate flow combinations, delivered by 2 dry-gas flowmeters and mixed in a chamber, were analyzed using a balanced Beckman D-2 paramagnetic O2 analyzer. Concentrations predicted from the nomogram and measured on the analyzer were virtually identical. As a check on the accurary of the mixing system, 30 random air-02 mixtures were analyzed with the D-2 analyzer and the results compared with O2 concentrations computed by the equation using air L/min, O2 L/min, and total L/min of mixture. Computed and measured O2 concentrations again were virtually identical.

An improved method for simultaneous measurement of red-cell, plasma, and extracellular fluid volume with radioactive tracers.

HE TECHNIC for simultaneous measT urement of red-cell, plasma, and extracellular fluid (ECF) volume has been further improved and simplified by use of a dual-scaler analyzer system for measuring lasI and W r and a liquid scintillation system for counting 3%. The efficiency of the beta-counting system has been greatly enhanced and the amount of radiation per tracer dose has been greatly reduced. Measurement of ECF volume by the present modified method compares favorably with results reported utilizing the anthracene cell as a beta-particle detector.132

Circulating blood volume measurements for cardiac surgery

Abstract The only reasonable method presently available to estimate the amount of circulating blood is the direct measurement of the circulating blood volume. In cardiac surgery, blood volume measurements serve as a guide for surgical management and the regulation of the amount of circulating blood. This often makes the difference between a successful procedure and a complete failure. Patients with cardiovascular anomalies compensate for dynamic disorders by adapting the amount of circulating blood volume to meet the need. This, in turn, necessitates careful pre- and postoperative adjustments. The presently available technic for measuring blood volume is simple and practical.

Use of Magnetic Tape for Recording Radioactivity

Radioactive isotopes are frequently used as tracer material for diagnostic purposes. The principle employed for determining rate of blood flow is based on a dilution or elimination rate of the administered tracer dose. Activity rate is measured with a suitable detector and recording system. Interpretation of disappearance curves is at times rendered difficult because of a weak dose of radioactive material introduced into the system or inadequate settings of the rate meter as to scaling and time factors. To obviate loss of valuable data, a recording system that could register all impulses emitted by the detector probe would be of value. These could then be reproduced at leisure through a scaler or integrating rate meter. Commercial tape recorders have proved adaptable for registering radioactive disintegration impulses. Method A suitable detector probe is activated to the proper voltage level by an appropriate power supply source, either from a scaler or rate-meter unit. The output from the scaler or rate ...

NEW ADAPTATION TO THE STANDARD THREE-WAY STOPCOCK

The standard three-way stopcock is valuable in present-day anesthesia, as it permits administration of fractionating doses of thiopental (Pentothal) sodium, relaxants, and fluids intravenously through a single venipuncture. The principle disadvantage is that there is no stability to the syringe, and the incidence of syringe breakage is quite high. We have been able to replace the screw at the base of the selecting directional faucet with a long screw and a cylindrical washer. This is introduced into a suction rubber stopper that can be applied to any flat surface. The latter keeps the stopcock firmly secure and gives stability to the syringe. We find it both practical and more economical than the various syringe holders found at present on the market. 19th and E streets, S.E. (3) (Dr. S. N. Albert).The standard three-way stopcock is valuable in present-day anesthesia, as it permits administration of fractionating doses of thiopental (Pentothal) sodium, relaxants, and fluids intravenously through a single venipuncture. The principle disadvantage is that there is no stability to the syringe, and the incidence of syringe breakage is quite high. We have been able to replace the screw at the base of the selecting directional faucet with a long screw and a cylindrical washer. This is introduced into a suction rubber stopper that can be applied to any flat surface. The latter keeps the stopcock firmly secure and gives stability to the syringe. We find it both practical and more economical than the various syringe holders found at present on the market. 19th and E streets, S.E. (3) (Dr. S. N. Albert).