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The peri-operative management of surgical insertion and removal of the intravenous oxygenator device (IVOX) (1993)

MURDOCH, L. J. ; BOYD, O. F. ; MACKAY, J. ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

Anaesthesia 48 (1993), S. 0

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ISSN: 1365-2044

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Intravenous oxygenation (IVOX) is a new technique for augmentation of gas exchange in patients who require near maximal conventional ventilatory support. Patients who require IVOX are, by definition, critically ill with a high expected mortality. At present, these high risk patients must be transferred to the operating theatre for the IVOX device to be inserted. This report describes the anaesthetic problems associated with nine patients in whom an IVOX device was inserted and removed in our institution. The mortality was six out of nine patients; all deaths occurred with the IVOX device in situ. Three patients died within 6 h of insertion. Four patients were female. The patients' ages ranged from 14 to 76 years. There were few immediate ventilation changes in the first 4 h after IVOX insertion. Inspired oxygenation concentration was reduced in only one patient. Positive end-expiratory pressure was not reduced. Peak inspiratory pressure decreased in four patients. Arterial oxygen tension increased in four patients (range 0.1–2.5 kPa) and decreased in five (range 0.1–3.4 kPa). Arterial carbon dioxide tension increased in one patient (0.3 kPa) and decreased in eight (range 0.1–2.7 kPa). Inotropic support with adrenaline, dobutamine and nor adrenaline needed to be initiated or increased in eight patients. Eight patients required 2–4 units of blood to be transfused during IVOX insertion or in the following 2 h. One patient suffered an asystolic cardiac arrest during the operation, but was resuscitated successfully. Three patients survived to have the IVOX removed. There were no cardiorespiratory problems associated with its removal and although all three required a vein patch to repair the venotomy site, no patient required blood transfusion. We conclude that IVOX insertion (including transfer to and from the operating theatre) represents a significant cardiorespiratory insult to these critically ill patients. Anaesthetic staff need to be aware of the potential problems to enable them to minimise the risk of serious complications during the insertion of this novel device.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1365-2044.1993.tb07411.x

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Components in the haustorial wall of the flax rust fungus,Melampsora lini, are labelled by three anti-calmodulin monoclonal antibodies (1998)

Murdoch, L. J. ; Hardham, A. R.

Springer

Protoplasma 201 (1998), S. 180-193

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ISSN: 1615-6102

Keywords: Biotrophic pathogen ; Calmodulin ; Haustorium ; Linum ; Melampsora

Source: Springer Online Journal Archives 1860-2000

Topics: Biology

Notes: Summary Immunolocalisation studies, using flax leaf material infected with the flax rust fungus,Melampsora lini, and isolated haustorial complexes, have shown that three anti-calmodulin monoclonal antibodies bind to the haustorial wall of the fungus. The epitopes recognised by these antibodies are inserted into the wall during the early stages of haustorium development and remain in the wall throughout the life of the haustorium. The epitopes are present in both compatible and incompatible reactions and are oligosaccharide in nature. The results provide evidence for molecular differentiation within the haustorial complex ofM. lini.