Lege Artis Medicinae

[Emergency circulatory support]

MATTHEW J Barnard, STEPHEN P. K. Linter1

JANUARY 31, 1994

Lege Artis Medicinae - 1994;4(01)

[Many drugs enhance cardiac performance by improving tissue blood supply, but this is often achieved at the cost of increasing the oxygen demand of the myocardium. This can be critical when cardiac function is significantly impaired or ischaemia is the underlying cause of dysfunction. The use of combination drug therapy to restore cardiovascular balance requires a precise knowledge of the pharmacodynamics and interactions of the individual agents, so that the treatment plan can be tailored to best suit the individual patient. In some situations, the combined administration of inotropic agents and vasodilators is desirable to reduce the cardiac workload. In other cases, vasopressors are necessary to restore a minimum perfusion pressure. The present communication reviews this class of drugs and the mechanical circulatory support devices that can be used in the event of failure of pharmacological treatment. ]

AFFILIATIONS

  1. consultant anaesthetist, Harefield Hospital, Harefield

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[EEG mapping is a new method which serves for processing the data of the quantitative analysis of the brain electrical activity. In its final form it is a neuroimaging technique. The present study was designed to examine the localization reliability and clinical utilization of the mapping. 103 patients with focal cerebral disorders were investigated: 70 patients with cerebrovascular diseases, 33 patients with tumour, epilepsy, migraine, meningoencephalitis, subdural haematoma, subarachnoid cyst. The EEG mapping, the routine EEG and the CT were performed and their findings were compared. In comparison with the traditional EEG, the mapping has the advantage that it can detect the alpha asymmetry. It shows the focal, functional damages more correctly than the EEG does. The mapping provides information about the ischemic lesions before the CT can visualize the tissue hypodensity. In comparison with the CT, the mapping has a good localization reliability although there are some sources of error in the method. It can detect minimal cerebral damages. It is applicable for follow-up studies on transient ischemic attacks. ]

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