Subject(s)
Energy Metabolism , Infections/metabolism , Blood Glucose/metabolism , Burns/metabolism , Carbon Dioxide/blood , Critical Care , Energy Intake , Fever/metabolism , Hormones/blood , Humans , Oxygen/blood , Sepsis/metabolism , Surgical Wound Infection/metabolism , Wounds and Injuries/metabolismSubject(s)
Data Collection/methods , Intensive Care Units , Humans , Information Systems , Medical RecordsABSTRACT
There are different opinions about the efficiency of preventing the succinylcholine-induced increase of serum potassium by precurarization. The following case report demonstrates that this method is not practicable in risk patients. A case of severe cerebral trauma is reported, in whom after precurarization with 2,0 mg diallyl-nortoxiferine and with 1.5 mg pancuronium, too, there was an increase of a normal serum potassium level up to 9.35 respectively 9.20 mEq/l about 1-2 minutes after injection of succinylcholine. 20 minutes after the injection serum potassium decreased to a normal level again. Only a short lasting bradycardia was noticed during the hyperkaliaemic period. Similar results reported in the anaesthesiologic literature are discussed.
Subject(s)
Alcuronium/administration & dosage , Anesthesia, Intravenous , Potassium/blood , Succinylcholine , Toxiferine/analogs & derivatives , Alcuronium/adverse effects , Brain Injuries/surgery , Heart Rate/drug effects , Humans , Male , Middle Aged , Pancuronium/administration & dosage , Pancuronium/adverse effects , Preanesthetic Medication , Succinylcholine/adverse effectsABSTRACT
We report on the development of a data collection form for anaesthesia. The difference between this form and the previously published recommendations is that it does not require any coding of data prior to collection. The anaesthetist completing the form needs no knowledge of data processing. Qualitative data have only to be marked, while quantitative data must be entered as such. So far, more than 90,000 anaesthesias have been collected with the form presented, therefore usefulness may be assumed.
Subject(s)
Anesthesiology/methods , Data Collection/methods , Electronic Data Processing , HumansABSTRACT
The indication for the infusion of plasma substitutes has been considerably limited as the result of a series of grave incidents. Prior to each application, differential-therapeutic deliberations must decide on the choice of plasma substitute bringing about the desired success in accordance with its physico-chemical characteristics and clinical values. The type and severity of a probable anaphylactoid incident and its therapy should also be considered.
Subject(s)
Anaphylaxis/prevention & control , Plasma Substitutes/adverse effects , Burns/therapy , Diarrhea/therapy , Half-Life , Hemorrhage/therapy , Humans , Molecular Weight , Oxygen Consumption , Shock/therapy , ViscosityABSTRACT
Clinical observations during postoperative feeding (observation period 10 to 30 days) are reported. We compared glucose and fructose intake at different intake rates to glucose and fructose urinary output. Insulin admixture per 100 g of glucose is not constant. It can be progressively reduced following operation.
Subject(s)
Fructose/metabolism , Glucose/metabolism , Insulin/administration & dosage , Parenteral Nutrition , Accidents, Traffic , Adult , Female , Humans , Intestinal Fistula/surgery , Male , Nutritional Requirements , SuturesABSTRACT
44 patients are analysed for the frequency of postoperative vomiting and the amount of gastroatonia following aorto-femoral bypass operations during neuroleptanaesthesia and halothane combination anasthesia. More than 60% of patients develop gastroatonia during both methods of anaesthesia. However it is less apparent on the first postoperative day after neuroleptanaesthesia and does not affect as many patients as after halothane combination anaesthesia. Postoperative vomiting is significantly more frequent after halothan combination anaesthesia than after neuroleptanaesthesia.
Subject(s)
Anesthesia, Inhalation/adverse effects , Blood Vessel Prosthesis , Halothane , Neuroleptanalgesia/adverse effects , Stomach Diseases/etiology , Vomiting/etiology , Adult , Aged , Female , Humans , Male , Middle Aged , Muscle Tonus , Postoperative Complications , Time FactorsABSTRACT
In 13 postoperative patients (1st to 9th day) of both sexes, aged 32 to 74, we studied whether an additional volume of 500 ml Haemaccel might demonstrate-as in earlier test series--a correlation between CVP measured in the horizontal position and changes of CVP and Pa measured at atrial level in a partly upright position (tilting angle 45 degrees and 60 degrees of the revolving bed). After volume administration (average: 8.13 ml/kg body weight) and raising of CVP in the horizontal by 3.42 cm H2O corresponding to an E'-value of 0.42 cm H2O/ml/kg body weight, we noticed a significant reduction of the decrease due to orthostasis as well of Pa at heart level as of the "shock index"; at the same time, however, the extent of the CVP decrease registered for all patients increased significantly regardless of tilting angle. Therefore, a correlation between the intravasal filling state and the reaction of orthostatic CVP and Pa may be assumed. In conclusion, the explanation for these results and the relation between the venous filling volume and some pathophysiological functions at the right heart are discussed.
Subject(s)
Blood Pressure , Blood Volume , Central Venous Pressure , Posture , Adult , Aged , Female , Heart Atria , Humans , Male , Middle Aged , Plasma Substitutes , Postoperative Care , Time FactorsABSTRACT
By adding a manometer and a pressure valve to the anaesthetic equipment used for newborns and children (Ayre-T-piece, modified by Kuhn) we are able to control airway pressures continuously and to draw out all narcotic gases from the operating room. The concentration of halothanee thus can be diminished to a very low level around the aneasthesist and the surgeon.
Subject(s)
Respiration, Artificial/methods , Ventilators, Mechanical , Air Pollution/prevention & control , Child , Humans , Operating RoomsABSTRACT
The debate concerning the relative merits of about prolonged nasal intubation or tracheostomy on adult patients continues. We had only very positive experiences in our intensive care unit describing 7 patients in whom the average duration of nasal intubation was 28,7 days (Range 26 to 33 days). All patients had a regularly weekly bronchoscopy to avoid any damage to the larynx or trachea.
Subject(s)
Intubation, Intratracheal/methods , Adolescent , Adult , Humans , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/instrumentation , Long-Term Care , Male , Middle Aged , Nasal Cavity , Time Factors , TracheotomyABSTRACT
In 18 postoperative patients (1st to 10th day) of both sexes, aged 26 to 74, the relation was studied between the CVP and arterial BP measured in the horizontal and in a partly upright position (45 and 60 degrees respectively). Patients with higher CVPs in the horizontal position generally showed a lesser orthostatic drop of the BP. The fall of CVP which we observed simultaneously in all patients was, however, significantly more marked in the patients with the higher horizontal CVP values, irrespective of the angle of inclination. The cause of these findings appears to be the dependence of the venous hydrostatic indifference point upon the intravascular volume.
