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Biomedical subjects

A Neuhaus

Publications and source records attributed to A Neuhaus.

8 recordsLinked to original sources
PubMed1993

The role of duplex ultrasound arterial imaging in patients with penetrating extremity trauma.

OBJECTIVE: To investigate the role of color-flow duplex ultrasound vascular imaging in screening patients for potential arterial injuries following penetrating trauma of the extremities. DESIGN: In this prospective study, patients with penetrating trauma in proximity to major peripheral vessels but without signs of arterial injury underwent color-flow duplex imaging. Patients with abnormal color-flow duplex examination results were then studied with angiography, and the results of the two studies were compared. In patients who presented with signs of arterial injury, immediate operative exploration and/or angiography was performed. SETTING: An urban trauma center. PATIENTS: Patients entering the trauma center with penetrating trauma between April 1991 and December 1992. RESULTS: Seventy-seven patients with 86 extremity injuries were initially screened with color-flow duplex imaging. Four patients had positive study results, and all injuries were confirmed with angiography (100% true positive). No missed arterial injuries were detected in clinical follow-up. CONCLUSIONS: Color-flow duplex imaging reliably detects occult arterial injuries and may also have a role in following up minor injuries treated without surgery.

Adolescent↗
PubMed1981

Modification of the effect of fiberoptic bronchoscopy on pulmonary mechanics.

Thirty-three patients who were to undergo diagnostic fiberoptic bronchoscopy were studied. Pulmonary function tests were performed before the procedure, after topical lidocaine anesthesia, and immediately and four hours after bronchoscopy. Nine patients received aerosolized isoproterenol (Isuprel) before the topical anesthesia, and nine received aerosolized atropine. Pulmonary function tests were also performed after this intervention. In those patients receiving no premedication, all the indices of expiratory flow were reduced significantly immediately after bronchoscopy, and after the topical anesthesia, the FEV1 and FVC were significantly reduced. In the atropine groups, the FVC and FEV1 increased significantly after atropine, and increased still further following topical lidocaine anesthesia. By four hours after bronchoscopy, however, the midmaximal expiratory flow ws significantly reduced. In the isoproterenol group, only the FEV1 was significantly improved by the drug, and this improvement persisted even after the lidocaine. It decreased transiently immediately after bronchoscopy, but by four hours, was significantly above baseline again. The FVC diminished significantly immediately after bronchoscopy. It is concluded that fiberoptic bronchoscopy deleteriously affects pulmonary function and that inhaled isoproterenol or atropine largely protects against these deleterious effects.

Adult↗
PubMed1978

The effects of fiberoptic bronchoscopy with and without atropine premedication on pulmonary function in humans.

Pulmonary function studies, including arterial blood gas analysis, were performed in 21 patients undergoing fiberoptic bronchoscopy. Eight received premedication with atropine and 13 did not. In the atropine-treated group there was no significant deterioration in pulmonary function immediately after bronchoscopy compared with baseline. Compared with the values obtained after topical lidocaine anesthesia, however, there was a decrease in peak expiratory flow rate (PEFR) (20 +/- 20%), forced expiratory volume in one second (FEV1.0) (11 +/- 12%), forced expiratory flow between 25 and 75% of vital capacity (FEF25-75) (22 +/- 16%), and forced expiratory flow at 75% of exhaled vital capacity (FEF75) (28 +/- 38%) and an increase in residual volume (RV) (16 +/- 19%). In the no-atropine group, postbronchoscopy values showed a decrease in PEFR (13 +/- 19%), forced vital capacity (FVC) (13 +/- )9%), FEV1.0 (14 +/- 16%), and oxygen partial pressure (Pa02) (11 +/- 9%) and an increase in RV (19 +/- 31%) and alveolar-arterial oxygen pressure gradient (deltaAaPO2) (91 +/- 129%) compared with baseline values. In this group also, topical lidocaine anesthesia resulted in a decrease in FVC compared with baseline. We conclude that the deleterious effect of bronchoscopy on pulmonary function is counterbalanced by the beneficial effect of atropine and that atropine is therefore a useful premedication for fiberoptic bronchoscopy.

Adolescent↗
PubMed1978

Pulmonary embolism in respiratory failure.

The occurrence of pulmonary emboli in 617 patients admitted to a respiratory intensive care unit was studied. Pulmonary emboli were found in 18 (27 percent) of 66 autopsies. Half of these pulmonary emboli were not diagnosed before death, despite persistent aggressive attempts to document pulmonary emboli. In this subpopulation of patients with respiratory failure, the usual clinical manifestations of pulmonary emboli (symptoms, signs, chest x-ray film, electrocardiogram, and changes in arterial blood gas levels) frequently are already present, due to the severe underlying pulmonary disease, and any superimposed manifestations of pulmonary emboli are often inapparent. In this group under study, the ventilation/perfusion lung scan correlated poorly with pulmonary angiographic results and with examinations at autopsy; the scan generally was inadequate to rule in or rule out pulmonary emboli. Again, this was due to the distortion of both ventilation and perfusion by the severe underlying pulmonary disease. Currently, pulmonary angiographic studies remain the only reliable technique to confirm or exclude pulmonary emboli in patients with respiratory failure.

Electrocardiography↗