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Biomedical subjects

B Stangl

Publications and source records attributed to B Stangl.

At least 19 recordsLinked to original sources
PubMed1990

Double-blind placebo controlled clinical trial of almitrine bismesylate in patients with chronic respiratory insufficiency.

The efficacy and safety of almitrine bismesylate, a new respiratory stimulant, in patients with the hypoxaemic form of chronic respiratory insufficiency caused by chronic bronchitis and emphysema has been assessed. The multicentre trial of 12 weeks duration was double-blind and placebo controlled, with individual and group comparisons. Twenty three patients received almitrine 50 mg b.d. p.o. and 17 took placebo. In the almitrine group a significant increase in PaO2 was achieved (control value 54.4 mm Hg, rising to 59.1 mm Hg after 6 weeks, and to 59.4 mm Hg after 12 weeks). There was also a significant decrease in PaCO2 in the almitrine group after 12 weeks. No correlation was found between the plasma almitrine concentration, PaO2 and PaCO2. Lung function (FVC, FEV1, FEV1/FVC, Raw, TLC, RV, FRC) did not change in either group, but the degree of dyspnoea and performance in the 6 min walking test were significantly improved in the almitrine group. Adverse reactions appeared in 6 out of 23 patients on almitrine bismesylate (headache, urticaria, breathlessness, diarrhoea, chest pain, nausea and vomiting), causing drop out of 4 patients. Thus, almitrine bismesylate can be considered useful in the treatment of patients with chronic respiratory insufficiency.

Adult↗
PubMedDate not supplied

[Respiratory function in patients immediately after surgery of the thorax or upper abdomen].

The study deals with the patients in the first postoperative hour following the operation in the upper abdomen or thorax. We considered the respiratory function of the patients in the first postoperative hour and how the respiratory function is influenced by the residua of general anesthesia at that time. Statistically significant decrease of postoperative SaO2 values was found and many patients were hypoxemic after the operation. We found decreased minute ventilation in the first postoperative hour in both groups of patients. Anyway the minute ventilation was more decreased in the abdominal group of patients who recovered from intravenous anesthesia. The conscience as well was more slowly returned to the patients in the abdominal group. In the first 30 minutes more abdominal patients suffered from the muscular weakness following intraoperative relaxation. But this first half an hour after the operation they had satisfactory level of analgesia left. To the contrary the postoperative pain was more severe in the thoracal group of patients. Postoperative gas exchange was more often and more seriously disturbed in the thoracal group of patients who in majority suffered from previous lung disease, which means they had greater ventilation/perfusion imbalance and greater right to left shunt. In the abdominal group only the patients who had relatively short intravenous anesthesia were found hypoxemic in the first postoperative hour. We think that in these patients the gas exchange abnormalities immediately after the operation are also caused by the hypoventilation which often follows general anesthesia.

Abdomen↗
PubMedDate not supplied

[Evaluation of the Vitalomer-1 electronic spirometer].

A new home-made electronic spirometer (Vitalomer 1) is presented. The adequacy of measurement of lung volumes and flows with Vitalomer is assessed in two ways: by registration of volume changes after filling the device by air from the syringe of known volume and by so called "biological testing". By this method in the group of healthy subjects and patients with airflow obstruction the volumes and flows were simultaneously measured both by Vitalomer and standard spirometer (Vitalograph). The values, measured by both devices, were compared according to two statistical methods. Analysis has showed that Vitalomer is comparable in measurement of volumes and flows with well-known Vitalograph and that it fulfils the criteria proposed for spirometers by American Thoracic Society (ATS) and Communauté Européenne du Charbon et de l'Acier (CECA). The handling with new device is very simple as well as its cleaning. Vitalomer is therefore appropriate for diagnostic spirometry both in out-patients clinics as well as in hospital wards.

Adolescent↗
PubMedDate not supplied

[Recommendations for the standardization of bronchial provocation tests using bronchoconstriction agents].

The author is resuming part of the reports and discussions from the 26th Golnik symposium with the main topic "The measurement of nonspecific bronchial responsiveness." The indications for nonspecific bronhcoprovocation tests, different methods for production of aerosol and ways of inhalation of bronchoconstrictory agent are discussed. Further on the procedures for measurement of bronchial response, shorter one by inhalation of one dose and longer one by increased quantities of metacholine or histamine together with the interpretation of the results have been introduced as well.

Bronchial Provocation Tests↗
PubMedDate not supplied

[The effect of positive end-expiratory pressure on gas exchange and hemodynamics].

The effects of positive end-expiratory pressure (PEEP) on arterial and mixed venous blood oxygenation as well as the effects on systemic and pulmonary circulation were studied in 15 patients with adult respiratory distress syndrome (ARDS) on mechanical ventilation. The measurements of arterial and mixed venous blood oxygen pressure (PaO2, PvO2), heart rate (HR), central venous pressure (CVP), pulmonary wedge pressure (WP), mean pulmonary arterial pressure (Ppa), mean systemic arterial pressure (Psa) and cardiac output (CO) were performed at 0, 5, 10 and 15 cm H2O PEEP. The positive effect of + 10 cm H2O on arterial oxygenation was found (PaO2 raised from 11.49 +/- 3.5 kPa to 13.3 +/- 3.3 kPa). Ppa raised too, from 23 +/- 7.6 mm Hg to 26 +/- 7 mm Hg. Psa and CO lowered at + 15 cm PEEP. Psa from 85 +/- 17 mm Hg to 73 +/- 17 mm Hg as well as CO from 8.22 +/- 1.1 l/min to 6.91 +/- 1.40 l/min. Authors conclude that PEEP can be accepted form of therapy in the treatment of refractory hypoxemia in patients with ARDS. Despite this beneficial effect, PEEP may adversely affect cardiovascular function. As with any therapy, the optimum PEEP "dose" should be tailored to each patient according to his needs and response.

Adolescent↗
PubMedDate not supplied

[Measurement of pulmonary transfer factor using the CO rebreathing method of gas mixtures].

The measurement of transfer factor of the lung with CO rebreathing method (TLcoRB) is presented by slightly modified method of Clark et al. The measurements were performed in 32 healthy subjects and in 24 patients with restrictive or obstructive ventilatory defect and compared with the values of TLcoSB. TLcoRB was in all examined persons cca 30% lower than TLcoSB. Contrary to that Kco in healthy subjects was the same in both methods while the values of KcoRB in patients were slightly lower than KcoSB. It is concluded that measurement of TLco rebreathing method is suitable for routine use. The measurement of TLcoRB may be performed also in patients with severely decreased ventilatory capacity and even at patient's bed. In specialised laboratories for lung function test TLcoRB should be used as parallel method in routine work.

Adult↗