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Biomedical subjects

B Viell

Publications and source records attributed to B Viell.

30 records · Page 2Linked to original sources
PubMed1987

[Comparative study of circulatory and ECG-changes after supraclavicular plexus block with bupivacaine-HCl 0.5 per cent in patients with chronic kidney failure].

The systemic effects of local anesthetic drugs, especially bupivacaine, on myocardial conduction and the increase of cardiotoxicity by hypoxemia, acidosis, and hyperkalemia has been proven in numerous animal experiments. In our department, supraclavicular brachial block with bupivacaine is the method of choice for patients with chronic renal failure requiring operations of the upper limb. The question may be raised whether or not these patients with their concomitant disease--electrolyte and acid-base imbalances, uremic cardiomyopathy--are especially endangered by the use of this drug. Supraclavicular brachial blockade (3 mg/kg bupivacaine 0.5% + 0.1 IU vasopressin/ml) was performed in 10 patients with chronic renal failure requiring hemodialysis. The control group consisted of 10 healthy patients who were admitted for minor hand surgery. Preoperative blood samples were taken for measurements of blood urea nitrogen, serum creatinine, serum electrolytes, and arterial blood gas analysis. Long-term ECG monitoring begun 20 min before injection of the block and continued over a total of 200 min. Serum concentrations of bupivacaine were determined at 10, 20, 30, 60, 120, and 180 min after injection. Comparing the two groups, no severe changes in electrolytes or acid-base status could be found despite some statistical significances. Even though bupivacaine serum concentrations proved to be 3 times higher in the study group than in the control group, no changes in cardiac conduction could be registered. We conclude that bupivacaine is as safe in dialyzed patients with chronic renal failure with regard to possible changes in circulatory parameters and myocardial conduction as in healthy patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Chemical Analysis↗
PubMed1987

["Self-taming": an alternative to the prevention of succinylcholine-induced pain].

Muscle pain associated with single-bolus administration of suxamethonium is reported to be one of the common complications of this technique. Since suxamethonium is the most commonly used relaxant in our department and priming with nondepolarizing muscle relaxants is also reported to be linked with complications, while the literature concerning this problem is very contradictory, we wondered if the so-called "self-taming" method represents an alternative to pretreatment with nondepolarizing muscle relaxants. One hundred thirty-two patients (69 male, 63 female) were randomly allocated to three groups. Anesthesia was induced with thiopentone 7 mg/kg body weight. Group 1 (n = 44) was pretreated with 2 mg pancuronium bromide 3 min prior to full relaxation with suxamethonium 1.5 mg/kg. Group 2 (n = 43) received no pretreatment. Group 3 (n = 45) received 4 mg suxamethonium i.v. after induction. One minute later the remaining dose of suxamethonium was applied ("self-taming"). Muscle fasciculation and postoperative myalgia were verified by means of a score. Neuromuscular transmission was recorded on a monitor after controlled train-of-four stimulus and time of onset of neuromuscular blockade was measured. With regard to muscle fasciculation, postoperative pain, and onset of neuromuscular blockade, "self-taming" with suxamethonium yielded results identical to pretreatment with pancuronium bromide. It may therefore be considered as an alternative to pretreatment with nondepolarizing muscle relaxants.

Adult↗
PubMed1985

[Endoscopic percutaneous gastrostomy--a simple technic for long-term nutrition].

A simple procedure: 'Percutaneous endoscopic gastrostomy' was useful to provide seriously ill patients with a long-term enteral nutritional support. The catheter remained in place for 26 days in median, up to 1 year. No complications were related to the puncture of stomach. One leakage after changing the catheter through a narrowed channel had to be treated surgically.

Adolescent↗
PubMed1984

[Effect of immunoglobulin and antibiotic in E. coli infection of malnourished mice].

Malnourished mice, which exert a greater susceptibility to E.coli induced intraperitoneal infection than standard fed animals, cannot be protected by application of immunoglobulin (2 X 10(5) cells/animal). If, however, an antibiotic (mezlocillin, 500 mg/kg s.c.) is given shortly after infection, the surviving rate increases dramatically to 42%. This effect is enhanced to 63% survival, if the infected animals receive an additional dose of immunoglobulin.

Animals↗
PubMed1984

[Dissociation behavior of peptide diets].

The solution stability of different diets (Peptisorb, Salvipeptid, Survimed and Survimed neutral) was investigated. All diets exert a more or less cream formation. Additionally in some of them one can observe the sedimentation of particulates. When these diets were pumped out of the nutrient bag, as usually done in clinical practice during enteral nutrition, some of them produce an effluent, which contains a high portion of sedimenting particulates at the beginning of the infusion. All of them show a very high colloidal portion in the last pumping fraction. The question is raised, whether these phenomena may lead to an osmotic burden of the bowel, thus in consequence, causing the often observed diarrhoea in tube fed patients.

Chemical Precipitation↗
PubMedDate not supplied

Transintestinal elimination of ciprofloxacin in humans--concomitant assessment of its metabolites in serum, ileum and colon.

Ciprofloxacin (200 mg) was infused to seven patients at the beginning of elective colorectal surgery. Thirty minutes after the end of infusion (i.e. 60 min after the start of the operation) ciprofloxacin reached concentrations of 1.60 mg/l in serum and of 3.42-6.07 mg/kg fresh weight in the ileum and colon. During the next 30 min (90 min after the start of operation) the concentration of ciprofloxacin in serum decreased to 86% of its initial level, but this decrease was less rapid than that observed in the ileal (to 56.8%) or colonic (to 74.8%) mucosa. Three metabolites could be identified (desethylen-, sulpho-, oxociprofloxacin). Initially, at 60 min the amount of these metabolites was about 15% of the total drug concentration in serum, but only 2-3% of that in the gut tissues. At 90 min the relative amount of metabolites was increased in serum as well as in the gut tissues. It is concluded that transintestinal elimination of ciprofloxacin is a general feature of the whole gut. Obviously, the elimination process is not due to degradation of ciprofloxacin within the gut wall.

Adult↗