PubMed Health⌕ Search

Biomedical subjects

D Claussen

Publications and source records attributed to D Claussen.

At least 19 recordsLinked to original sources
PubMed1997

[Malignant hyperthermia and sevoflurane--a case report].

The authors report on a course of malignant hyperthermia (MH) in an almost 5-years old boy. In the past, he had been anaesthetized two times with halothane without complications. The causative triggering agent was sevoflurane, a new user-friendly substance for paediatric anaesthesia. Forty five minutes after induction of anaesthesia he developed symptoms of a MH-crisis with increase in endexspiratory CO2 up 87 mmHg and followed by an increase in heart rate up to 160 beats/minute. The blood gas analysis showed a respiratory and metabolic acidosis. The timely administration of dantrolene rapidly reversed the life-threatening signs and prevent progression of the disease. It is apparent that monitoring of endtidal carbon dioxide by means of capnometry is of crucial importance in detecting MH at an early stage, and appropriate treatment is being instituted more promptly. By such early recognition, and treatment with dantrolene, we can reasonably except a further decrease in mortality and morbidity of this enigmatic disorder.

Anesthetics, Inhalation↗
PubMed1994

[Pituitary crisis and acute renal failure--a case report].

Based on a case report, the combined occurrence of a hypopituitary crisis and acute renal failure (ARF) is discussed. Aetiologically, the patient's disease dates back to an operation on the pituitary gland 40 years previously followed by a panhypopituitarism. The course of the disease presented initial symptoms which did not suggest a hypopituitary crisis to the first physician. The patient was hospitalized primarily on the tentative diagnosis of encephalitis. Subsequently, both laboratory findings and sonography of the abdomen pointed to chronic renal failure. The severity of the clinical course led to the transfer of the patient to our hospital for haemodialysis. Examination of the soporous patient revealed in addition to symptoms of ARF based on ambilateral pyelonephritic nephrocirrhosis typical cardinal symptoms of an endocrine insufficiency. Sopor, serious exsiccosis, pale, cool, pigmentless skin, deficiency of axillary and pubic hair, gonadal atrophy, hypotonia, hypothermia, bradypnoea and bradycardia as well as anamnesis of the patient substantiated the tentative diagnosis of a hypophysical coma based on hypopituitarism, clinically dominated by hypothyroidism. Following an immediately launched hormone substitution in combination with haemodialysis the state of the patient improved. However, during the fifth haemodialysis cardiac arrest occurred, the cause of which was put down to a dysequilibrium syndrome. The cause, however, must be seen in a continuing stress situation, inadequate hormone substitution and in sedation with diazepam. After reanimation the patient was transferred to the ICU.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1992

Mazicon (flumazenil/Roche).

Flumazenil exerts its effect by competitive inhibition of the benzodiazepine agonist from the receptors in the CNS, thereby blocking the effect of the agonist. Flumazenil, in doses to 1.0 mg intravenously, has been shown in clinical trials to be effective for the complete reversal of benzodiazepine sedation after intravenous conscious sedation or general anesthesia. It is effective even in the presence of other drugs, including opioids. Most patients are aroused and completely alert within a few minutes after the administration of flumazenil and maintained their alertness throughout the 180-min observation period.

Flumazenil↗
PubMed1992

Omnipaque (iohexol).

The largest nationwide comparative clinical study evaluated 337,647 patients receiving high-osmolar ionic contrast media or low-osmolar nonionic contrast media and the incidence of adverse drug reactions. The overall prevalence of adverse drug reactions was 12.66% in the ionic contrast media group and 3.13% in the nonionic contrast media group. Severe adverse drug reactions occurred in 0.22% of examinations in the ionic contrast media group and in 0.04% of examinations in the nonionic contrast media group. Thus, the use of nonionic contrast medium significantly reduces the frequency of severe and potentially life-threatening adverse drug reactions to contrast media.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1992

Asacol (mesalamine).

Asacol (mesalamine) is a delayed release pH-sensitive, polymer-coated, oral preparation of 5-ASA which releases the drug in the terminal ileum and colon for the treatment of mildly to moderately active ulcerative colitis. Treatment modalities using Asacol appear to be an alternative for sulfasalazine-sensitive patients as well as potential first-line therapy in the treatment of irritable bowel diseases.

Aminosalicylic Acids↗
PubMed1992

Sandostatin (octreotide acetate).

Sandostatin is an antineoplastic drug used to control diarrhea and improve hypokalema in patients with metastatic carcinoid tumors and vasoactive intestinal peptide-secreting tumors. Sandostatin has been used to treat life-threatening hypotension and acromegaly. Sandostatin has also been used after endoscopic retrograde cholangiopancreatography to reduce the motility of the pancreas. Generally side effects of Sandostatin are rare and medically manageable when recognized. Chronic therapy with Sandostatin warrants monitoring of serum electrolyte and blood glucose levels. Baseline thyroid studies should be investigated prior to therapy and monitored throughout therapy. Sandostatin may alter fat absorption and gallbladder function; therefore, monitoring of appropriate laboratory values and ultrasonography studies may also be indicated.

Humans↗
PubMed1992

Droperidol (Inapsine).

Droperidol may be used to bring about conscious sedation in therapeutic and diagnostic endoscopy. Droperidol is a neuroleptic tranquilizer that produces marked tranquilization and sedation. Droperidol may be used to allay apprehension and provide a state of mental detachment while maintaining reflex alterness necessary in endoscopic interventions. Adverse reactions to droperidol are generally self-limiting or readily managed with hydration to correct hypotension.

Adjuvants, Anesthesia↗
PubMed1991

The helminth fauna of the common seal (Phoca vitulina vitulina, Linné, 1758) from the Wadden Sea in Lower Saxony. Part 1: Trematodes, cestodes and acanthocephala.

Between August 1988 and January 1989 110 common seals found dead along the coast of Lower Saxony were investigated for the occurrence of trematodes, cestodes and acanthocephala. Two fluke species, Cryptocotyle lingua Creplin, 1825 and Phagicola septentrionalis Van Den Broek, 1967, two tapeworm species Diphyllobothrium cordatum Leuckart, 1863 and Diphyllobothrium elegans Krabbe, 1865, and the acanthocephala species Corynosoma strumosum Rudolphi, 1802 were found. Phagicola septentrionalis and the cestodes were always found together with Cryptocotyle lingua. The prevalence of Phagicola septentrionalis, the diphyllobothriids and the acanthocephala increased with increasing age of the pinniped host. The worm counts of all species appeared to increase with increasing age of the host. The adult male seals were more often infested with Phagicola septentrionalis and cestodes than the female adults and the younger pinnipeds. There was no correlation between blubber thickness of the seals and parasitic infection. The prevalence of the diphyllobothriids and the intensity of the infection with acanthocephala were higher in seals found in the eastern part of the Wadden Sea.

Acanthocephala↗
PubMed1991

The helminth fauna from the common seal (Phoca vitulina vitulina, Linné, 1758) of the Wadden Sea in Lower Saxony. Part 2: Nematodes.

During the seal epidemic in 1988 and the beginning of 1989, 115 common seals found dead on the shores of the Wadden Sea of Lower Saxony were investigated for the presence of nematodes. The lungworm Otostrongylus circumlitus Railliet 1899 was found in 26.1% of the seals, the lungworm Parafilaroides gymnurus Railliet 1899 in 26.9% and the heartworm Dipetalonema spirocauda Leidy 1858 in 32.2% of the seals. In the digestive tract, two anisakid species were found, Pseudoterranova decipiens Mozgovoi 1951 in 87.8% and Contracaecum osculatum Rudolphi 1802 in 10.4% of the seals. Statistical analysis revealed a negative correlation between age of the seals and prevalence and intensity of infestation with the two lungworm species and the heartworms. Adult seals were found not to be infected with Dipetalonema spirocauda and Parafilaroides gymnurus, whereas the prevalence of the two anisakid species increased with increasing age of the seals. Pseudoterranova decipiens was found more often in autumn and winter than in summer. This parasite was more prevalent and had higher worm counts in the eastern part of the Wadden Sea than in the western part. Parafilaroides gymnurus and Dipetalonema spirocauda were found more often in seals with smaller blubber thickness than in well fed seals.

Age Factors↗
PubMed1990

[Functional scintigraphic studies of perfusion and ventilation during high frequency jet ventilation (HFJV)].

In a controlled study, functional-scintigraphic investigations into perfusion and ventilation were performed on 10 dogs with non-damaged and extremely severely damaged lungs. The pulmonary damage was produced by injecting oleic acid (OA) into the right atrium of the heart under controlled ventilation (IPPV). The scintigraphic examinations were carried out using 133Xenon. The study compared HFJV (HFJV100, HFJV300) with IPPV in the non-damaged lung as well as HFJV300 with IPPV and CPPV (PEEP 1 kPa) after damage by OA. With the aid of the present radionuclide investigations, new insights can be gained into the largely unclear regional conditions of the gas exchange under HFJV in both the healthy and the damaged lung. Results from controlled studies on the distribution of ventilation and perfusion under HFJV have not been reported to date. The functional-scintigraphic examination with 133Xe on dogs shows, based on specific conditions of the gas exchange and special anatomic conditions of the lungs, a ventilation distribution that differs fundamentally from all other forms of ventilation, including HFOV, preference being given to apical pulmonary segments. This refers to the normal and the damaged lungs alike. However, ventilation-specific changes in pulmonary perfusion do not occur. The resulting deviating regional VA/Q relationship are obviously not of crucial influence upon the gas exchange. Rather, it is influenced and determined by damage-induced intraregional functional-structural alterations in the lung.

Animals↗
PubMed1990

[Circular intrathoracic tracheal replacement by a devitalized artery in the dog].

Prepared artery (origin: human, calf, dog) with external or internal teflon-spiral-supporting was implanted in dogs (n = 10) as a circular intrathoracic tracheal substitute after cross-resection. Human arteries were rejected (n = 2). Calf arteries (n = 5) and dog arteries (n = 3) were incorporated fibrously. Central granulations appeared. The longest survival time was 36 days.

Animals↗
PubMed1990

[High-frequency jet ventilation and the function of the right heart--an animal experimental study].

In a controlled study, 10 dogs with normal and severely damaged lungs were subjected to nuclide angiocardiographic investigations into the function of the right ventricle. The pulmonary injury was produced by infusion of oleic acid (OA) into the right atrium during controlled ventilation (IPPV). The angiocardiographic examinations were performed using 133Xenon in the first pass technique. The study compared HFJV (HFJV 100, HFJV 300) with IPPV in the non-damaged lung as well as HFJV 300 with IPPV and CPPV (PEEP 1.0 kPa) after injury by OA. Whereas for the non-damaged lung no different right ventricular (RV) function between IPPV and HFJV was observed, the RV functional parameters after OA injury under HFJV showed, as opposed to CPPV, more favourable values on the whole. This became clear in particular in the significantly higher ejection fraction (RVEF) during HFJV. The RV function which is influenced during CPPV in terms of a favourable oxygenation is the consequence of an increased mean pressure in the airways with subsequent rise in the RV afterload and decrease in the RV preload. In contrast, the more favourable RV haemodynamics during HFJV are associated with a comparatively lower mean airway pressure and a significantly worse oxygenation. As the RV function also during HFJV has to be seen in direct dependence on the mean airway or intrapulmonary pressure necessary for sufficient oxygenation, the employment of this form of ventilation in the presence of an acute respiratory insufficiency has no impact on the RV haemodynamics different from the other compared forms of ventilation.

Animals↗
PubMed1989

[A comparison between high-frequency jet ventilation (HFJV) and conventional positive end-expiratory pressure ventilation (CPPV)--an experimental study on dogs with acute lung damage].

In a controlled study on 24 dogs with severe damage to the lungs HFJV was compared to CPPV on the basis of selected cardiorespiratory parameters. The pulmonary damage was produced by injection of oleic acid (OA) into the right atrium under conventional mechanical ventilation (IPPV). After the damage, the dogs were randomly allotted into one of two groups. Twelve dogs (group I) were ventilated for 5 hours with a PEEP of 10 cm H2O (1 kPA), 12 animals (group II) for 5 hours with HFJV. The oleic-acid-induced damage results in the known hypoxaemia with an increase in the intrapulmonary shunt. After changing to CPPV, the PaO2, which fell from 27.2 +/- 3 kPa to 10.8 +/- 2.9 kPa, rises to 20.3 +/- 7.7 kPa, but shows no further significant alteration until the end of the experiment. In contrast to the clearly improved oxygenation, essential cardiocirculatory parameters (CI, SVI, RVSWI, LVSWI, TCO2) are partially reduced by more than 50% of the initial values. PAP, PCWP, HR, TPR and PVR increase significantly, MAP remaining nearly unchanged. After changeover to HFJV, there is first a further fall of PaO2 from 11.1. +/- 3.0 kPa to 9.1 +/- 1.4 kPa following OA, then, however, until the end of the experiment, a continuous elevation to 15.6 +/- 2.4 kPa with a mean airway pressure that is by 75% lower. The haemodynamic parameters show no significant changes as compared to the initial values, overall, however, they lie significantly below or above those of group I. The results from our investigations allow to draw the conclusion that, despite haemodynamic advantages, HFJV in consequence of deterioration of the arterial oxygenation currently is no alternative superior to CPPV in ventilating the severely damaged lung.

Animals↗
PubMed1989

[The use of the jet ventilation technic in surgical interventions on the trachea].

Based on our own experiences and on comparisons with the literature, we demonstrated the possibilities and problems of jet ventilation technique during surgical interventions at the trachea. This method has been applied 28 times and in two cases surgical manipulations caused complications in the form of bronchial bleedings, with the occurrence of hypoventilation in one case. Due to the essentially improved prerequisites for the surgeon and optimal ventilation, the procedure of jet ventilation presents a true enrichment of the anaesthesiological repertoire, provided the indications are well established and the cooperation between surgeon and anaesthetist is good. On the other hand, however, owing to insufficiencies in the adequate monitoring if this form of ventilation, a comparably higher risk for the patient has to be taken into account.

Adult↗