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Biomedical subjects

D M Geiss

Publications and source records attributed to D M Geiss.

6 recordsLinked to original sources
PubMed1989

Prolonged ventricular support using a centrifugal pump.

The Biomedicus centrifugal pump was required to provide prolonged ventricular support to 13 patients with hemodynamic instability: 11 after cardiovascular surgical procedures, 1 after myocardial infarction and 1 after failure of a heart transplant. The duration of support ranged from 3.5 hours to 9 days (mean 72 hours). Complications included bleeding in six patients, renal insufficiency in three and central nervous system deficit in three. Six patients (46%) were successfully weaned from the pump. The patient with graft failure had hyperacute rejection of a second heart. Five patients were discharged from the hospital. There was one death 8 months postoperatively. Prolonged ventricular support with the centrifugal pump may allow recovery of potentially reversible ventricular dysfunction in selected patients after cardiac surgical procedures.

Adolescent↗
PubMed1987

Hypothermia for the treatment of postsurgical greatly accelerated junctional ectopic tachycardia.

Three infants developed greatly accelerated junctional ectopic tachycardia with a heart rate greater than 200 beats/min after open heart surgery. When the heart rate exceeded 200 beats/min for 5 hours, all the infants had congestive heart failure and clinical signs of low cardiac output. Conventional therapy (cardioversion, lidocaine, verapamil, digoxin and ice to face) has been shown in the past to be unsuccessful in controlling the heart rate. Because hypothermia is known to decrease automaticity of the heart, these patients were treated with induced hypothermia. The goal was to arbitrarily decrease the junctional ectopic rate to less than 180 beats/min to increase cardiac filling time. The duration of the junctional ectopic tachycardia greater than 180 beats/min ranged from 0.5 to 17 hours after cooling began. The duration of the hypothermia ranged from 4 to 24 hours. Spontaneous reversion to sinus rhythm occurred either during the hypothermia or shortly thereafter in all three patients. The blood pressure and urinary output remained stable during hypothermia. Hypothermia is an effective means of controlling the rate of greatly accelerated junctional ectopic tachycardia after open heart surgery in infants. Although hypothermia does not convert junctional ectopic tachycardia to sinus rhythm, it slows the rate to a more acceptable level, allowing the infants' survival and eventual recovery of sinus rhythm.

Electrocardiography↗
PubMed1976

Reversibility of hepatic failure following jejunoileal bypass.

Jejunoileal bypass was performed in 50 morbidly obeses patients. The morbidity encountered compared favorably with that of other series. All patients manifesting hepatic failure demonstrated hyperbilirubinemia within the first three months postoperatively. Hyperbilirubinemia, if uncorrected, resulted in a mortality of 75%. Augmentation jejunal interposition was performed in three patients who demonstrated hepatic decompensation or severe electrolyte imbalance or both. This resulted in rapid correction of electrolyte disturbances, liver function measurements, and patient symptoms without significant postoperative weight gain. Persistent hyperbilirubinemia or recalcitrant electrolyte problems or both are indications for augmentation jejunal interposition.

Body Weight↗