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Biomedical subjects

E Jungck

Publications and source records attributed to E Jungck.

12 recordsLinked to original sources
PubMed1987

[Involvement of the growth hormone in rapid increases of the potassium concentration of the serum].

As a rule, the infusion of arginine hydrochloride is followed by an increase in serum potassium. The investigation is concerned with the short-term effect of growth hormone, which can be stimulated by arginine (0.6 g/kg body weight), on potassium concentrations in rats and patients with cerebral death. The administration of human somatotropin causes a significant rise in potassium concentrations in patients with cerebral death (0.4 IU/kg body weight) and in rats (4.0 IU/kg body weight). In comparison, the infusion of arginine hydrochloride will produce only a slight increase in serum potassium in both hypophysectomized rats and patients after cerebral death. Four of the ten animals even exhibited decreases in serum potassium content. Investigations of the cationic property of arginine are used to interpret the potassium increases in the extracellular space. The transport of amino acids through the cell membrane, which can be affected by somatotropin, is put forward as a further explanation. All findings are based on measurements carried out 10-30 min after termination of the infusion.

Anesthesia↗
PubMed1983

[Resuscitation injuries].

This investigation is based on 140 autopsy protocols of unsuccessful resuscitation procedures (Resuscitation Center of the Army Hospital, Hamburg); injections and closed-chest cardiac massage had been performed in every case. - Most of the patients had collapsed because of cardiac shock; patients with thoracic or abdominal injury were excluded from this study. In individual cases only, the following severe complications originated from the resuscitation procedures: fracture of a chest vertebra, serial fractures of ribs resulting in an unstable thorax, bilateral haemothorax, tension pneumothorax, rupture of kidney and of spleen (but not of liver). In one case the lesions caused by the resuscitation measures must be considered as responsible for the lethal outcome. Fractures of ribs and/or sternum were found in 45.9% of all cases, the frequency increasing with age. The number of fractured ribs ranged up to 16, mainly 3-8 ribs were fractured. Fractures of rib No. 1 and 8-12 were very rare. The fractures were located between the parasternal and axillary lines.--In a comparative study the site of rib fractures after heavy blunt thoracic injuries was preferably found in the dorsal region.

Adult↗
PubMed1983

[Erosion hemorrhage from an esophago-aortic fistula in congenital anomaly of the thoracic aorta as a fatal complication of a stomach tube].

UNLABELLED: A 6 year old boy was admitted to ICU because of severe polytrauma. He was ventilated for 4 weeks using a nasotracheal tube (high-volume-low-pressure cuff) and fed by nasogastric tube for 6 weeks. After this time severe haemorrhage from the oesophagus occurred, caused by an oesophago-aortic fistula. Bleeding could be stopped by a Sengstaken-Blakemore-tube. The child died during emergency thoracotomy as a result of ventricular fibrillation after clamping of the aorta. Autopsy revealed a malformation of the aortic arch (type II B 4a according to Kirklin and Clagett 1950). This vascular ring had been the site of a pressure necrosis of the oesophagus due to the nasogastric tube. Finally an erosion of the aortic malformation (a. lusoria) had been the result. CONCLUSIONS: Malformation of the aortic arch sometimes can be suspected by x-ray of the chest: right-sided shadow of the ascending aorta. If severe arterial bleeding from the oesophagus occurs, one should think of this malformation. A Sengstaken-Blakemore-tube can be a useful emergency method for temporary stopping of haemorrhage.

Aorta, Thoracic↗
PubMed1983

[Experiences with the steroid narcotic alfaxalone/alfadolone (Aurantex) in emergency patients in rescue service].

Prehospital emergency patients, especially with polytrauma and/or severe head injury need sedation for intubation and transportation. The use of relaxant drugs is dangerous under these circumstances. The "ideal drug" for this indication should not have any harmful effects on respiration, circulation, intracranial pressure, and should facilitate intubation. Short action without cumulation is desirable to make an early neurological diagnosis possible. Althesin was studied in our rescue service (ambulance and helicopter) in 133 cases (trauma n = 91, neurologic n = 18, cardiologic n = 12, intoxication n = 12), Althesin facilitated intubation in 129 cases, and was generally sufficient for sedation. Negative side effects were not seen provided althesin was correctly used. The necessity of the preceding use of an antihistaminic drug is emphasized. Althesin should not be used in patients suffering from severe cardiac disease because of its possible negative influence on cardiocirculatory function.

Adult↗
PubMed1982

[Tube change in nasotracheally intubated intensive care patients using injector ventilation: a method for the prevention of hypoxic complications].

Conventional methods for the replacement of nasotracheal tubes are often dangerous. The interruption of respiration while replacing the nasotracheal airway may cause severe hypoxia. We developed a technique which shortens the time of apnoe to a few seconds. A 16F nasogastric tube is connected to a simple jet ventilation device driven by 100% oxygen. The nasotracheal tube is disconnected from the respirator and its cuff deflated. While performing jet ventilation (inspiration time 1.5 sec, frequency 12/min., pressure 1.5-2 bar) the nasogastric tube is threaded into the nasotracheal tube until the tip lies inside its distal end. The old endotracheal tube can now be retracted over the nasogastric tube under continuous jet ventilation. The nasogastric tube need only be disconnected from the jet ventilator for a few seconds while the old endotracheal tube is replaced for a new one. Now the new endotracheal tube is guided into the trachea by the nasogastic tube while jet ventilation is continued. We used this technique 19 times without any complications. We found the method safe and simple, giving sufficient ventilation in all patients, provided that contraindications and precautions are observed.

Adult↗
PubMed1982

[Thiopental for the prevention of severe brain damage after carbon monoxide poisoning. Case report on 3 cases].

Three cases of severe carbon monoxide poisoning are described presenting with deep coma, generalised extensor spasms and myoclonia as symptoms of acute midbrain syndrome. Despite this poor prognosis all patients survived without essential neurological impairment. This favourable outcome is thought to be due to the administration of thiopentone for the amelioration of hypoxic brain damage in dosages commonly employed in anaesthesia.

Adult↗
PubMed1981

Mixture of bupivacaine 0.5% and hyperbaric mepivacaine 4% for spinal anaesthesia.

Recent research shows that using more than 12.5 mg bubivacaine for spinal block may possibly be harmful. A dose of 12.5 mg isobaric bupivacain does not always establish a spinal anaesthesia sufficient for hip or lower abdominal surgery. However short acting local anaesthetics of sufficient effectiveness usually do not last long enough for those operations. We evaluated a method using the subarachnoid injection of 2 to 3 (4) ml of an equal parts mixture of isobaric bupivacain 0.5% and hyperbaric mepivacaine 4%. We generally achieved good spinal anaesthesia with quick onset and long duration of action making longer operations such as total hip endoprothesis possible. The duration of action was longer (130 min) than that of plain mepivacaine (90 min) and shorter than that of plain bupivacain.

Aged↗
PubMed1977

[Recovery from apparently hopeless fresh-water drowning (author's transl)].

Report of 3 cases of drowning (children). 2 patients survived without severe injury, 1 patient died after 13 days. The protective action of hypothermia to the brain and heart in hypothermic drowning is emphasized. Even in apparently hopeless cases resuscitation should be started immediately and should not be discontinued too early. Especially in hypothermic drowning efforts can be successful after more than 60 min. of resuscitation. In cases of drowning an emergency physician should be called immediately (emergency-ambulance, rescue-helicopter). A short survey of pathologic physiology, emergency therapy and intensive care of drowning is given.

Adolescent↗
PubMed1975

[Soft tissue calcification - a complication in intensive care patient (author's transl)].

In this paper two cases of soft tissue calcification in patients suffering from severe head injuries are reported. The pathologic physiology of calcium and phosphate metabolism and possible causes of soft tissue calcifications are discussed. The value of prophylaxis is emphasized. If treatment by aluminum hydroxide or Na2SO4-infusions does not lead to success surgical treatment will be necessary. Presently therapy by vitamin D, diphosphonates and thyreocalcitonin is under clinical investigation.

Accidents, Traffic↗