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F K Lippert

Publications and source records attributed to F K Lippert.

8 recordsLinked to original sources
PubMed2001

[Admission, initial examination and care of severely injured in Denmark].

INTRODUCTION: The aim of this study was to describe the initial care and management of trauma patients in Denmark. MATERIAL AND METHODS: A questionnaire was sent to all 64 hospitals in Denmark in July 1999. All responded. The questionnaire covered 81 questions. RESULTS: The number of severely injured patients received by the hospitals was evenly distributed. Nine hospitals received more than 50 severely injured patients/year. Protocols for trauma care were available in 46 hospitals. Monitoring with ECG and pulse oximetry in the emergency room was possible in most hospitals. Most hospitals were also equipped to perform endotracheal intubation, chest tube drainage, surgical airway, and peritoneal lavage. Radiological and clinical laboratory services were available round the clock in most hospitals. Ultrasonography could be performed in 41 and CT in 36 hospitals. Three hospitals did not transfer patients to other facilities. An estimated quarter of the severely traumatised patients are transferred to a hospital with a higher level of trauma treatment. CONCLUSION: Many Danish hospitals receive trauma patients. However, a number of hospitals do not have the necessary organisation, clinical capabilities, or resources for trauma care. There is a need for regional and national guidelines for trauma care with recommendations ensuring early recognition of patients who may be sufficiently cared for in the local hospital, and those who require transfer to trauma centres for definitive care.

Clinical Competence↗
PubMed2001

[Visits to hospital emergency departments after restricted-admission changes at the Rigshospitalet].

INTRODUCTION: The aim of this study was to describe changes in the use of accident and emergency departments in the Copenhagen Hospital Co-operation after restricted admittance to the accident and emergency department at a large Danish university hospital, Rigshospitalet (admittance only for patients transported by ambulance or presenting with a referral from a doctor). MATERIAL AND METHODS: A retrospective study compared the number of patients treated in two periods, 1.7.1998 to 30.6.1999 and 1.7.1999 to 30.6.2000. Additional patient data were collected for the periods 1.7.1998 to 31.12.1998 and 1.7.1999 to 31.12.1999. RESULTS: A 4% decrease was seen in the total number of patients treated at the accident and emergency departments. The decrease in the number of patients treated at the accident and emergency department at Rigshospitalet was 69%, whereas the accident and emergency department at Bispebjerg Hospital experienced a 53% rise. DISCUSSION: The study showed good compliance in the local population after the restricted admittance to an accident and emergency department at a large university hospital. An expected total fall in the number of patients treated at the accident and emergency departments in the Copenhagen Hospital Co-operation could not be documented.

Adolescent↗
PubMed1999

Monitoring of beta-receptor sensitivity in cardiac surgery.

OBJECTIVE: To determine the repeatability of the hemodynamic response to repeated isoproterenol challenge doses to validate the standardized isoproterenol sensitivity test as an index of cardiovascular beta-receptor function. DESIGN: Prospective, single-blind, nonrandomized clinical trial. SETTING: University department of cardiothoracic anesthesia. PARTICIPANTS: Twenty middle-aged men scheduled for primary elective coronary artery bypass surgery, 10 of whom had been treated with cardioselective beta1-antagonists for more than 3 months. INTERVENTIONS: After induction of anesthesia and baseline hemodynamic evaluation, cardiac beta-receptor sensitivity was estimated from the chronotropic/inotropic responses to four intravenous 4-microg isoproterenol bolus doses. MEASUREMENTS AND MAIN RESULTS: Baseline cardiovascular function and pharmacodynamic response to the four isoproterenol challenge doses were monitored with catheters in the radial and pulmonary arteries (thermodilution). Heart rate was continuously recorded and calculated from the electrocardiogram. Baseline hemodynamic status and response to the first 4 microg of isoproterenol were similar in the 10 patients treated with beta1-antagonists and the rest of the patients. In all 20 patients, heart rate response to the three subsequent isoproterenol challenge doses decreased progressively by 28%. CONCLUSION: The standardized isoproterenol sensitivity test is unreliable for clinical monitoring of cardiac beta-adrenoceptor function.

Adrenergic beta-Agonists↗
PubMed1998

[Do cardioselective beta-antagonists block the cardiac beta-receptor function also in the long run?].

As the human cardiomyocyte expresses both beta 1 and beta 2 adrenoceptors it is to be expected that the inhibition of one species of receptors can be counteracted by the other. This hypothesis was tested in 40 middle-aged men scheduled for coronary artery bypass surgery. Half the patients had been treated with cardioselective beta 1 antagonists for more than three months while the 20 control patients had never been beta-blocked. The haemodynamic status after induction of a standardized fentanyl/midazolam anaesthesia and the sensitivity of the cardiovascular beta-adrenoceptors to isoprenaline titration were similar in both groups. In conclusion, patients chronically treated with cardioselective beta 1-blockers compensate for the perturbation to such a degree that their cardiovascular function is indistinguishable from patients who have never received beta-blockers.

Adrenergic beta-Antagonists↗
PubMed1997

Are patients chronically treated with beta 1-adrenoceptor antagonists in fact beta-blocked?

OBJECTIVE: To determine cardiovascular beta-receptor function in patients with ischemic heart disease chronically treated with beta 1-adrenoceptor antagonists. DESIGN: Prospective, single-blind, nonrandomized clinical trial. SETTING: University Department of Cardiothoracic Anesthesia. PARTICIPANTS: Forty middle-age men scheduled for primary elective coronary artery bypass surgery. Twenty patients were treated with beta 1-antagonists. INTERVENTIONS: After induction of anesthesia, increasing intravenous bolus doses of isoproterenol were administered in order to increase heart rate more than 25 BPM. From this dose-response curve, the isoproterenol dose needed to increase heart rate by exactly 25 BPM was calculated. MEASUREMENTS AND MAIN RESULTS: Baseline cardiovascular variables and the pharmacodynamic responses to isoproterenol were monitored with catheters in the radial and the pulmonary artery (thermodilution catheter). Heart rate was continuously calculated from the electrocardiogram. The hemodynamic status after induction of a standardized fentanyl anesthesia and the chronotropic and inotropic responses to the isoproterenol titration procedure were identical in the 20 beta 1-blocked patients and in the 20 control patients. The median dose of isoproterenol needed to increase heart rate 25 BPM was 10.9 micrograms in the beta-blocked patients and 9.4 micrograms in the control group. CONCLUSION: Patients chronically treated with beta 1-antagonists compensate for the perturbation to such a degree that cardiovascular beta-receptor function is in fact normal.

Adrenergic beta-Antagonists↗
PubMed1997

Readiness for surgery after axillary block: single or multiple injection techniques.

We have assessed prospectively the time to readiness for surgery following axillary block (sum of block performance and latency times) in 80 patients. The brachial plexus was identified using a nerve stimulator, and anaesthetized with 45 mL of mepivacaine 1% with adrenaline 5 micrograms mL-1. In group 1 (single injection) the whole volume of mepivacaine was injected after locating only one of the plexus nerves. In group 2 (multiple injections) at least three plexus nerves were located, and the volume of mepivacaine was divided between them. Sensory block was assessed by a blinded observer every 10 min. Patchy analgesia was supplemented after electrolocating the unblocked nerves after 20, 30 or 40 min. The patient was pronounced ready for surgery when analgesia was present in all areas to be operated upon, which always included the three nerves to the hand. The single injection technique required less time for block performance (mean 5.5 min) than multiple injections (mean 9.5 min), P < 0.0001. However, latency of the block was longer and the requirement for supplemental nerve blocks was greater, after single injections (33 min and 57%) than after multiple injections (15.5 min and 7%, respectively), P < 0.0001. As a result, readiness for surgery was achieved faster in group 2 (25 min), than in group 1 (38.5 min), P < 0.0001. After supplementation, block effectiveness was 100% in group 1 and 98% in group 2 (NS). The frequency of adverse effects (vessel puncture or paraesthesia) was similar in both groups. No neurological sequelae were observed. We conclude that the multiple injection technique takes longer to perform than single injection, but that readiness for surgery is faster because of shorter block latency and better spread of analgesia.

Adolescent↗