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Biomedical subjects

F Kulka

Publications and source records attributed to F Kulka.

At least 19 recordsLinked to original sources
PubMed1991

Estimation of the optimal tissue oxygenation parameters in adult respiratory distress syndrome (ARDS).

We hypothesised earlier that the simultaneous examination of the basic tissue oxygenation parameters (O2 delivery-DO2, O2 extraction ratio-O2ER, O2 consumption-VO2) results in a more adequate relationship to characterize the oxidative metabolism of tissues than a separate evaluation. The aim of present study was to prove this hypothesis. That is for while the results of these oxygenation measurements were examined simultaneously in a 3-dimensional analysis in 30 patients with ARDS. It was found that all measured values distributed on a 3-dimensional space net. An optimal range on the tissue oxygenation surface could be separated where 64% of the data of survivors were inside this range, while 77% of the data of "late stage" nonsurvivors--patients, where the measurement were done on the last 5 days of their life--were outside this range. The therapeutic goal in the treatment of ARDS patients is to change the oxygenation parameters to be inside this optimal range.

Adolescent↗
PubMed1988

Surgical alternatives in ipsilateral recurrence of bronchogenic carcinoma.

In our unit, 5847 patients had pulmonary resections for bronchogenic cancer. Among them, 30 patients suffering from ipsilateral recurrence were operated upon. Recurrence because of incomplete first resection was found most frequently. Operations on ipsilateral recurrent tumours involve a high mortality. However, secondary resection of a recurrent bronchogenic carcinoma may sometimes be a suitable step towards achieving an appreciable survival.

Adult↗
PubMed1987

Tissue oxygenation in septic respiratory failure.

The relationships between tissue oxygenation and the different haemodynamic and respiratory parameters were studied in 20 patients with ARDS of septic origin. Good regressions were found between O2 delivery and cardiac index (r = 0.8507), O2 delivery and systemic vascular resistance (r = -0.7051), O2 extraction ratio and mixed venous O2 saturation (r = 0.8978), O2 consumption and cardiac index (r = 0.6593), O2 consumption and systemic vascular resistance (r = -0.6548), and O2 consumption and mixed venous O2 saturation (r = -0.7068). The correlation among the parameters of tissue oxygenation was more expressed between O2 extraction ratio and O2 consumption (r = 0.7285), than between O2 delivery and O2 consumption (r = 0.6095). A better result was achieved by multiple regression analysis, where the multiple r was 0.9748 between O2 consumption and O2 delivery + O2 extraction ratio, whereas the other variables did not increase the multiple r significantly. These regressions also proved the relationship following from the Fick equation, that is O2 consumption is the result of O2 delivery multiplied with the O2 extraction ratio.

Adolescent↗
PubMed1987

A new reflux-free surgical esophageal intubation technique.

Pull-through esophageal intubation with a composite, detachable prosthesis allows insertion of the tube only in the narrowing due to the tumor. Using this easy technique, which permits a convenient low, small 3 millimeter gastrotomy, the intra-abdominal contamination is reduced. The end of the tube does not pass across the cardia, so the patient is free from gastroesophageal reflux and its consequences.

Esophageal Stenosis↗
PubMed1986

Tissue oxygenation: another aspect of the Fick equation.

Substituting the formulas of O2 delivery (DO2) and O2 extraction ratio (O2ER) into the Fick equation, a new equation representing tissue oxygenation is obtained: VO2 = DO2 X O2ER. This aspect of the Fick equation is important in clinical practice as it provides a reliable picture of tissue oxygenation if all related variables are examined together.

Cardiac Output↗
PubMed1984

[Analysis of reoperations after 10,000 lung resections].

Within a period of 17 years (1965 to 1981) 10,000 patients underwent lung resections at our dept. A reoperation was required in 392 cases. The reinterventions are classified into three groups: urgent, early and late reoperations. The proportion of urgent and early interventions is 1.2%. 392 cases are also analysed according to the type of complications, character of primary disease, as well as method of treatment. Detailed discussion is provided for the most frequent complications requiring reoperation, such as bleeding, bronchus fistula and pulmonary infarction. Viewpoints of treatment are described and method of prevention are emphasized.

Adult↗
PubMed1982

Saphenous-jugular bypass as palliative therapy of superior vena cava syndrome caused by bronchial carcinoma.

This study discusses the techniques and results of the saphenous-jugular bypass procedure. The operation was introduced into Hungarian medical practice and used for palliation of superior vena cava syndrome (SVCS) resulting from malignant disease. The bypass operation was performed on seven patients to relieve symptoms of SVCS caused by unresectable bronchial carcinoma. Postoperative survival times averaged 6.1 months. The symptoms of SVCS were relieved in all patients and did not recur. This study also compares the operative results of the saphenous-jugular bypass operation with results of the widely known operative techniques.

Antineoplastic Agents↗
PubMed1981

Pulmonary and systemic circulatory responses elicited by hyperosmotic solutions injected into the bronchial artery.

In open chest anaesthetized dogs the haemodynamic effects of solutions of equal hyperosmolarity (viz. NaHCO3 8%, NaCl k.6%, and glucose 34.3%, solutions) given into the bronchial artery were studied. Administration of any of these solutions directly into the bronchial artery resulted in increased cardiac output, stroke volume, bronchial blood flow, and bronchial fraction of the cardiac output, and decreased heart rate and bronchial as well as pulmonary vascular resistances. When given into the pulmonary circulation, the same solutions evoked similar reactions of smaller magnitude. To exclude the effect of major surgical trauma and the open-chest condition, another experimental model closer to the physiological situation was also developed. In this preparation NaHCO3 failed to produce the above haemodynamic response even when given into the bronchial artery. After a one-hour bleeding period resulting in a drop of arterial blood pressure to 40 mmHg, while using the same preparation, the administration f NaHCO3 solution into the bronchial artery caused a significant rise in blood pressure in both the systemic and pulmonary arteries. In these experiments a correlation was found between arterial oxygen tension and the extent of change in blood pressure. The exact mechanism of action of the observed haemodynamic changes is still not clear. However, it is likely that receptors localized in the area of the bronchial circulation and sensitive to hypoxia might have played a role in the development of the haemodynamic effects described.

Animals↗
PubMed1979

Role of the arterial bronchial system in the pathomechanism of the shock lung.

Experimental results suggested that in normovolaemia 0.5% of the total pulmonary circulation flows through the bronchial arteries. In haemorrhagic shock bronchial flow dropped to 0.04% of the total pulmonary circulation and ceased completely below 40 mmHg. The authors claim that a hypoperfusion of both circulatory systems (pulmonary and bronchial) is an important pathogenetic factor in the first step of the development of the shock lung. A two-hour abolishment of the nutritive circulation of the lung caused already hypotension, hypoxaemia and metabolic acidosis. Tissue hypoxia was confirmed by the rise in the enzymatic activity of the lung tissue. An abolishment of bronchial circulation in the described manner was enough to induce the development of the shock lung, as confirmed by the visible changes (changed colour, greater weight, development of congestive atelectasis and oedema) of the lung and by the haemodynamic and respiratory changes. Here too the increase in pulmonary vascular resistance is attributed an important role due perhaps in the beginning to an enhancement of the sympathetic tone and later to hypoxia and metabolic acidosis. If the effect of haemorrhage alone is compared to the effect of simultaneous haemorrhage and elimination of the bronchial artery, it appears that the functional lesion of the lung becomes considerably more pronounced with the abolishment of the nutritive circulation. Severe hypoxia and metabolic acidosis cause an extreme rise of the pulmonary vascular resistance. The severity of metabolic acidosis, the degree to which pulmonary vascular resistance has increased and its duration seem decisive from the aspect of both the development and outcome of the shock lung.

Animals↗
PubMed1978

[Experimental model for the study of the vascular system of the bronchial artery].

An experimental model was worked out for the isolated study of the vasculal system of the bronchial artery. The model allowed to study 1) the role of bronchiar circulation in the pathomechanism of the shock lung; 2) the effect of charges in fusion of the isolated circulation of the microstructure of the lungs; 3) the effect of changes in pH, CO2 level and O2 tension on the greater and lesser circulation, on ventilation, CO2 loss, and O2 uptake were studied.

Animals↗