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G J Teule

Publications and source records attributed to G J Teule.

89 records · Page 5Linked to original sources
PubMed1986

Biventricular function during volume loading in porcine E. coli septic shock, with emphasis on right ventricular function.

In 14 anesthesized pigs, the effect of E. coli (2 X 10(8)/kg) and volume loading on hemodynamics and right and left ventricular performance were studied. Autologous red cells were labeled in vitro with 99mTC (15-20 mCi). Gated blood pool studies and hemodynamics were performed simultaneously. E. coli infusion resulted in an abrupt increase in pulmonary artery pressure, whereas systemic blood pressure fell gradually. Gated studies showed a transient increase in right ventricular end-diastolic volume (RVEDV) after 1 hour; left ventricular end-diastolic volume (LVEDV) declined gradually during sepsis. During volume loading, RVEDV and LVEDV both increased. As estimated from the altered Frank Starling relation between preload and SW, a depressed performance of both left and right ventricle was found. We conclude that volume expansion in porcine E. coli septic shock results in a uniform increase of left and right preload despite a substantial increase in pulmonary vascular resistance.

Animals↗
PubMed1985

Hepatic trapping of red cells in canine endotoxin shock: a variable phenomenon after splenectomy.

We studied in 20 splenectomised dogs the incidence of early intravascular hepatic pooling after administration of E. coli endotoxin. Autologous red cells were labelled in vitro with 99mTc. Bloodpool imaging and haemodynamic measurements were performed simultaneously. Changes in hepatic red cell volume were estimated from alterations in hepatic activity. In 10 dogs, hepatic red cell activity increased considerably (156 to 359% of the basal value). In the remaining animals the hepatic activity did not change markedly or even decreased. The decline in arterial pressure and cardiac output seemed more pronounced in dogs with clear evidence of hepatic pooling. However no significant differences in absolute haemodynamic values could be demonstrated between dogs with and without pooling. It is concluded that an hepatic outflow block is not a constant feature of canine endotoxin shock. Absolute haemodynamic values do not depend on the presence of an outflow block. Thus the presence of hepatic pooling need not make the canine model inappropriate for studies on human sepsis.

Animals↗
PubMed1985

Left and right ventricular function in porcine Escherichia coli sepsis.

In anesthesized pigs, hemodynamic measurements and gated bloodpool scintigraphy were performed during and after infusion of live Escherichia coli (2 X 10(8)/kg). Ejection fractions (EF) as well as the relation between end-diastolic volumes (EDV) and stroke work (SW) were used to evaluate changes in left (LV) and right ventricular (RV) function. Porcine E. coli sepsis proved to be characterized by pulmonary vascular hypertension (PVH) and systemic arterial hypotension, accompanied by a reflex increase in heart rate. Systemic flow remained essentially unchanged. E. coli infusion resulted in pronounced and opposite changes in LV and RV preload. RVEDV increased initially and then returned to the value observed before E. coli infusion. LVEDV showed a continuous decrease during the observation of 3 hours. Alterations in LVSW and RVSW appeared to parallel the changes in LVEDV and RVEDV. No significant changes in LVEF and RVEF were found. It is concluded that porcine E. coli sepsis might be a suitable model for human sepsis complicated by PVH. In this animal model no clear signs of myocardial depression or evidence of right heart failure were observed.

Animals↗
PubMed1984

Diagnosis of deep venous thrombosis with 99mTc plasmin using the gamma camera.

The 99mTc-plasmin-uptake test is a screening test for deep vein thrombosis with a reported sensitivity of 91%-100% and a rather low specificity of 33%-51%. In trying to improve the qualities we used gamma camera imaging and compared the results with those of the standard probe techniques and X-ray venography. In 34 patients, 23 thromboses were detected by venography. The probe technique had a sensitivity of only 75% and the gamma camera technique 100%. The specificity of both techniques was about the same (36% and 50%). A diffuse rather than focal accumulation of radioactivity was seen by the gamma camera technique, indicating that the plasmin test is not based on the detection of hot spots.

Aged↗
PubMed1984

Problems in the treatment of septic shock.

A small review is presented on the problems encountered in the treatment of septic shock. The discussion is focussed on haemodynamic problems. At least three and possibly four haemodynamic mechanisms seem to be involved: peripheral pooling, increased vascular permeability, myocardial failure (right and/or left heart failure) and probably peripheral vascular failure. A method is indicated to study some of these mechanisms.

Animals↗
PubMed1984

Role of peripheral pooling in porcine Escherichia coli sepsis.

In anesthesized pigs the effects of E. coli (2 X 10(8)/kg) on hemodynamics and red cell distribution were studied. After injection of 99m-Tc red cells (15 mCi), regional radioactivity was followed during 3 hours. Gated bloodpool studies were performed to measure end-diastolic volumes (EDV). Escherichia coli E. coli was infused in 14 pigs, while 7 animals served as controls. E. coli resulted in an early increase in pulmonary arterial pressure. Systemic arterial pressure decreased gradually, while cardiac output did not change significantly. The gated studies revealed that especially left ventricular end-diastolic volume (LVEDV) declined, to 50% of the basal value. Regional radioactivity did not change over lungs, liver and abdomen. Splenic activity declined markedly. Over the hindlimb a significant increase (29 +/- 8%) was observed. It is concluded that E. coli infusion in pigs induces a hemodynamic pattern similar to human sepsis. The decrease in LVEDV is probably related to peripheral pooling and a change in right ventricle (RV) performance.

Animals↗
PubMed1983

Reproducibility of ejection fraction measurements by gated equilibrium blood pool scintigraphy.

The reproducibility of ejection fraction measurements has been studied using gated equilibrium blood pool scintigraphy. The use of appropriate statistical tests is proposed and commented upon. The intra-observer variability for our group of patients has a standard deviation of 6.4%, the interobserver variability of 3.2% and sequential studies done on the same and different days give standard deviations (due to "time" alone) of 1.0% and 1.9%, respectively. Different factors and sources involved in variability are mentioned. Variability values reported in the literature are discussed.

Adult↗
PubMed1983

Effect of volume loading and dopamine on hemodynamics and red-cell redistribution in canine endotoxin shock.

We studied in 20 anesthetized dogs (11-15 kg) the effect of volume loading and dopamine in the period between 90 and 120 min after injection of E Coli endotoxin (1.5 mg/kg). Changes in red-cell distribution were estimated from changes in regional radioactivity emitted by autologous 99mTc tagged red cells. Four groups of five animals were formed by randomization, such that effects of dopamine (15 micrograms/kg/min) and isotonic gelation solution (40 ml/kg/30 min) could be analyzed separately and in combination. Ninety minutes after endotoxin a significant decrease in cardiac output, arterial, and pulmonary arterial wedge pressures were observed. Thoracic radioactivity decreased by 26% and an increase in abdominal (11%) and hindlimb (17%) activity was measured, while the changes in hepatic activity were variable. No interaction between dopamine and volume for any parameter was found. Dopamine resulted in an increase in heart rate, while the other hemodynamic parameters did not change significantly. Dopamine resulted only in a slight increase in abdominal radioactivity. Volume loading produced an increase in cardiac output to greater than 200% of the value before endotoxin. This increase was accompanied by a considerable decrease in systemic resistance. No major changes in red-cell distribution were observed. We concluded that volume loading and dopamine did not affect red-cell redistribution in a later phase of canine endotoxin shock. Furthermore, our results suggest that correction of the volume deficit in this model results in a high-cardiac-output-low-systemic-resistance hemodynamic pattern.

Animals↗
PubMed1982

Ventricular function, hemodynamics, and oxygen consumption during infusions of blood and glucose-insulin-potassium (GIK) in canine endotoxin shock.

We have studied the acute effects of blood and glucose-insulin-potassium (GIK) infusions during endotoxin shock in dogs. In a first group (n = 7) we have compared the effects of blood transfusions with those of GIK. Both infusions increased left-ventricular end-diastolic pressure (LVEDP), end-diastolic diameter, mean systemic blood pressure, and cardiac output; but with GIK cardiac output rose more and left-ventricular dP/dt (LV dP/dt) also increased. During GIK end-systolic diameter decreased while it increased during blood transfusion. Peripheral resistance declined after GIK. The hemodynamic effects were of short duration. Oxygen consumption and arterial lactate increased after GIK, while serum phosphate decreased. In a second group (n = 9) we have studied the relationship between changes in serum osmolarity, hematocrit, cardiac output, and LV dP/dt during infusions of either GIK, glucose 50%, or sorbitol 50%. We found a close relationship between changes in serum osmolality, cardiac output, and LV dP/dt. We conclude that GIK has positive inotropic action, probably because it increases serum osmolality. Metabolic effects of GIK probably do not contribute to its early action.

Animals↗
PubMed1981

Preliminary report. Noninvasive detection of blood volume redistribution in canine endotoxin shock.

In 15 splenectomized dogs changes in blood volume distribution after injection of endotoxin or normal saline were followed during 2 hr with a noninvasive method. Autologous red cells were labeled with 6-8 mCi 99mTc in vitro. After injection of the tagged red cells radioactivity was collected by a gamma camera connected to a computer system. In six control animals the radioactivity over thorax, liver, abdomen, and hindlimb decreased in a similar way. This small decrease was found to be the result of elution of 99mTc from the red cells (3-5% per hour). After endotoxin an immediate decline in blood pressure was accompanied by a persisting decrease in radioactivity in the thoracic region and a considerable but temporary increase in hepatic activity. Changes in abdominal activity were variable. Over the hindlimb, a significant increase, 2 hr after endotoxin, was observed. These changes are generally in agreement with reported results obtained by invasive techniques. It is concluded that changes in blood volume distribution can be detected with the described noninvasive method, which in principle could be used in clinical investigation. Considering the elution of 99mTc the method is probably less suitable for longer observations.

Animals↗
PubMed1980

Haemodynamic effects of terbutaline in chronic obstructive airways disease.

Terbutaline, a cardioselective beta-adrenoceptor agonist, administered intravenously (250 micrograms) to seven patients with chronic obstructive airways disease (mean FEV1 0.99 l) resulted in reduction of mean pulmonary artery pressure (resting 23 +/- 2 to 19 +/- 2 mmHg, p < 0.05; exercise 43 +/- 3 to 35 +/- 3 mmHg, p < 0.05) and calculated pulmonary vascular resistance (resting 168 +/- 27 to 109 +/- 17 dyne s cm-5, p < 0.01; exercise 170 +/- 30 to 119 +/- 18 dyne s cm-5, p < 0.01) accompanied by an increase in heart rate (resting 86 +/- 5 to 96 +/- 4 per min, p < 0.01; exercise 108 +/- 2 to 114 +/- 2 per min, p < 0.01) and cardiac output (resting 3.7 +/- 0.4 to 4.1 +/- 0.4, p < 0.05; exercise 4.9 +/- 0.06 to 6.1 +/- 6 l, min-1 m-2, p < 0.05). The haemodynamic changes were associated with an increase in resting peak expiratory flow rate (184 +/- 20 to 216 +/- 25 l/min, p < 0.01), while the calculated indices of ventilation/perfusion relationship remained essentially unchanged. The reduction in mean pulmonary artery pressure after terbutaline observed in the present studies was probably the result of a combination of simple vasodilator effect, the reduction in airways resistance, and increase in the ventilation.

Aged↗
PubMedDate not supplied

Feasibility of planar myocardial carbon 11-acetate imaging.

BACKGROUND: Myocardial oxygen consumption can be determined by using carbon 11-acetate (11C-acetate) and positron emission tomography (PET). The aim of this study was to validate planar 11C-acetate scintigraphy in healthy individuals by relating the myocardial clearance rate of dynamic 11C-acetate scintigraphy with the rate-pressure product, which is used as a measure of cardiac work. Also, the optimal curve-fitting procedure of the time-activity curve and the intraobserver and interobserver variation of determining the clearance rates were assessed. METHODS AND RESULTS: Six subjects were studied at rest, and seven subjects were studied during dobutamine stimulation. Imaging was performed with a planar camera equipped with high-energy collimators for 45 minutes after the injection of 185 MBq of 11C-acetate. Myocardial time-activity curves were corrected for decay. During the study, heart rates and blood pressures were measured to calculate the rate-pressure product. Myocardial time-activity curves showed a clear biphasic pattern. Clearance rates were expressed in k values. The best fitting procedure, as assessed by means of the lowest error of k and the best correlation with the rate-pressure product, proved to be a monoexponential fit on the first part of the time-activity curve (kmono). Subjects studied during dobutamine infusion had significantly higher rate-pressure product (15.0 +/- 2.1*10(3) vs 8.6 +/- 1.2*10(3), P < .001) and 11C-acetate clearance rates (kmono = 0.0657 +/- 0.0110 vs 0.0313 +/- 0.0056, P < .0001) than subjects studied at rest. There was low intraobserver and interobserver variation in determining kmono values. A significant correlation between the rate-pressure product and the monoexponential clearance rate was found (kmono = 5.11*10(-6)*RPP-0.012; r = 0.94, P < .001). CONCLUSIONS: The estimation of myocardial oxygen consumption is feasible with planar 11C-acetate scintigraphy. Clearance rates and the relation with the rate-pressure product are similar to those reported in PET studies. This technique may be used for the assessment and follow-up of global myocardial metabolic abnormalities, eg, in patients with hypertensive heart disease, cardiomyopathy, myocarditis, and valvular disease.

Acetates↗
PubMedDate not supplied

Distribution and kinetics of 131I-labeled human IgM monoclonal antibody 16.88 in patients with advanced colorectal cancer.

Sequential immunoscintigrams were used to describe the relative distribution and kinetics of 8 mg 131I-labeled human IgM monoclonal antibody 16.88 in 20 patients with colorectal cancer. The results show that the initial activity was higher and the clearance rate was faster (P < 0.05) from the left ventricle and liver than from most organs. In bone marrow the reverse was observed (P < 0.05). The biological half-life of 131I(-16.88) in tumor tissue (range 35.4-47.5 h) was longer (P < 0.01) than that in normal tissue (30.2-41.9 h). The image contrast ratio between liver metastases and background increased from 0.8 to 1.3 and for lesions outside the liver from 1.1 to 1.6. The estimated effective dose equivalent was 0.12 mSv/MBq. A second infusion 2 weeks after the first with the addition of unlabeled 16.88 up to 1000 mg for improvement of tumor tissue uptake was not of clinical relevance.

Antibodies, Monoclonal↗