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Biomedical subjects

G Kroesen

Publications and source records attributed to G Kroesen.

At least 19 recordsLinked to original sources
PubMed1990

High-frequency pulsation (HFP) in a patient with Guillain-Barré syndrome.

A patient with Guillain-Barré syndrome (GBS) developed a respiratory crisis despite recurrent treatment with plasma exchange. Thus mechanical ventilatory support became necessary. As an alternative to conventional ventilatory techniques high-frequency pulsation (HFP), a modified high-frequency jet-ventilation technique was used. According to the observations HFP may be a valuable technique for the continuous adaptation to the patient's individual respiratory demands in GBS.

Adult↗
PubMed1990

[The results of prehospital cardiopulmonary resuscitation in the initial years of a mobile emergency care system].

In this study the outcome of out-of-hospital cardiac arrest (CA) was analyzed during the first 3 years after installation of a mobile intensive care unit (MICU). The unit is staffed by an anesthesiologist as the emergency-care physician and specially trained health-care personnel. The success of cardiopulmonary resuscitation (CPR) was classified into three stages: (1) CPR with temporary cardiac output; (2) CPR primarily successful with spontaneous rhythm and a palpable pulse; (3) CPR, definitely successful resulting in the patient's discharge from the hospital without important neurological sequelae. All patients are grouped according to the disease underlying the CA. The performance of bystander CPR was recorded. The influence the factors sex, age, response time, cardiac rhythm, location of the collapse and period of investigation (1st year, 2nd year, 3rd year) had on the outcome was analyzed. RESULTS. Eighty-nine patients (32.96%) had a temporary cardiac output; 56 patients (20.74%) were primarily successfully resuscitated; and 12 patients (4.44%) survived without important neurological sequelae. Most of the diseases underlying the CA were in the internal disease group. Only 16 cases of bystander CPR performance were recorded. In the group with primarily successful CPR, significantly important factors arose with the increasing CPR success rate due to the period of investigation (1st year: 10.00%, 2nd year: 19.61%, 3rd year: 30.77%) and due to cardiac rhythm "ventricular fibrillation" (34.62%) and "asystole" (11.88%). Furthermore, significantly important factors were found for definite CPR success when comparing males (1.72%) and females (10.64%) and comparing the location of the collapse "in public places" (9.80%) and "at home" (2.00%). CONCLUSION. Our study shows that in spite of installing a MICU, the outcome of CPR is poor without supplementary measures. We consider that systematically teaching the public about basic life support measures and teaching medical students about emergency medicine will lead to a better CPR success rate in combination with continuing education of the MICU personnel.

Age Factors↗
PubMed1989

[The use of a transcutaneous pO2/pCO2 combination electrode during volume therapy in a child in shock].

We report a 1-year-old boy in hemorrhagic shock due to a large subgaleatic hematoma following severe head trauma (blood pressure (BP) 30/15 mmHg; heart rate (HR) 110; Hb 45 g/l; arterial pH 7.16; BE-20 mEq/l). The child was intubated and ventilated; initial FIO2 was 0.9. In an attempt to monitor the cardiovascular system noninvasively a transcutaneous oxygen/carbon dioxide combielectrode was placed on the chest. Initially we observed a large difference between arterial pO2 (paO2 = 166 mmHg) and transcutaneous pO2 (tcpO2 = 7 mmHg) and arterial pCO2 (paCO2 = 16 mmHg) and transcutaneous pCO2 (tcpCO2 = 55 mmHg), reflecting poor skin perfusion and severe tissue acidosis. Under aggressive volume replacement tcpO2 rose along with BP and tcpCO2 returned to near arterial values. Even after stabilization of gross hemodynamic parameters such as HR and BP and despite reductions in FIO2, tcpO2 continued to increase with further volume replacement, reflecting an existing volume deficit.

Blood Gas Monitoring, Transcutaneous↗
PubMed1987

Resection of the tracheal bifurcation through a left thoracotomy.

The surgical management of tumors of the left main bronchus with involvement of the lower trachea is one of the most difficult problems of tracheobronchial surgery. Two cases of adenocystic carcinoma in this location are presented, where resection of the tumor and reconstruction of the airway were performed through a left thoracotomy. In one case reconstruction of the tracheobronchial tree could be accomplished without loss of lung parenchyma; in the second case the left lung had to be removed since the lobar bronchi were infiltrated by the tumor. Such extensive left tracheobronchial resections have so far not been reported in the literature.

Adult↗
PubMed1985

Catheter jet ventilation, a favorable technique during resection of the central tracheobronchial system.

Experience with catheter jet ventilation as an optimal ventilation technique during the critical phase of resection in the region of the central tracheobronchial system (bifurcational resections, extended resections in the bifurcational region) in 9 patients is described. For this technique we use a simple and cheap system consisting of a pressure-reduction valve, an interruption valve manually worked with a pistol handle, 2 manometers and a thin plastic catheter as a jet. In 8 cases the anesthesiologic management during the jet ventilation phase, ranging between 35 and 150 minutes, was without any problem; the one complication and the possible way of solving similar accidents are discussed. In comparison with the conventional technique, catheter jet ventilation gives the surgeon the possibility of complete freedom of action during suturing of the airway anastomosis.

Bronchi↗
PubMed1978

Plasma lipids, coagulation factors, and fibrin formation after severe multiple trauma, and in adult respiratory distress syndrome.

Following severe multiple trauma, decreases were observed in a) Free cholesterol, b) Cholesteryl esters, c) Total phospholipids, and d) Lysolecithin. Comparatively slight changes in coagulation parameters did not differ regardless of whether pulmonary complications developed. In contrast, increased fibrin lipid complexing was more closely correlated with clinical data, because: a) Plasmatic lipids, particularly triglycerides complexed with fibrins, were elevated severalfold in patients with adult respiratory distress and fat embolism syndromes when compared with multiple trauma patients without pulmonary complications. This was independent of plasma lipid levels. b) Plasmatic triglycerides complexed with fibrins were significantly higher in patients who died than in those who survived. The considerable changes in the plasma lipid pattern following severe trauma suggest the presence of an abnormal lipoprotein with increased affinity to fibrin, thereby inhibiting fibrinolysis. This might well be one pathogenic mechanism in the development of post-traumatic respiratory distress syndrome.

Adult↗
PubMed1978

[Comparative studies of the warming capacity of 2 blood warmers].

The warming effect of two apparatuses using dry heat and of one apparatus with blood warming by microwaves is measured at the entry of the blood into the venous circulation. The following facts were compared: the time needed to prepare the apparatus, any occuring technical hazards, the relationship between blood temperature and blood flow, and finally the economy of the equipment. The results show alternative indications, on one hand for the use of warmers with dry heat, on the other hand for those with microwaves. The low flows are of interest in the warming procedure of patients with hypothermia following trauma and the blood transfusion applied to infant anaesthesia.

Blood Flow Velocity↗
PubMed1978

[The influences of anesthetic methods on intraoperative cholangiometry (author's transl)].

The influence of several anaesthetic methods on the tonus of the sphincter of Oddi was investigated in 45 selected patients undergoing cholecystectomy (halothane; fentanyl; fentanyl-droperidol (DHB); all in combination with N2O:O2 and relaxant). The fentanyl collective showed a significant rise of the common bile duct pressure, while the fentanyl-DHB and the halothane collectives did not show any statistical difference in their parameters. From these results neuroleptanalgesia appears to be a surtable method for biliary surgery.

Adult↗
PubMed1978

[Technique for removal of anaesthetic vapours from the operation theater. CO2-concentrations in the Jackson Rees system using a removal unit (author's transl)].

The Jackson Rees system was used for short operations in 50 infants combined with or without a system for removal of excess anaesthetic vapours developed by the authors. The CO2-concentration in the system was measured directly before the upper airway of the patients. No statistically significance difference between the CO2-concentration with or without the use of the removal system. A variable power of suction up to 61/min is thought to be sufficient and harmless.

Air↗
PubMed1977

[Post-operative surveillance and intensive care after orthopedic procedures of the vertebral column (author's transl)].

113 corrective procedures of the vertebral column by ventral and/or dorsal approach have been analysed. The post-operative findings have been reported, including blood-gas analysis, hemoglobin and hematocrit, electrolytes, and fluid balance. A correlative-statistical analysis of the scoliosis group was carried out according to number of involved segments, degree of curvature, age, length of operative time and total blood loss. The post-operative complications were related to preexisting risk factors.

Adolescent↗