Biomedical subjects

G Mollenhoff

Publications and source records attributed to G Mollenhoff.

2 recordsLinked to original sources

PubMed1999

[In Process Citation]

Mechanical ventilation is a well-established strategy in intensive care medicine. ICU trauma patients require analgesia, and sedation mostly consists of benzodiazepines and opioids with increasing doses over time. The weaning period is complicated by the withdrawal syndrome, showing tachycardia, hypertonia, tachypnea and restlessness. Although treatment with clonidine can influence these symptoms, tachypnea still remains the main problem in weaning patients from mechanical ventilation. Adding sufentanil, an opioid with greater effects on analgesia than on respiratory depression compared with fentanyl, tachypnea can be reduced to normal frequency. In this way weaning management can be managed more easily for the benefit of both, the patient and physician. In comparison with a group of 50 patients treated with clonidine alone, 72 patients treated with clonidine/sufentanil showed a shorter period from the start of spontaneous ventilation until extubation (4.8 vs 7.6 days) and until discharge from the ICU (7.7 vs 12.4 days). The number of reintubations caused by respiratory exhaustion decreased from 16.0 to 2.8%.

Journal Article↗

PubMed1996

[Perineal injuries in complicated pelvic trauma].

Severe comminuted pelvic ring fractures are often associated by genitourinary and rectal injuries. Because of severe retroperitoneal bleeding, shock management has to be initiated before further diagnosis of the perineal lesions. If normotonic conditions cannot be achieved by volume replacement, a pelvic clamp is indicated providing immediate reduction of the posterior pelvic ring. A subsequent emergency laparotomy has to be considered if stable circulatory conditions cannot be achieved by these emergency procedures. After the initial management of the hypovolemic shock further examination of the rectum by endoscopy and endosonography is performed. Urethral lesions have to be excluded by ultrasound of the bladder, retrograde urethrography and intravenous urography. Urethral and bladder injuries can be initially treated by suprapubic fistula, whereas rectal and pararectal wounds have to be managed by immediate debridement, jet-lavage and wound drainage. Rectal wall and sphincter lacerations are initially restored by suture because delayed reconstructions have poor results. A deviation colostomy is mandatory in cases of colonic and rectal injuries about the internal sphincter.

Colon↗