Biomedical subjects

G Oechtering

Publications and source records attributed to G Oechtering.

5 recordsLinked to original sources

PubMed1998

[Reflections on anesthetic risk].

All anaesthetic drugs and techniques inhere risks, that can cause illness and death even in the sound. Beside this common anaesthetic risk caused by anaesthesia itself, risks specific for the patient and the surgery, the influence of the anaesthetist and the available facilities are additional factors contributing to the risk involved for any particular animal. In this article the factors in anaesthetic risk and their importance for the individual risk of a patient are discussed. Distinct is that a systemic disease and the resulting incapacity stand for a much higher risk than anaesthesia by itself or the surgery. Beside the preoperative physical status the urgency of the operation has a decisive influence upon the anaesthetic risk. Deficient monitoring and an unrecognized and/or untreated respiratory depression are the most common reasons for anaesthetic death in veterinary medicine. The anaesthetist has a profound bearing on the degree of risk to which a patient is exposed, because most of the avoidable anaesthetic mishaps are caused by human mistakes. The individual anaesthetic risk of a patient is determined with the help of the preanaesthetic examination. Referring to the factors in anaesthetic risk strategies for the prevention of anaesthetic mishaps and complications are discussed.

Anesthesia↗

PubMed1996

[Oximetry in veterinary anesthesia: the continuous determination of mixed venous oxygen saturation in dogs and horses].

The continuous fiberoptical measurement of the mixed venous partial oxygen saturation is described. It is an enrichment of the diagnostical possibilities in veterinary medicine. In the horse it is of great interest, because disturbances of the pulmonary gas exchange and the myocardial function are common in the anaesthetised horse, and reliable methods of assessing the cardiac output are rare. Using this monitoring technique in nearly 100 equine high risk patients facilitated insight into the complex changes of the pulmonary, cardiac and circulatory function in the anaesthetised horse. The registered data are the basis of the presented case reports. Values measured "behind the tissue" are influenced by the oxygen supply and the oxygen consumption within the periphery. Changes of the mixed venous oxygen status can be caused by a disturbance of the arterial oxygen status, by a insufficient performance of the cardiovascular system or by a change in metabolic activity. Being a multifactorial influenced parameter the mixed venous oxygen saturation can only be interpreted in connection with other parameters. The mixed venous oxygen status gives global information about the whole organism, but it is not able to inform about the oxygen supply of single organs. From our own personal experience it reflects an aggravation of the patient very early and reliable.

Anesthesia↗

PubMed1996

[The determination of von Willebrand factor activity in the plasma of dogs. 1. Experimental evaluation and methods].

Using a new aggregometer, the plasma activity of von Willebrand factor (vWF) in dogs was measured. The method is described. It has the advantage of being more precisely for the diagnosis of von Willebrand's disease than the determination of von Willebrand antigen (vWF: Ag) by using an ELISA. With the method described reproducible and reliable result can be obtained.

Animals↗

PubMed1995

[Non-invasive patient monitoring in veterinary medicine: pulse oximetry and capnography. II. Capnography].

Capnography measures carbon dioxide concentration or partial pressure of the respiratory gas continuously and non-invasively. The endtidal value is of great diagnostic value, it corresponds approximately to the arterial value, except for ventilation-perfusion-mismatching (horse), shunting (horse), or increased dead-space-ventilation (panting in the dog). Capnography primarily serves for monitoring of spontaneous and artificial ventilation, it is a reliable method for detecting hypo- and hyperventilation. Because metabolism and circulation influence the amount of carbon dioxide eliminated in the lung, capnography monitors these functions too. The plotting of the carbon dioxide concentration as a carbon dioxide-time-diagram draws attention to malfunctions of the equipment. Technical problems of capnography depend on the design of the capnograph (main- or side-stream) used as well as on the weight of the patient. In the discussion the value of pulse oximetry and capnography in detection of critical events during anaesthesia is compared. Capnography is superior to pulse oximetry in the capability to detect critical events. But pulse oximetry complements capnography perfectly, both methods together give a good impression of the patient's state of health.

Animals↗

PubMed1994

[Noninvasive patient observation in veterinary medicine: pulse oximetry and capnography. I. Pulse oximetry].

Two non-invasive continuous techniques for monitoring the respiratory function during anaesthesia have been established during the last year: pulse oximetry for monitoring the adequate oxygen supply and capnography for measuring the carbon dioxide elimination. In human medicine both are accepted as essential monitors with great reliability. Whether clinical use and interpretation can be transferred to animals without any restrictions will be discussed by looking on the physical and engineering background as well as the physiologic interpretation of the measured variable and their capability to detect critical events during administration of anaesthesia. Part I: Pulse oximetry measures the arterial oxygen saturation continuously and non-invasively. Its application in veterinary medicine must be discussed critically concerning the method as well as the interpretation. The information obtained is very different during injectable and inhalant anaesthesia. Respiratory depression is easy to detect while the animal breathes room air spontaneously. Is the inspired air enriched with oxygen, like during inhalant anaesthesia, normal values of oxygen saturation can mask the respiratory insufficiency and may give a false sense of security.

Anesthesia↗