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Biomedical subjects

G Schüpfer

Publications and source records attributed to G Schüpfer.

35 records · Page 2Linked to original sources
PubMed1997

[Oxygen embolism after use of hydrogen peroxide in thoracic surgery].

UNLABELLED: Hydrogen peroxide is often used for irrigation of surgical wounds. In the presented two cases hydrogen peroxide was used to irrigate the thoracic cavity after thoracotomy for lung surgery. After irrigation with hydrogen peroxide only one patient showed clinical signs of pulmonary embolism. In both cases the postoperative recovery was uneventful. In one of the cases transesophageal echocardiography showed air bubbles, a sign of oxygen embolism, passing the right heart. CONCLUSION: The application of hydrogen peroxide in preformed cavities, such as the thoracic, should be avoided.

Echocardiography↗
PubMed1997

[Resuscitation].

By the measures of basic life support (BLS) as well as those of advanced cardiac life support (ACLS) a large portion of the 8,000 to 10,000 victims of sudden circulatory arrest in Switzerland might be resuscitated successfully without permanent neurological deficits. Prerequisites are an early installation of measures as well as the control of the rationale and the individual techniques by trained personnel. The single most important measure is electric defibrillation of ventricular fibrillation. With the aid of automatic defibrillators it can be made available to a wider range of users. Pharmacotherapy is of minor importance.

Algorithms↗
PubMed1997

Is an alkalinized lignocaine solution a better topical anaesthetic for intratracheal application?

Topical anaesthesia of the trachea is used to avoid coughing during emergence from anaesthesia. This study was designed to compare the effects of an alkalinized lignocaine and plain lignocaine solution given intratracheally. After institutional approval and written informed consent, 30 patients were randomized into three groups and received in a double-blind fashion: lignocaine, alkalinized lignocaine and normal saline for control. After application of normal or alkalinized lignocaine the tolerance to the tube was significantly better during extubation (P = 0.001). Noradrenaline levels were significantly diminished in the lignocaine groups (P < 0.05). Plain and alkalinized lignocaine solutions for topical anaesthesia significantly improved tolerance to the tracheal tube during emergence from anaesthesia. Plain and alkalinized lignocaine given directly before intubation reduced the sympathomimetic stress response resulting in a lower noradrenaline concentration and a reduced heart rate.

Adolescent↗
PubMed1996

[Latex allergy--not only a threatening danger to patients. A case report from an anesthesiological department].

A 31-old male nurse of anesthesiology was exposed to rubber gloves over a period of ten years. An atopic diathesis was known. From time to time he had episodes of pollinosis. Since nine months he had suffered from conjunctivitis, rhinitis and shortness of breath while wearing latex gloves. During a night shift ten minutes after consumption of tropical fruit (bananas, kiwi) he had to care for a patient in the emergency room. He wore rubber gloves and had to clean the emergency room. Initially, his palms and feet itched. Then he experienced angor and increased perspiration 90 seconds later he suffered severe dyspnea and dysesthesia in the lower extremities. Treatment with theophylline and beta sympathomimetics, steroids and antihistaminics was successful. This male nurse had a positive history for contact urticaria after exposition to rubber. He suffered a dramatic exacerbation when wearing latex gloves and inhaling latex-contaminated air after eating tropical fruits. Fruit could have been a potent booster. Hospital employees with a history of atopic disease should be screened for potential latex allergy before occupational exposure.

Adult↗
PubMed1996

[Venous access and methods of drug application in ACLS (Advanced Cardiac Life Support)].

After initiation of cardiopulmonary resuscitation [CPR] with ventilation, chest compression and defibrillation when necessary, venous access, which allows administration of drugs and fluids, is the next measure. A large diameter peripheral vein should be the first choice and should be cannulated with a plastic catheter. If this is delayed or impossible, alternative routes such as central iv lines, intraosseous infusion or endobronchial drug administration should be considered.

Catheterization, Peripheral↗
PubMed1996

[Pharmacotherapy in resuscitation].

Although pharmacologic intervention has traditionally been a mainstay in the treatment of circulatory collapse and cardiac arrest, a critical reappraisal of the relevant literature does not support this stance in every case. During cardiac arrest, medications take second place to other forms of intervention: initiation of basic life support with ventilation [100% oxygen!], chest compression and defibrillation if indicated. Epinephrine is still the drug of choice in all types of cardiac arrest. Atropine is recommended for asystole and pulseless electrical activity [PEA] with bradycardia, while lidocaine has a place in the therapy of persistent ventricular fibrillation. Sodium bicarbonate is of only limited benefit in special cases.

Adrenergic Agonists↗
PubMed1992

[Ambulatory long-term blood pressure determination: technique and ways of risk identification].

Traditional noninvasive measurement of blood pressure with the sphygmomanometer has as a punctual method been considerably expanded by the development of methods for recording blood pressure repeatedly under normal daily activity. Such procedures have contributed much to understanding of circadian regulation of blood pressure. Normo- and hypertensive patients experience a physiologic drop in systolic and diastolic blood pressure during night hours. Ambulatory blood pressure recordings are suitable to increase treatment compliance by patients. They allow qualitative evaluation of antihypertensive treatments and elimination of overshooting reactions to the measuring process by the physician (white-coat effect). This method has the potential for better definition of cardiovascular risk factors through recording of circulatory stress by blood pressure. No accepted guidelines exist, however, to date for definition of normal values for such measurements. The upper limits of normality for averaged blood pressure appear to be 140/90 mmHg during the day and 120/80 mmHg at night.

Blood Pressure↗
PubMed1992

[The Excimer laser. I. The Lucerne evaluation procedure for Excimer therapy].

The Excimer laser has been available for clinical applications in the Lucerne Eye Hospital since September 1990. Excimer laser keratectomy as a refractive therapy option is meeting with widespread interest among patients. As this is an invasive method whose complications cannot be neglected and for which long-term experience is so far lacking, this interest has to be balanced by extremely strict and responsible diagnosis by those offering the therapy. The authors present their evaluation concept here. The figures below document the reticence exercised in diagnosis: 1100 information leaflets dispatched are contrasted in the final analysis with only 34 laser treatments in a period of 10 months. 50 of the 200 patients admitted (referred by specialists) for preliminary examinations were definitively excluded from treatment in Lucerne as early as the administrative stage, and 61 during the clinical evaluation proper.

Cornea↗
PubMed1992

[The Excimer laser. II. Initial experiences with the Excimer laser in Lucerne].

In the period between September 1990 and July 1991, 35 patients (46 eyes) were treated with the Excimer Laser. In 25 patients (34 eyes), a Myopia-Laser-Shaping was performed, one patient was treated for both myopia and astigmatism. In eight patients (10 eyes) correction of astigmatism was carried out. Two patients with recurrent erosions and one patient with superficial scarring of the cornea were treated. The authors review their initial experience with the Excimer Laser. The decision to initiate treatment must not be undertaken lightly, because the possibility of serious complications may not be neglected. This method shows promise in selected patients with light to medium degrees of myopia. In cases of severe myopia, our experience is encouraging. Subjectively, the patients are satisfied with the results, which do not fall short of their expectations. Further research and clinical experience in this area is urgently required.

Astigmatism↗
PubMed1989

[The Tube-Stat: a useful aid in difficult intubation].

A patient (ASA class I) scheduled for an elective gynecological operation, could not be intubated by conventional means, as no part of the glottis could be seen on direct laryngoscopy. Endotracheal intubation was successful on the first attempt using a lighted intubation stylet (Tube-Stat, Concept Corporation, Clearwater, Florida, USA). Transillumination of the neck tissues acted as a guide for correct placement of the endotracheal tube. Postoperatively, the patient complained of hoarseness and sore throat that cleared up completely within 5 days. Cases of difficult-intubation are often impossible to recognize preoperatively [3]. When problems arise, a difficult-intubation drill should be instituted without delay. The view obtained at laryngoscopy in our patient corresponded to a Grade III case according to the classification of Cormack and Lehane [3]. Our usual routine in such cases calls for blind intubation using a flexible introducer passed posteriorly to the epiglottis or blind nasal intubation. Recent reports testify to the potential dangers of blind procedures [4, 19, 23]. Light-wand-guided intubation has been reported to be an easily learned, atraumatic alternative to laryngoscopic or blind nasal intubation [6, 9]. We employed the Tube-Stat light-wand in a series of routine surgical cases with encouraging results. Our case report documents our first patient intubated with the light-wand after failure of conventional larnygoscopy. The first lighted stylet was described some 30 years ago, and the method of transillumination as an aid in difficult intubation developed over the following years.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

[Acute abdomen in patients under anticoagulant treatment].

Hemorrhagic complications induced by anticoagulants occur in about 10-20% of patients treated. The bleeding source is found in the gastrointestinal tract in 30%. A careful history and physical examination, in combination with radiologic evaluation, serve to localize the bleeding site and avoid unnecessary surgery. Because anticoagulated patients may have the clinical picture of acute abdomen, it is important to differentiate extra-, intra- and retroperitoneal complications. During the past ten years we have treated 16 patients with acute abdomen under anticoagulation therapy: extra-, intra- and retroperitoneal complications were found in three, nine and four cases respectively. Rectus sheath hematomas, intramural bowel hematomas and retroperitoneal hematomas primarily underwent conservative, symptomatic treatment. Only intraperitoneal hemorrhage and psoas hematomas with neurologic manifestations required early surgical treatment. After successful treatment the indication for anticoagulation therapy should be reevaluated.

Abdomen, Acute↗