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Biomedical subjects

G Tempel

Publications and source records attributed to G Tempel.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Occupational and social rehabilitation of patients in an operative-traumatologic intensive care unit].

About 100 polytraumatized patients were treated yearly at the ICU of the Institute of Anaesthesiology of the Technical University of Munich. Mortality lay in the range between 30 to 40%, i.e. approximately 70 patients had to be rehabilitated per year. 75 patients treated from 1976 to 1977 were followed-up and their condition was investigated together with an inquiry into their work readjustment and social rehabilitation. In most cases the patients were found to be able to resume their previous work and it was possible to reintegrate them into society and their families. With the exception of 2 patients all examined patients still suffered some disablement.

Abdominal Injuries↗
PubMed1984

[Experiences and impressions of patients in an surgical-trauma intensive care unit].

Within the framework of a retrospective study performed by the Department of Anaesthesiology at Munich Technical University, 150 polytraumatized patients admitted to the intensive-care unit between 1976 and 1978 were questioned as to experiences and general impressions during their stay in the unit. The data obtained in this manner were recorded and systematically analysed. The average period of time between initial treatment and follow-up examination was 5 years. Average length of admission to the intensive-care unit was 20 days and the average age at time of injury was 27 years; 73% of the patients were artificially ventilated for approximately 7 days; 94 patients (63%) had cranio-cerebral trauma. A marked sense of security as well as strong emotional attachment to the ICU personnel were the most prevalent impressions obtained on questioning; these impressions were shared by almost all of the patients within the study. Reports of experience of anxiety were the exception. The presence of other patients within the same room, as well as the resulting opportunity to communicate with these patients, was psychologically supportive and provided a feeling of solidarity. Among the most prevalent of the negative impressions was a feeling of extreme thirst reported by 40 of the patients interviewed. Detrimental effects mentioned in many of the other investigations of intensive care patients such as loss of ability to communicate, lack of orientation as well as abolition of circadian rhythm played only a minor role in our study.

Adaptation, Psychological↗
PubMed1983

[Fat emulsions in parenteral feeding. Clinical experience with multiple injury patients].

Serious injury and functional disturbances following multiple trauma make long-term parenteral nutrition necessary. Due to the significance of fats as a major source of energy and provider of essential fatty acids, parenteral fat emulsions are indicated in the treatment of severely injured patients. As soon as the excessive, trauma-induced metabolic derangement begins to subside, parenteral nutrition can be initiated. The presence of respiratory insufficiency can no longer be considered a contraindication for the infusion of fat emulsions. On the contrary, in the management of the post-traumatic clinical state, especially when complicated with the incidence of respiratory insufficiency, bacterio-toxic syndrome or long-term intestinal atony, an adequate regimen of parenteral nutrition including fat emulsions is of particular importance for the successful convalescence of the patient.

Critical Care↗
PubMed1979

Hyperprolactinaemia in the spontaneously hypertensive rat.

A hypothalamic role in the aetiology of hypertension in the spontaneously hypertensive rat (SHR) has been suggested by prior observations. In an attempt to determine whether the central control of prolactin (PRL) release is altered in the SHR we have compared the PRL response to immobilization stress, thyrotrophin releasing hormone (TRH), haloperidol, and L-DOPA in the SHR and in normotensive Wistar control rats. Carotid artery catheters were inserted 48 h prior to the PRL response studies and the catheters were maintained patent with heparinized saline. Timed blood samples were obtained in SHR and control rats weighing 180-225 g. The SHR demonstrated elevated basal serum levels of PRL and greater PRL responses to stress. However, administration of L-DOPA resulted in a similar suppression of serum PRL in the SHR and in the normotensive controls. These findings suggest alteration in the central control of PRL release in the SHR. Observations of elevated basal PRL, exaggerated PRL in response to L-DOPA in SHR are consistent with normal pituitary responsiveness to dopamine suppression of PRL release, but defective hypothalamic metabolism of dopamine. Alterations in central dopamine control mechanisms in the SHR may play a role in the pathogenesis of essential hypertension in these animals.

Animals↗
PubMed1979

[The role of anaesthesiology in intensive care (author's transl)].

The German Society of Anaesthesia and Resuscitation was founded in 1953. The change of name to "German Society of Anaesthesia and Intensive Care" in 1977 reflects the development that this specialty has undergone since 1953; it is also an indication of the claim of anaesthesia to play a part in the care of the critically ill surgical patient. To the questions: what is the basis for this claim, what can anaesthesia contribute towards the care of these cases, where is the dividing line between anaesthesia and the other disciplines concerned in intensive care, what effect has intensive care work on the training of the anaesthetist, the answers are as follows: the concern of the anaesthetist is the care of the patient whose vital functions are impaired by surgery, anaesthesia or disease; he has therefore acquired techniques and means to maintain and assist these vital functions. His work in the intensive care ward is thus often no more than a continuation of the work he is doing in the operating theatre. This does not mean that he should replace the clinician of the traditional specialties working in the intensive care unit; rather that he should function as a co-ordinator as regards the type and course of treatment and nursing. For the anaesthetist there is the advantage that he can enlarge and consolidate the skill and knowledge acquired in the operating theatre, deepen his understanding of pathophysiological conditions and gain experience and assurance in evaluation of a variety of clinical situations. By becoming competent in diverse fields (at a time when the general trend is for ever more specialization) he will contribute towards raising the status of the anaesthetist who is still apt to be regarded as merely a technician.

Anesthesia↗
PubMed1979

[A retrospective study of the impressions and psychic reactions experienced by patients in a traumatological intensive care unit (author's transl)].

30 persons who had been treated for an average of 22 days on a traumatological intensive care unit were asked to comment on their impressions and experiences. 80% of the patients had been in need of artificial respiration; but this had not unduly distressed them and they remembered it only vaguely. The major worry in 30% of the cases was awareness of their condition and the fear of permanent physical and mental disablement. 25% had greatly suffered from thirst. There was no mention that finding themselves in an intensive care ward, being dependent on a respirator or monitoring equipment or being disorientated had caused distress. None of them had seriously contemplated the possibility of his own death. The frequent visits by relatives were regarded as great comfort and help towards achieving mental equilibrium. All these critically ill persons were highly impressed by the constant and dedicated medical and nursing care they had received.

Anxiety↗
PubMed1979

[A case of severe multiple trauma (author's transl)].

A case of severe multiple trauma sustained in a road accident is reported. The aim of the report is to show the determing role played by diagnostic and surgical methods and therapeutic possibilities available in the intensive care unit (shock treatment, controlled respiration, parenteral feeding, haemodialysis) in winning the five-months' battle for the life of the patient. Early haemodyalisis as supporting therapy in respiratory failure and conservation treatment of intestinal fistulae are important. Post-traumatic pancreatitis which is a not infrequent complicating feature of severe multiple trauma may present diagnostic difficulties.

Accidents, Traffic↗
PubMed1978

Transthoracic electrical impendance in anaesthesia and intensive care.

Pulmonary fluid accumulation plays an important role in the development of post-traumatic pulmonary insufficiency. Yet initially diagnosis may be difficult. The measurement of transthoracic electrical impedance was used to detect early pulmonary fluid overload. In healthy test persons infusions of isotonic electrolyte solutions and diuresis were accompanied by changes of impedance dependent on the amount of infused or withdrawn fluid. In patients with pulmonary insufficiency a relatively low mean body impedance was recorded. Enforced diuresis resulted in a rise and in diminution of the alveolar-arterial oxygen difference.

Adult↗
PubMed1978

Changes in essential fatty acids in plasma lipid fractions of polytraumatized patients with different parenteral nutrition.

We investigated changes in the fatty acid pattern of plasma lipids during the phase of total parenteral nutrition in two groups of polytraumatized patients. For parenteral nutrition we gave L-amino acid solutions in a dose of 0.24 g N day-1kg-1 body weight. In addition, we administered in the first group glucose and fructose, and in the second group glucose, fructose and fat emulsions in a total dose of 30 kcal day-1kg-1 body weight. In the latter group, the proportion of the fat emulsions was 30-40% of the calories administered. The most striking findings were the decrease of the essential fatty acids with regard to the phospholipid fraction from about 60% to 30% in the early post-traumatic phase. In the first group of patients we observed a further reduction of the essential fatty acids in the period of observation. This could be avoided by administering fat emulsions of the same type as we gave in the second group of patients. The functions of essential fatty acids in membranes and in the intermediary metabolism are discussed.

Dietary Fats↗