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Biomedical subjects

H J Trampisch

Publications and source records attributed to H J Trampisch.

13 recordsLinked to original sources
PubMed1992

No evidence for the existence of preformed antibodies against hydroxyethyl starch in man.

Using the highly sensitive ELISA technique for detecting anti-hydroxyethyl starch (HES) antibodies in man sera from 1,056 patients were analyzed. Patients of both sex, who had never had any prior contact with HES, were included in the study. In none of the cases could any titer of HES-reactive antibodies be detected. These data suggest that in man preformed HES-reactive antibodies do not exist or are extremely rare. In any case, unlike dextran-reactive antibodies, they should not have a high clinical importance. The mechanism behind the very rarely observed anaphylactoid reactions after HES application is still unknown.

Adult↗
PubMed1991

Right ventricular function assessed by thermodilution technique during apnea and mechanical ventilation.

OBJECTIVES: To evaluate strategies for thermodilution-based measurement of cardiac output and right ventricular (RV) ejection fraction and to assess the effects of controlled mechanical ventilation in patients. Furthermore, to compare strategy-associated reproducibility with reference values obtained during long-term apnea. DESIGN: Crossover trial in patients; reference values from apneic animals. SETTING: University ICU and physiology laboratory. PATIENTS: Six consecutive male ICU patients (48 to 70 yrs) after major abdominal vascular surgery. ANIMALS: two adult female sheep. INTERVENTIONS: Three ventilatory rates (8, 16, and 24 cycles/min) and 15-sec periods of apnea were selected for measurements in patients. In animals, continuous apnea was achieved with extracorporeal CO2 removal and apneic oxygenation. MEASUREMENTS: Measurements were performed using an appropriate pulmonary artery catheter and an ejection fraction/cardiac output computer prototype. The thermal indicator was injected automatically at four defined points of the ventilatory cycle, but triggered manually during apnea. MAIN RESULTS: At 8 cycles/min, there was a wide mean range of cyclic variable modulation, with a coefficient of variation of 11.6% and 23.2% for cardiac output and RV ejection fraction, respectively. Allowing for ventilatory phase or changing from 8 to 16 cycles/min reduced errors by half. Combining both procedures resulted in a coefficient of variation of 4.7% and 6.6% for cardiac output and RV ejection fraction, respectively. The best coefficient of variation values obtained during 15 secs of apnea in patients approached those variations in experimental apnea (coefficient of variation of 2.1% and 4.5% for cardiac output and RV ejection fraction, respectively). CONCLUSIONS: At low ventilatory rates, best results are achieved by averaging four phase-selected measurements. One-point measurements were less accurate and random point measurements less reproducible.

Aged↗
PubMed1990

Birth weight of children with congenital heart disease.

Birth weights of 843 children with congenital heart disease (CHD) were compared to the respective data of a normal West German population. On average, the CHD group had significantly lower birth weights, but the weight deficit was far less pronounced than in previous studies. The decrease in birth weight was distinct only in children with tetralogy of Fallot and atrial septal defect. Compared to normal newborns, patients with CHD were more often small for gestational age (15.0%) or had a low (less than 2500 g) birth weight (8.6%). The prevalence of prematurity was not increased. Extracardiac malformations were not significantly more common in CHD patients, who were small for gestational age, than in CHD patients with normal birth weight.

Birth Weight↗
PubMed1990

Diagnostic value of electrocardiographic variables to predict the presence of ventricular late potentials.

To test the hypothesis that the presence of ventricular late potentials in the highly amplified, averaged and filtered surface electrocardiogram (ECG) can be predicted from the conventional surface ECG, 211 patients with and without previously documented sustained ventricular tachycardia outside the acute phase of myocardial infarction were studied. The presence of left ventricular akinesia or aneurysm was significantly correlated with the ECG score (based on Q wave duration, R wave duration and amplitude ratio). The mean ECG score in patients without ventricular tachycardia was 3.4 +/- 3.5 points compared with 5.5 +/- 3.9 points (p less than 0.001) in patients with ventricular tachycardia. The presence of late potentials was positively correlated with the ECG score in the whole cohort of patients. This was also the case in the subgroup of patients without a history of sustained ventricular tachycardia. In contrast, in patients with ventricular tachycardia, the presence of late potentials was independent of their ECG score. Using linear discriminant function analyses to predict the presence of late potentials, a history of ventricular tachycardia alone and the ECG score alone had a high predictive power (high standardized coefficients). If combinations of variables were analyzed including estimates of left ventricular function (presence of aneurysm or akinesia; ejection fraction), the ECG score and a history of ventricular tachycardia still ranked highest. The influence of ejection fraction if used in combination with other variables for the prediction of late potentials was relatively small (standardized coefficient of 0.4). In conclusion, the surface ECG can be used in patients previously free of sustained ventricular tachycardia to predict the presence of ventricular late potentials.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrocardiography↗
PubMed1989

Endobronchial versus intravenous application of the vasopressin derivative glypressin during diagnostic bronchoscopy.

Glypressin is a vasopressin derivative which is used in the present study to stop pulmonary bleeding. The effects of endobronchially versus intravenously applied glypressin were examined during diagnostic fibreoptic bronchoscopy in 27 patients. Transcutaneously measured blood gases and haemodynamics were analysed after 1 mg glypressin was given. The glypressin plasma level was 251 fold higher after the intravenous than after the endobronchial administration. After endobronchial application no significant changes were observed for blood pressure, heart rate or blood gases. Following the intravenous glypressin application there was a significant increase in diastolic blood pressure. The bronchial mucosa pallor appeared earlier after topical than after systemic glypressin application. The haemostyptic effect was similar for both routes of application.

Adult↗
PubMed1989

[Normal values of the growth of the pulmonary arteries in children. An angiography study].

Systolic and diastolic diameters of the pulmonary artery anulus (PA-A), pulmonary artery sinus (PA-S), pulmonary artery trunc (PA-St), as well as those of the right and left pulmonary arteries (RPA, LPA) were measured from cineangiograms of 51 infants, children and adolescents without heart disease (n = 16) or with cardiovascular malformations which had no hemodynamic relevance (n = 35). The following diagnostic categories were included in the normal group: pulmonary stenosis (n = 16), bicuspid aortic valve (n = 4) or subvalvular aortic stenosis (n = 2), all with a systolic gradient lower than 15 mm Hg, aberrant innominate artery (n = 5), small PDA (n = 3) or small VSD (n = 2) and patients with Kawasaki disease without coronary aneurysms (n = 3). The patients were sedated and studied in a fasting state and in the supine position. Angiocardiographies were performed in the right ventricle or/and in the pulmonary artery. A grid or the known diameter of the catheter was used for calibration purposes. The corresponding systolic and diastolic diameter values were averaged in order to obtain a mean diameter of each vascular segment. All measurements were correlated with the body length and the body surface area (BSA). A root exponential function [square root of y = a(1 - e-bx) + c] was used, the regressions coefficients of which can be explained by physiological means. In this function c2 is the theoretical minimal diameter and (a + c)2 the theoretical maximal diameter of a cardiovascular structure; in this way the growth of the cardiovascular dimensions could be well defined mathematically and correlated strongly (r = 0.99) with body length and BSA. Different exponents were found for the pulmonary artery anulus, sinus, trunc as well as right and left pulmonary arteries. All the diameters showed a systolic increase between 8 to 10% above diastolic measurements. The anulus had an average diameter 16% smaller than the sinus and 9% than the distal region of the pulmonary artery; the right pulmonary artery was 7% larger than the left. A limitation of the study was that the diameters were measured in single projections only, necessitating the assumption of a circular cross section of the cardiovascular structures. The angiographically determined PA-A was larger than those of formaldehyd-fixed hearts. This finding indicates that the fixation method may alter the anatomic structures probably due to shrinkage process. PA-S measurements were closest to echocardiographic diameters measured by other authors.

Adolescent↗
PubMed1989

[Normal values of the growth of the aorta in children. An angiography study].

Angiocardiography is a standard procedure for quantification and evaluation of congenital heart disease. Knowledge of the diameters at the level of aortic valve ring, ascending and descending aorta can contribute to the decision in repair of congenital heart disease. Moreover, they are helpful for postoperative follow-up studies. In order to establish normal standards, analysis was performed on 51 cineangiograms obtained from infants, children and adolescents with no evidence of heart disease (n = 16) or only hemodynamically irrelevant cardiovascular malformations (n = 35). The individual diagnoses in these patients appear in the accompanying publication in this issue. Patients with bicuspid aortic valve or subvalvular aortic stenosis were excluded from measurements of the aortic valve ring, the sinus and the ascending aorta. Angiocardiography was performed in a fasting state, after sedation and in the supine position with injections of contrast material in the pulmonary artery and or in the left ventricle and ascending aorta. For purposes of calibration, a grid or the known diameter of the catheter was used. Systolic and diastolic diameters of the aortic valve ring (AO-R), sinus (AO-S) and distal region, between sinus valsalvae and ascending aorta (AO-D), as well as those of the isthmus (DAO-I), postisthmic region (DAO-PI) and descending thoracoabdominal aorta (DAO-T) were measured. To obtain a mean value for each vascular structure, the corresponding systolic and diastolic diameters were averaged. The mean diameter was referenced to body length and body surface area (BSA).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Principles for evaluating simple, diagnostic tests].

The fundamental terms in the evaluation of diagnostic tests are described and the differences to corresponding test parameters in clinical chemistry are emphasized. The derivation of a two-by two contingency table is explained in detail and basic characteristics of diagnostic tests, i.e. sensitivity and specificity as well as their independence of the prevalence (in the sense of a-priori-probability) is pointed out. The importance of the so-called predictive values is shown graphically, also the problem of selecting a cut-off-level (discrimination value) for the evaluation of quantitative data. The various attempts to find a single value for the description of a diagnostic test are discussed and it is stressed that there is no principal necessity to use other terms than those mentioned above. Nevertheless it is possible to give a prevalence-independent measure which has some additional advantages in rating and comparing simple diagnostic tests.

Diagnostic Tests, Routine↗
PubMed1988

Reappraisal of criteria for assessing drug efficacy in patients with ventricular tachyarrhythmias: complete versus partial suppression of inducible arrhythmias.

To test whether increased difficulty in inducing ventricular tachycardia during antiarrhythmic therapy can be considered a sufficient criterion for predicting long-term efficacy of such therapy in patients with ventricular tachyarrhythmias, 95 patients were studied with a graded stimulation protocol (single and double premature stimuli during sinus rhythm and ventricular drives of 120, 140, 160 and 180 beats/min). After a control study, the effects of oral antiarrhythmic drugs on the ability to induce ventricular tachycardia were assessed. The median number of drug trials was four per patient. After antiarrhythmic therapy, four subgroups of patients were identified. In 36 patients, there was no change in inducibility (group 1), whereas in 18 patients ventricular tachycardia was rendered more difficult to induce; that is, a sustained ventricular tachycardia was inducible at a basic drive at least 40 beats/min faster than during the control study (group 2). In 34 patients, ventricular tachycardia induction was suppressed (group 3) and in 7 patients with nonsustained ventricular tachycardia, only 3 to 5 repetitive ventricular responses were induced after treatment (group 4). During follow-up of 15.5 +/- 11.5 months, 10 patients of group 1 had a recurrence of ventricular tachycardia and 6 died suddenly, whereas in group 2 only 1 patient died suddenly and in group 3, 2 patients had a recurrence of ventricular tachycardia (group 1 versus 2 and 3, p less than 0.001, Mantel-Cox and Breslow; group 2 versus 3, no difference). Thus, increased difficulty in inducing ventricular tachycardia is a sufficient criterion for predicting long-term efficacy of an antiarrhythmic drug regimen.

Adult↗
PubMed1976

A discriminant analysis for qualitative data with interactions.

Two linkable computer programs have been developed for a discriminant analysis with qualitative variables, which permit taking into account 1st order interactions. The first program is used to estimate the parameters required in the second program. The second program allows a classification of new cases as well as an unbaised estimation of error rates.

Computers↗