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Biomedical subjects

H Samnegård

Publications and source records attributed to H Samnegård.

At least 19 recordsLinked to original sources
PubMed1982

Peritoneovenous shunting for intractable ascites.

Ten patients with intractable ascites were treated with the LeVeen peritoneovenous shunt. Of these, three died perioperatively. Three patients with malignant ascites died within 2-3 months, but with good shunt function. In four patients, the shunt became occluded, after 2 weeks to 8 months. Percutaneous puncture of the shunt and injection of radiopaque dye revealed the occlusion t be due to thrombosis of the venous limb of the shunt. In one patient, superior vena cava thrombosis occurred. Another ten patients were treated with the Denver peritoneovenous shunt. One patient died perioperatively; four patients with malignant ascites and one with cirrhosis died after 11 days-3 months, but with good shunt function. One patient with cirrhosis is alive after 5 months, with good function. In three patients the shunt became occluded after 5 days-1 month but two of these could be cleared with the fluschchamber of the Denver shunt. It seems that the Denver shunt functions better than the LeVeen shunt, and that the primary indication for peritoneovenous shunting is malignant ascites. Here palliation is excellent. No patient developed clinical signs of disseminated intravascular coagulation following ascites infusion and in six patients where coagulation variables were studed, there were no signs of a consumption coagulopathy.

Ascites↗
PubMed1981

The effect of somatostatin on blood flow through coronary bypass grafts in anesthetized man.

The effect of intravenous somatostatin on blood flow through coronary bypass grafts was studied in 12 patients subjected to aorto-coronary bypass surgery. Aorto-coronary bypass blood flow was determined by means of electromagnetic blood flowmetry. No change was observed in the bypass blood flow, either during or after intravenous somatostatin at doses of 100 microgram/h and 250 microgram/h. These findings suggest that somatostatin has no effect on coronary haemodynamics in man.

Aged↗
PubMed1981

Effect of carotid endarterectomy on the antihypertensive properties of the carotid sinus reflex.

In eight patients subjected to carotid reconstructive surgery, the reflex effect on systemic pressure of an increase in carotid sinus transmural pressure was studied, before and two months after endarterectomy. The increase in carotid sinus transmural pressure was obtained by applying subatmospheric pressure to the neck. It was found that the closed loop gain of the carotid sinus reflex, calculated as the ratio of change in systemic pressure to change in carotid sinus transmural pressure, was 0.53 before and 0.52 two months after endarterectomy. It is thus concluded that carotid endarterectomy has no persisting effect on the antihypertensive properties of the carotid sinus reflex.

Blood Pressure↗
PubMed1980

Effect of somatostatin on regional splanchnic blood flows in man. Angiographic studies.

The effect of somatostatin (1 microgram/kg b.w. i.v. over one minute) on regional splanchnic blood flows was studied in nine patients subjected to diagnostic angiography of the coeliac artery, the superior mesenteric artery or the aorta. Following somatostatin there was a prolongation of the circulation times and a marked constriction of the hepatic and splenic vascular beds corresponding to a 50% decrease in blood flow. Blood flow in the gastroduodenal, pancreatic, superior mesenteric and renal arteries was also decreased, but to a lesser extent. There was no effect on the lumbar arterial flow. The time for maximum filling of the portal vein was delayed and the contrasting effect in this vessel was decreased, indicating a decrease in portal flow. It is concluded that somatostatin reduces splanchnic blood flow in unanaesthetized man, while there is no decrease in skeletal muscle blood flow. It is suggested that this effect of somatostatin is due to a direct action on vascular receptor sites.

Angiography↗
PubMed1980

Internal carotid artery blood flow during the Valsalva manoeuvre in man.

In five patients subjected to reconstructive surgery of the internal carotid artery (ICA), postoperative measurements of the ICA blood flow during the Valsalva manoeuvre were obtained by means of an implanted electromagnetic flow probe. ICA blood flow varied rapidly and parallel to the changes in calculated cerebral perfusion pressure during the Valsalva manoeuvre. At the end of the manoeuvre there was no overshoot in arterial pressure, indicating poor baroreceptor function in these patients.

Blood Pressure↗
PubMed1980

Rational treatment of hypotension after carotid endarterectomy by carotid sinus nerve blockade.

Intraarterial blood pressure was monitored continuously for the first 24 postoperative hours in twenty consecutive patients subjected to carotid endarterectomy. Ten patients developed postoperative hypotension not attributable to hypovolaemia, depressant drugs, myocardial impairment or arrythmias. The postoperative hypotension was readily reversed by local blockade of the sinus nerve on the operated side. This blockade was accomplished by the injection of 2 ml of Lignocain (1%) through a catheter placed with its tip in the vicinity of the sinus nerve at the carotid bifurcation. It is concluded that the postoperative hypotension is due to increased activity in the sinus nerve and that this hypotension should rationally be treated by carotid sinus nerve blockade.

Carotid Arteries↗
PubMed1980

Effect of carotid endarterectomy on baroreflex sensitivity in man. Intraoperative studies.

In six patients subjected to carotid reconstructive surgery, the reflex effect on systemic pressure of unilateral carotid artery occlusion was studied before and after endarterectomy. Before endarterectomy, carotid occlusion lowered carotid sinus pressure by 45 mmHg evoking a reflex increase in systemic pressure of 12 mmHg. After endarterectomy the corresponding values were 34 mmHg and 19 mmHg. The closed loop gain of the carotid sinus reflex, calculated as the ratio of change in arterial pressure to change in carotid sinus pressure was therefore increased from 0,27 before endarterectomy to 0,56 after endarterectomy. It is concluded that carotid endarterectomy improves carotid sinus baroreflex sensitivity ant that the carotid sinus nerve should therefore be preserved whenever possible.

Blood Pressure↗
PubMed1980

Accidental drainage of ovarian cyst into superior vena cava.

A case of pulmonary edema and anuria with fatal outcome after insertion of a LeVeen peritoneovenous shunt is reported. It was proved at autopsy that the shunt was draining a voluminous ovarian cystic carcinoma into the superior vena cava. Abdominal ultrasound scanning is recommended in patients selected for shunt surgery to avoid this complication.

Aged↗
PubMed1979

The effects of changes in the carotid sinus baroreceptor activity on splanchnic blood flow in anesthetized man.

In 9 patients being subjected to abdominal surgery, electromagnetic blood flow measurements were obtained from the hepatic, mesenteric and iliac beds while the carotid sinus baroreceptors were stimulated by carotid sinus massage. Carotid sinus stimulation produced an average maximum decrease in mean arterial pressure of 21%. Hepatic and mesenteric blood flows decreased by 15% and calculated vascular resistances were not significantly changed in these vascular beds. Iliac blood flow, on the other hand, showed a slight increase and iliac vascular resistance was decreased by 29%. It is concluded that the splanchnic vascular bed is of less importance in the carotid sinus baroreflex control of systemic arterial pressure in anesthetized man.

Abdomen↗
PubMed1979

Circulatory effects of somatostatin in anesthetized man.

The effect of intravenous somatostatin (1 microgram.kg-1 over 1 min) on arterial pressure and on the blood flow to various splanchnic organs, skeletal muscle and brain tissue was studied by means of electromagnetic blood flow measurements in patients undergoing abdominal surgery or reconstructive surgery of the internal carotid artery. Somatostatin infusion reduced the blood flow in the common hepatic artery by 56%, in the splenic artery by 26%, in the ileocolic artery by 34% and in the left colic artery by 36%. External iliac artery blood flow was increased by 43% while internal carotid artery blood flow was unchanged. Mean arterial pressure was increased by 20%. It is suggested that these circulatory effects of somatostatin are due to a direct effect of somatostatin on vascular smooth muscle.

Abdomen↗
PubMed1979

Treatment of bleeding oesophageal varices with somatostatin.

Cyclic somatostatin was administered intravenously on eight occasions to five consecutive patients with massive haemalemesis due to oesophageal varices. The doses administered with 0--250 micrograms as bolus, followed by 100--250 micrograms per hr during 2--12 hrs. The source of bleeding was determined by endoscopy. The volume of bleeding was estimated from the clinical condition of the patient and by gastric irrigation and iced water. The bleeding stopped immediately on all occasions when somatostatin was administered. It is suggested that the effect is due to the ability of somatostatin to reduce regional splanchnic blood flows and portal pressure.

Aged↗
PubMed1979

Circulatory effects of somatostatin in anaesthetized dogs.

Five anaesthetized dogs were given 20 infusions of 1--9 min duration of somatostatin in a dosage of 0.2--15 micrograms.kg-1.min-1. Cardiac output was measured by thermodilution. Electromagnetic blood flow measurements were simultaneously performed in the hepatic artery proper, the left gastric artery, the superior pancreatico-duodenal artery, the superior mesenteric artery and in the portal vein. Mean arterial blood pressure was recorded continuously. Somatostatin reduced all splanchnic blood flows measured by 15--35%, except for the hepatic artery flow, which was increased by 5% or unaffected. Cardiac output and mean arterial pressure were unchanged. Somatostatin was thus demonstrated to exert a specific vasoactivity in the splanchnic area without influencing central circulation. It is suggested that somatostatin acts directly on the vascular smooth muscle.

Abdomen↗