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Biomedical subjects

J Hausdörfer

Publications and source records attributed to J Hausdörfer.

At least 19 recordsLinked to original sources
PubMed2001

Acid-base, electrolyte and metabolite concentrations in packed red blood cells for major transfusion in infants.

METHODS: Acid-base, electrolyte and metabolite concentrations were determined in 100 U of packed red blood cells (RBC) preserved in extended-storage media to be used for major transfusion in paediatric and cardiac surgery. RESULTS: In fresh RBC, low pH, bicarbonate (cHCO3-), base excess (BE) and high glucose values were observed all outside the physiological range. With lengthening storage duration, values of pH, cHCO3-, BE, sodium and glucose decreased and carbon dioxide, potassium and lactic acid concentrations increased [mean +/- SD (range): storage duration 6.7 +/- 3.8 (1-17) days, pH 6.79 +/- 0.1 (6.53-6.99); mmol.l-1: cHCO3- 11.1 +/- 1.5 (6.2-14.5), BE - 29.2 +/- 4.1 ([-39.4] - [-20.9]), potassium 20.5 +/- 7.8 (4.2-43.6), glucose 24.1 +/- 6.1 (16.7-29.2), lactic acid 9.4 +/- 4 (4.3-21.4)]. CONCLUSION: Massive and rapid transfusion of RBC may lead to a severe burden of hydrogen ions, carbon dioxide, potassium, glucose and lactic acid and this can be avoided by cell saver blood processing, when autologous erythrocytes from the operative field are saved and substrate load and storage lesions from packed red blood cells are minimized in one step by washing.

Acid-Base Equilibrium↗
PubMed2001

[Value of EEG monitoring in intensive care patients in plastic surgery--indications and experiences].

EEG monitoring can be performed at the patients' bedside and it is a valuable support in therapeutic decision making providing unique information about the functional state of the brain. Due to newer technical developments, EEG monitoring can be conducted rather easily. In this article, indications for EEG monitoring in plastic surgical patients are presented: controlling the level of sedation, use in states of increased intracranial pressure, screening the cerebral state in comatose patients, diagnosis and therapy of epileptic seizures, and the search for circumscribed cerebral abnormalities. Furthermore, practical experience with the use of the new EEG monitor Narcotrend, which is provided with an automatic EEG classification, is described.

Cerebral Cortex↗
PubMed2000

Haemodynamic, acid-base and electrolyte changes during plasma replacement with hydroxyethyl starch or crystalloid solution in young pigs.

We investigated haemodynamic, acid-base and electrolyte changes during almost total plasma replacement with hydroxyethyl starch (HES) and physiological balanced electrolyte solution (PBE) by using a cell saver in ten young pigs. In the PBE group an additional 3550 (444) ml crystalloid solution [Mean (SD)] was infused over the course of the study in order to maintain pulmonary capillary wedge pressure. Plasma protein levels decreased in both groups and the colloid osmotic pressure increased in HES and decreased in PBE. At the end of the study, body weight [HES 10.4 (1), PBE 13.1 (1.4) kg, P < 0.01] and lactic acid concentration [HES 0.9 (0.3), PBE 2.9 (1. 3) mmol.l -1, P < 0.01] was higher and tissue oxygen delivery [HES 327 (22), PBE 89 (29) ml.min.m2, P < 0.01] was lower in the PBE group. There were only moderate acid-base changes in both groups, but at the end, anion gap was significant lower in HES. In conclusion, maintenance of colloid osmotic pressure close to the physiological range of infants seems to be advantageous during major paediatric surgery.

Acid-Base Equilibrium↗
PubMed1993

[Shortest possible muscle relaxation in children using atracurium and/or vecuronium].

The aim of this study was to monitor accelographically the impact of atracurium (A) and/or vecuronium (V) on intubation anaesthesia in infants and/or children for elective surgery or minor short-term surgery. An intra-individual evaluation is valid even though a very practical but less established monitoring method is used. Infants receiving a "priming"-dose of V 0.01 mg kg-1 BW or A 0.05 mg kg-1 BW followed 3 minutes later by a main dose of V 0.04 mg kg-1 BW or A 0.2 mg kg-1 BW were found to be in good or even very good intubation condition. These minimal doses afforded very short relaxation times, which are next in line to succinylcholin. A combination of V and A in the "priming"-technique did not lead to better conditions of any clinical relevance. Medium range non-depolarising muscle blockers, as they are available to the pediatric anesthetist nowadays, seem to compare favourable with the use of succinylcholin, which is to be considered an obsolete drug due to its various side effects.

Anesthesia, General↗
PubMed1993

Accumulation of acetone in blood during long-term anaesthesia with closed systems.

During closed system anaesthesia with isoflurane, patients with a preoperative increase in blood concentration of acetone (> 10 mg litre-1) had a significantly greater concentration of acetone than patients with an initial normal blood concentration of acetone (P < 0.01). Flushing the closed system with a high flow of fresh gas had no effect on the blood concentration of acetone. Using a large fresh gas flow, there was no increase in blood acetone concentration. Acetone concentrations of about 50 mg litre-1 cause problems such as nausea and vomiting in the postoperative period. These symptoms occurred more frequently after closed system anaesthesia.

Acetone↗
PubMed1992

[Humidification and heating of anesthetic gases during pediatric anesthesia using the Cicero Anesthesia Workstation].

A series of 52 infants underwent general or urological surgery; all were ventilated with the CICERO. Two different flows of fresh gas were used. In group I (n = 21) the fresh gas flow was set exactly at the level of the minute volume, representing a half-open, non-rebreathing system. In group II (n = 31) the fresh gas flow was adjusted to 10% of the required minute volume. Temperature and relative humidity of the inspired gas were measured continuously close to the tracheal tube. Anaesthesia was accomplished with 2 vol% isoflurane, 21-30 vol% oxygen in nitrous oxide. The results were compared with those achieved with our time-tested paediatric equipment, a SERVO 900D ventilator with a Fisher-Paykel humidifier (Group III, n = 35). Using a high fresh gas flow, no increase in relative humidity in the inspired gas could be detected. The values varied between 12% and 25% (group I). Reducing the flow of fresh gas as indicated above resulted in an increase in the relative humidity (group II). Over the evaluated period of 2 h, humidity increased slowly from an initial mean value of 20% to a maximum of something over 70%. Using the SERVO 900D ventilator combined with the Fisher-Paykel humidifier, humidity reached a value of greater 90% within 10 min after activation of the heated cascade. Humidity in the inspired gas should exceed 70% to avoid damage to infant airways. This will not be attained until after more than 2 h with unaided breathing systems, by when most operations performed on paediatric patients will already be over. Condensed water may aspirated by small infants. This potentially dangerous situation was only encountered in the CICERO circuit, and not in the system protected by the Fisher-Paykel cascade. Dry gases can result in thickened mucous and in obstruction of a small tracheal tube, which requires emergency reintubation. With artificial airways dry gases damage the ciliated epithelia of the trachea and cause loss of water and body heat. The temperature of the "cold" gases varied within a range of 21-33 degrees C and could not be adjusted by the anaesthetist. In the CICERO system, heating the gases at the valve only prevents mechanical failure caused by water condensation. In pediatric anaesthesia, variable heating and non-condensing humidity are essential. The dry and heated gases of the CICERO are not acceptable in the daily practice of paediatric anaesthesia.

Anesthesia, Inhalation↗
PubMed1991

[The evolution of carboxyhemoglobin during long-term closed-circuit anesthesia].

In 40 patients who underwent protracted orthodontic operations, the accumulation of carboxyhemoglobin (COHb) in the blood was studied. Mechanical ventilation during anesthesia was carried out in a closed system (group I, n = 20). Patients in a control group received mechanical ventilation with a constant fresh gas flow of 6 l/min (group II, n = 20). During closed-system ventilation, a constant rise of COHb was observed. Smokers had much higher COHb values than nonsmokers at the beginning of and during anesthesia. The relative increase of COHb in a defined time period was of the same magnitude for smokers and nonsmokers. Critical values for carbon monoxide (CO) intoxication were not measured. The mean rise was 0.05 g/100 ml COHb over 6 h. Two female patients had COHb rises of 0.29 g/100 ml and 0.18 g/100 ml over the same period. During ventilation with a high flow of fresh gas, the COHb level decreased in all patients. In nonsmokers, the value approached the physiological range of 0.4% to 0.8% COHb. A marked fall of COHb could also be observed in smokers; however, normal physiological values were not reached. Patients with low COHb tolerance (anemia, severe coronary heart disease, peripheral vascular disease) or with increased endogenous CO production (pregnancy, newborns, hemolytic disease, porphyria cutanea) should not undergo protracted ventilation in a closed circle system.

Adult↗
PubMed1988

[A case of central anticholinergic syndrome in pediatric anesthesia].

The central cholinergic syndrome developed in a 5 1/2-year-old child after premedication with midazolam and a short volatile anesthetic. Diagnosis was made more difficult because of a history of nephrotic syndrome, convulsions, relative acetylcholinesterase deficiency and chronic medication with a corticosteroid. Successful management of such cases depends on a through differential diagnosis before the institution of physostigmine therapy. Intensive postoperative monitoring is strongly recommended.

Autonomic Nervous System Diseases↗
PubMed1987

[Technical improvements in the 900 D anesthetic servo-ventilator].

Demonstrated is a Mapleson D (Kuhn) modification integrated into a Siemens Elema Servo-Ventilator 900 D as it is used in pediatric anesthesia. The advantage seems to be the better feeling on the bag while briefly ventilating a child in critical phases of anesthesia. The disadvantage is to be seen in the lack of gas monitors (pressure, volume, content) advised by the DGAI for longer periods of manual ventilation. The scavenging system has an akward appeal and last not least the additional manual system stalls with electric power failure.

Anesthesiology↗
PubMed1987

[A new instrument for blood pressure determination in neonatal care].

A new instrument for measuring blood pressure by oscillometry conceived for neonates was tested in 30 children between 32.6 kg and 1200 g body weight (the emphasis being on infants) using sphygmanometric and invasive arterial measurements for comparison. High accuracy and good reproducibility of the individual measurements were found, the time required for measurement being short. The authors discuss the problems governing the sphygmanometric and oscillometric method.

Adolescent↗
PubMed1986

[Comparison of volume substitutes 5 percent human albumin and 6 percent hydroxyethyl starch (40,000/0.5) in pediatric anesthesia].

Human albumin 5% (HA), frequently used in paediatric anaesthesia as a human plasma substitute, could be replaced by hydroxyethyl starch 6% (HES) 40,000/0.5 provided its use would not entail any disadvantages but rather advantages instead. This problem was studied by examining 30 children (mean body weight 32.5 kg) in general anaesthesia. During about 3 hours of surgery the patients lost up to 15 per cent (approx. 400 ml) of blood volume. In a randomised study the blood loss was compensated either via HA or HES with 14 ml/kg body weight each, respectively. Blood pressure and pulse rate remained within the normal range. Haemodilution was represented by a drop in the erythrocyte count to about 3 million/microliter, haematocrit (HCT) to about 30% and haemoglobin to approx. 10 g/100 ml. Slight metabolic acidosis (Bodansky unit = -4 mmol/l) was found to be statistically not significant (= n.s.) with both methods, as was the difference in serum albumin and during serum electrophoresis. Serum [Na+] was reduced in those children who had been treated with HES, to 137.33 +/- 33.30 mmol/l; however, in those children who received HA with low sodium content (statistically significant difference = s.s.) the corresponding level was 134.15 +/- 2.36 mmol/l. Serum creatinine rose in each case from 60 to 80 mmol/l (s.s.), renal function being slightly impaired probably due to the anaesthesia and surgery. The value according to Quick's test and the partial thromboplastin time (PTT) remained in the normal range both with HA and HES treatment (in each case over 70% and below 25s, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1986

[Isoflurane in pediatric anesthesia].

Seventy patients 1-10 years of age were submitted to isoflurane (I) or halothane (H) anaesthesia (O2:N2O = 1:3); H was used as a reference substance. Under I anaesthesia, haemodynamic parameters proved to be well preserved. While the pulse rate under I increased significantly, the diastolic pressure decreased as a result of peripheral vascular dilatation. Baroceptor reflexes seemed to function more properly under the effect of I. Spontaneous respiration was definitely depressed by I. Respiratory rate, minute volume, end-expiratory CO2 and pCO2 values indicated CO2 accumulation. Younger children breathing spontaneously were subject to airway problems in I more than in H anaesthesia by decreasing negative occlusion pressures. Increasing doses of vecuronium bromide (5, 10, 15 and 70 micrograms/kg body wt.) accomplished muscular relaxation of various degrees, as tested by the train-of-four (TOF) method. The use of I in two age groups resulted in faster onset, more profound muscular relaxation, and longer duration in comparison with H; these results were statistically significant.

Age Factors↗
PubMed1986

[Measurement of end-expiratory carbon dioxide values in pediatric anesthesia].

This study dealt with two principles of the evaluation of end-expiratory CO2 in pediatric anaesthesia: detection of CO2-influenced infrared rays with a full stream analyzer attached to the tracheal tube; CO2 measurement with a side-stream analyzer connected to the breathing and ventilating system by a small tube. The linearity of the analyzers was tested with gas mixtures containing 3.0/5.0/7.0 vol% of CO2 cycling at an increasing rate. Additional mass-spectrometry has proven that the instruments are accurate within the clinical range of pediatric anesthesia. A maximal deviation of 8% develops when cycling rates increase to 40 per min. To detect quality differences in the analyzers, tangential constructions onto the CO2 curves plotted by the capnographs provided valuable quotients. Depending on the length of the tubing that feeds samples of respiratory gas into the side-stream analyzer, the CO2 curves were subject to sinus degradation with increasing respiratory rates. Capnography with full-stream analyzers depended on inspiratory zero CO2 content for reference purposes.

Anesthesia↗
PubMed1983

[Efficacy of cimetidine in the prevention of aspiration pneumonia in paediatric anaesthesia].

In a prospective controlled study 63% of 150 children without prophylaxis were at risk of aspiration pneumonia in case of aspiration or regurgitation. In a second trial 10 mg/kg cimetidine orally 120 to 180 minutes prior to induction of anaesthesia proved to be a very effective prophylaxis. In small children up to 15 kg rectal application of 40 mg/kg cimetidine was even more effective than 10 mg/kg orally in reducing gastric volume. Premedication with cimetidine may be a practicable method for reducing the risk of aspiration pneumonia in paediatric anaesthesia.

Adolescent↗
PubMed1983

[Preoperative phase of limited normovolemic hemodilution].

In 35 cases, the attempt is made to present hemodilution as an appropriate means of hepatitis prophylaxis and blood sparing in patients having to undergo selective orthopedic or oral surgery. Especially in hospitals which cannot afford the expensive methods of autotransfusion, this method which is easy to perform from the technical and practical point of view offers a possibility of markedly reducing the transfusion rate of whole blood. Taking into account possible contraindications, this method is to be considered in all patients undergoing selective surgery where the general condition of the patient is sufficient and a blood loss of 1000-1500 ml is not exceeded.

Adolescent↗