[Repeated halothane-anaesthetics for laryngotracheal stenoses. How great is the risk of liver damage?].
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Biomedical subjects
Publications and source records attributed to K Bonhoeffer.
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The effect of altering end-expiratory inflation pressure from 0 to 20 cm H2O in relation to the pulmonary capillary wedge-pressure (PCWP) and the left atrial pressure (LAP) were studied in dogs, whose blood volume was varied by infusion of dextran or by haemorrhage. In the hyper- and normovolaemic state there was a good correlation between PCWP and LAP up to an end-expiratory pressure of 15 cm H2O. In the hypovolaemic dogs this close agreement existed only up to levels of PEEP 10 cm H2O. Above this end-expiratory pressure pulmonary capillary wedge-pressure increased more than left atrial pressure.
We measured in 8 experimental studies the oxygen and carbon dioxide partial pressure in systemic arterial, mixed venous and wedge-blood. The results were: 1. In healthy mongrel dogs with controlled intermittent and continuous positive pressure ventilation (FIO2 0,21 and 1,0) paO2 greater than pwO2 greater than pvO2 and pwCO2 less than paCO2 less than pvCO2. 2. During experimentally produced left-sided atelectasis of the lung and positioning of the catheter in the pulmonary artery a) in the ventilated lung we found pwO2 greater than paO2 greater than pvO2 and pwCO2 less than paCO2 less than pvCO2 b) in the atelectatic lung we found paO2 greater than pwO2 greater than pvO2 and paCO2 less than pwCO2 less than pvCO2. According to these findings the sample of highly saturated mixed venous blood from a catheter in the pulmonary artery should be a hint that pulmonary capillary blood is mixed with central venous blood.
Some of the main arguments are presented which led us to develop our present anaesthetic record. This record system and a part of its voluminous code is described. The new version provides for the documentation of arbitrarily complicated status, which are due to the preoperative condition of the patient. Furthermore, the course of aneaesthesia and its effects upon the patient can be numerically recorded in a detailed fashion. The punching is affected by a small rate of error only.
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