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Biomedical subjects

K J Vitikainen

Publications and source records attributed to K J Vitikainen.

8 recordsLinked to original sources
PubMed1981

Repair of tracheal intubation injuries.

Occult tracheal injuries occurring at the time of intubation frequently leave a posterior defect and lead to the rapid development of mediastinal infection. Some protection is provided by the endotracheal tube, which may further contribute to delay in diagnosis. Current descriptions of tracheal reconstruction emphasize circumferential excision and reanastomosis, but advanced infection and a probable need for ventilatory support are considered contraindications. Two cases of tracheal injury are reported in which a considerable delay in diagnosis resulted in severe mediastinal infection and respiratory failure. Use of an earlier method of tracheal repair, with pedicled intercostal muscle, resulted in control of mediastinal infection. Respiratory failure was treated effectively with a volume ventilator. It is recommended that the operation be given first consideration for such posterior injuries when they are accompanied by infection or respiratory failure.

Female↗
PubMed1979

Vascular evaluation for balloon pumping.

The effectiveness of intraaortic balloon counterpulsation is reduced frequently by arterial insufficiency following balloon insertion and occasionally by inability to pass the balloon centrally from a peripheral site. From a series of patients undergoing cardiac catheterization, a subgroup with increased likelihood of needing balloon counterpulsation can be selected. Patients so chosen have received one aortoiliac injection of contrast material at the time of cardiac catheterization. Impressive degrees of vessel irregularity and stenosis on an atherosclerotic basis and of tortuosity of normal lumen size have been noted. Such information, gathered at little additional risk or irradiation, is considered to be important in the subsequent choice of sides for transfemoral insertion and may rule out attempted passage of the balloon by this route, directing the surgeon to a deliberate, prompt, transabdominal or thoracic aortic insertion if necessary.

Aged↗
PubMed1975

The sequence of retrograde atrial activation in the canine heart. Correlation with positive and negative retrograde P waves.

The relationship of P-wave polarity and morphology in leads II, III, and aVF to the sequence of atrial activation was studied in the canine heart when the atria were paced from the region of the sinus node or the posterior-inferior left atrium and when retrograde activation of the atria occurred with right ventricular epicardial pacing. Deeply negative P waves in leads II, III, and aVF which occurred when the posterior-inferior left atrium was paced were associated with true retrograde activation of the atria. Positive P waves recorded in leads II, III, and aVF during retrograde atrial capture with right ventricular pacing were associated with rapid retrograde spread of the impulse in the interatrial septum to the region of Bachmann's bundle from which site the impulse spread to depolarize significant portions of both atria in a manner similar to that demonstrated during pacing from the region of the sinus node. When the atria were paced from a site just anterior to the coronary sinus ostium, positive P waves recorded in leads II, III, and aVF were associated with early activation in the vicinity of Bachmann's bundle and later activation of the posterior-inferior left atrium. When the atria were paced from a site just posterior to the coronary sinus ostium, negative P waves in leads II, III, and aVF were associated with early activation of the posterior-inferior left atrium and later activation in the vicinity of Bachmann's bundle. It was concluded that the time of arrival of the impulse at Bachmann's bundle relative to that at the posterior left atrium and the direction of spread of the impulse from and within Bachmann's bundle are critical in determining P-wave polarity and morphology.

Animals↗
PubMed1970

The P wave and P-R interval. Effects of the site of origin of atrial depolarization.

The atria of 37 patients were paced from selected sites during cardiac surgery. When the atria were paced from endocardial sites low in the right atrium, the P waves in ECG leads II, III, and aVF were shown to be either negative, biphasic, or positive, depending on the site paced. When the endocardial sites were paced, the P-R intervals were, almost without exception, less than 0.12 sec. When those endocardial sites closest to the A-V junction were paced, the P-R intervals were always less than 0.12 sec. When the atria were paced, from the epicardial sites, the P-R intervals were always greater than 0.12 sec. Negative P waves in ECG leads II, III, and aVF were recorded when the atria were paced from the postero-inferior left atrium and the caudal right atrium. The P-R interval did not always reflect the initial period of atrial activation because an isoelectric interval, generally of 0.01 to 0.025 sec, was frequently present between the onset of atrial stimulation and the first clear evidence of the P wave in the ECG. The implications of these results are discussed.

Adolescent↗