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Biomedical subjects

K Peter

Publications and source records attributed to K Peter.

At least 19 recordsLinked to original sources
PubMed1979

Enflurane in patients with coronary artery disease.

In 12 patients with coronary artery disease, hypertensive periods during aortocoronary bypass surgery were treated with 1 MAC enflurane. The effect of enflurane on the major determinants of myocardial oxygen consumption was studied. Systolic arterial pressure was reduced to a level of about 120 mmHg (16 kPa). The heart rate diminished by 16.5%. The cardiac index during enflurane application was unchanged. Pulmonary artery wedge pressure was measured at short intervals and remained unchanged. The fall in arterial pressure and heart rate under unchanged preload produced a significant reduction in myocardial oxygen consumption as determined by calculation of the systolic wall tension and the tension time index. In five patients, the O2 content in coronary sinus blood was measured and the arterial-coronary sinus O2 difference was found to be diminished. In the concentration used, enflurane reduced the myocardial oxygen consumption of patients with coronary artery disease.

Aged↗
PubMed1979

[Haemodynamic effects of combined dopamine and nitroprusside therapy early after open heart operations (author's transl)].

In 12 patients with moderate low-output-syndrome following aortocoronary bypass grafting, the pump function of the left ventricle was improved by sodium nitroprusside (SNP) and dopamine. The cardiac index (CI) on termination of cardio-pulmonary bypass was 2.2 +/- 0.2 1/min.m2 and the pulmonary capillary wedge pressure (PCWP) 20 +/- 3 mm Hg. Folowing infusion of SNP the Cl reached 2.4 +/- 0.2 l/min.m2 (p less than 0.05) and the PCWP was reduced to 13 +/- 3 mm Hg (p less than 0.01). After transfusion of blood the PCWP increased to 18 +/- 2 mm Hg (p less than 0.01), and the CI increased to 2.8 +/- 0.2 l/min.m2 (p less than 0.05). After administration of dopamine the CI was further improved to 3.3 l/min.m2, the PCWP remained constant. The combined therapy with dopamine and SNP is a rational concept to improve the function of the heart in failure following open heart surgery.

Blood Pressure↗
PubMed1979

Afterload reduction by enflurane.

In 12 patients with coronary artery disease, hypertensive period during aortocoronary bypass grafting were treated with enflurane. The effects of enflurane on the general hemodynamic and the major determinants of myocardial oxygen consumption were studied. Heart rate and systolic arterial pressure were significant reduced, cardiac index and pulmonary capillary wedge pressure remained unchanged. The calculated determinants of myocardial oxygen consumption decreased, as well as the measured arterial-coronary venous oxygen content difference. The authors conclude, that enflurane can reduce the afterload in patients with coronary heart disease.

Coronary Artery Bypass↗
PubMed1979

[Haemodynamics of the systemic and pulmonary circulation during surgery of hip fractures in spinal anaesthesia in elderly persons (author's transl)].

The haemodynamics of the pulmonary and systemic circulation during anaesthesia and surgical treatment of a hip fracture were investigated in 26 patients (mean age 73 +/- 4.5 years). After induction of spinal anaesthesia the mean arterial pressure, right atrial pressure, pulmonary capillary wedge pressure and systemic vascular resistance were significantly reduced. The cardiac index remained constant due to mild tachycardia. During the operation no significant variations of the haemodynamic parameters were observed. Implantation of methylmethacrylate in 10 patients was followed by a significant increase of the mean pulmonary pressure and pulmonary vascular resistance. The PaO2 DECREASED. 15 minutes after implantation the original values were again reached.

Aged↗
PubMed1979

[Hydrocephalic psychopathy. Psychopathology and clinical symptoms in organic psychosyndrome].

In reviewing the literature on the psychopathology "of chronic hydrocephalic psychopathy" attention is called to its complexity which includes also lack of any symptoms. Nevertheless a group can be distinguished showing affective disorders of diencephalic type. Glaus and Walther-Büel examined patients with disturbances of mood and energy due to hydrocephaly who were ascribed to the psychosyndrome of local organic brain foundation after M. Bleuler; according to the aeromegaloid psychopaths they were called "hydrocephalic psychopaths". A new case is discussed who presented a small-delinquency for years with long-during forensic consequences before the discovery of a marked hydrocephaly of unknown etiology; relapses could be avoided by compensation of the forensic measures by medical and psychoagogic care. The difficulties of diagnosis are shown with emphasis on neuroradiologic clarification in suspect cases.

Adolescent↗
PubMed1978

[Therapy of low-output syndrome in patients following cardiopulmonary bypass with sodium nitroprusside and dopamine].

In 12 patients with low output after open-heart surgery the therapeutic effect of vasodilatation with sodium nitroprusside (SNP) and dopamine was studied. All patients underwent aortocoronary bypass operations. After cardiopulmonary bypass, the cardiac index (CI) was 2.2 liters/min.m2. The pulmonary wedge pressure (PCWP) was about 20 mm Hg. Application of SNP lowered mean arterial pressure to 82 and PCWP to 13 mm Hg. Then PCWP was elevated to the control level by tranfusion of blood. This therapy increased CI by about 30% without positive inotropic intervention. Additional application of 5 micrograms dopamine/kg.min improved the CI to 3.8 liters/min.m2.

Blood Pressure↗
PubMed1978

[Haemodynamic response to sodium nitroprusside in healthy people and in patients with left heart failure (author's transl)].

In 10 healthy persons (group I) and in 10 patients with left heart failure the haemodynamic response to reduction of the arterial blood pressure with sodium nitroprusside (SNP) is studied. The systolic arterial pressure (SAP) is reduced in two stages first to 100 mm Hg and than to 90 mm Hg. The SAP was then allowed to reach 100 mm Hg by reduction of the SNP dose. At this SAP a constant amount of SNP and 500 ml Dextran 60 were infused. In group I the cardiac index (CI) decreases from 3,6 +/- 0,4 1/minXm2 at a SAP of 136 +/- 11 mm Hg to 3,2 +/- 0,2 1/minXm2 (p less than 0,05) at a SAP of 101 +/- 2 mm Hg. At a SAP of 89 +/- 3 mm Hg the CI is 3,0 +/- 0,3 1/minXm2 (p less than 0,05). The right atrial pressure (RAP) and the pulmonary capillary wedge pressure (PCWP) are significantly reduced (p less than 0,01). After infusion of 500 ml Dextran 60 the CI increases to 3,9 +/- 0,3 1/minXm2 (p less than 0,05). In group II at a SAP of 132 +/- 8 mm Hg the CI is 2,7 +/- 0,2 1/minXm2, at a SAP of 99 +/- 3 mm Hg the CI is 3,0 +/- 0,3 1/minxm2 (p less than 0,05) and at a SAP of 91 +/- 2 mm Hg decreases to 2,7 +/- 0,2 1/minXm2. RAP and PCWP are significantly reduced (p less than 0,01). After infusion of 500 ml Dextran 60 the CI increases to 3.3 +/- 0,2 1/minxm2 (p less than 0,05). These results show, that SNP-Infusion in patients with left heart failure can improve cardiac performance. In patients without cardiac disease the CI decreases after SNP-Infusion due to the low preload of the heart. In both groups preload restoration with Dextran 60 can increase the cardiac index.

Adult↗
PubMed1977

[Modification of urea-N and creatinine levels using need-adapted amino acids during parenteral nutrition in patients under intensive care].

The present retrospective study concerns two sub-groups of patients having normal serum creatinine levels, adequate 24-hour urine volumes and no pathological changes in the serum or urine osmolarity. There are differences in the initial values of the serum urea nitrogen, the higher (with almost 60 mg%) being already in the azotemia range. Both sub-groups received 100 g of an amino acid mixture adapted to requirements in addition to comparable parenteral nutrition. This did not lead to non-physiological changes in urea nitrogen or any of the other parameters measured in either of the groups. The findings obtained allow the following conclusions to be drawn: Parenteral administration of a quantity of essential and non-essential amino acids adapted to requirements did not bring about a rise in urea nitrogen in either the patients with normal or raised urea nitrogen values. Hence there are not grounds for assuming that in the post-operative or post-traumatic phase the use of a mixture of essential amino acids is necessary to reduce potentially occurring azotemia.

Adult↗
PubMed1976

[Postoperative total parenteral feeding with a carbohydrate mixture (autor's transl)].

After gastric operations, patients were fed completely by the parenteral route. Aminoacids, caloric nutrients and electrolytes were infused simultaneously and continuously 24 hours daily until the fourth postoperative day. The daily supply of aminoacids amounted to 80 g. Glucose, fructose and xylite in equal proportions were used to supply calories. The total daily amount was 605 g. The important electrolytes were contained in the infusion solutions in amounts corresponding to basic requirement. The results of the investigation confirmed that patients can be successfully nourished parenterally after extensive operations with the combined daily additives we have selected.

Amino Acids↗
PubMed1976

[Effect of intramuscular dihydroergotamine on blood circulation in the early postoperative phase. A clinical study].

The effects of Dihydergot (1,0 mg i.m.) and a placebo on orthostatic regulation disturbances were examined during the mobilisation in the first post-operative phase. According to a modified Schellong-test, 100 fresh-operated patients with hyper- rsp. hypodiastolic regulation disturbances were checked on the first post-operative day. In comparison with the placebo, Dihydergot showed a stabilisation of the systolic blood pressure and a decrease of the pulse rate during orthostatic conditions. Neither Dihydergot nor placebo influenced the diastolic blood pressure. Orthostatically caused side effects were observed less frequent within Dihydergot - therapy than under placebo.

Adolescent↗
PubMed1976

[The influence of different plasma substitutes on blood clotting in isovolaemic haemodilution (author's transl)].

In a clinical study, the influence of 6 per cent Dextran 60 and 6 per cent hydroxyethyl starch (HES) on blood clotting was measured in 2 comparable groups of surgical patients. Haematocrit, platelets, thromboplastin time according to Quick, partial thromboplastin time and fibrinogen level were determined before and after isovolaemic haemodilution, and subsequently during a period of 14 days. There was no significant difference between the diluents with regard to their effect on blood clotting. Changes within each group may be ascribed to the diluting effect of the plasma substitutes.

Blood Cell Count↗
PubMed1975

Suitability of non-glucose-carbohydrates for parenteral nutrition.

Postoperative parenteral nutrition can only be optimally effective if the characteristics of post-traumatic metabolism are taken into account. Two main possibilities are discussed for the carbohydrate component of parenteral nutrition during this phase: glucose with high doses of insulin or non-glucose carbohydrates (sugar substitutes) possibly in a suitable combination with glucose. The risks as well as the technical and organisational problems involved in the use of them are discussed and the authors prefer the second of the two alternatives. Possible side effects of non-glucose carbohydrates are pointed out and it is shown how these can be avoided by observing dose guidelines. So far a combination of frucose : glucose : xylitol in a ratio of 2 : 1 :1 with a total dose of 0.50 g/kg/hour has been studied most thoroughly. This combination normalises the fat metabolism and improves glucose tolerance without requiring exogenous insulin. Experiences with this combination as well as individual non-glucose carbohydrates on operated patients have been given continuously for up to 7 days and in some cases even for several weeks. No side effects, no deviations from a steady state and no abnormal changes of the laboratory values occurred. The authors are of the opinion that non glucose carbohydrates are necessary if the facilities for frequent blood sugar controls are not available.

Adenine Nucleotides↗
PubMed1975

[Behavior of the metabolism in gastric patients during a 4-day-long postoperative complete parenteral feeding with amino acids and a glucose-levulose-xylitol combination solution].

In a clinical study we tested the following parameters: free fatty acids, beta-hydroxybutyrate, acid-base-balance, lactate, bilirubin, uric-acid, fructose, xylitole, glucose in blood and urine. The tests were executed in 9 patients who were undergoing stomac operations. The cardio pulmonary system of all patients was normal, and there was a homeostasis in water and electrolytes preoperatively. In combination with the amino-acids we received a ratio of 1:1:1 for glucose, levulose and xylitole. Totally, the patients received 0.36 g per kg body weight and per hour of carbohydrates. Beta-hydroxybutyrate, aceto-acetat, and free fatty acids show normal values under conditions of parenteral nutrition as well as lactate, uric acid, and acid-base-balance. The ratio of the different carbohydrates in serum and urine prove that the infusion time and volume were extremely favourable. The loss of carbohydrates in urine was very low.

Acid-Base Equilibrium↗
PubMed1975

[Improvement of parenteral feeding through the additional administration of a serum protein solution].

On 7 days - 5 postoperative - patients undergoing Billroth I or Billroth II were continuously infused apparatively witn an amino acid mixture of 100% and a glucose-xylitol-solution of 25% (group I). One group (group II) additionally received a serum protein solution. From the first preoperative day to the fifth day of the postoperative period we determined individual parameters in blood and urine. A decrease of serum phosphate level beginning on the first day after starting parenteral nutrition was observed. In the nitrogen balances, in total protein and albumin concentration there were no differences, but serum gamma-globulin concentration of group II was very low at the end of the parenteral nutrition period, a point which at present cannot be explained.

Blood Proteins↗