[The child with heart disease. VI. Arrhythmias].
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Biomedical subjects
Publications and source records attributed to K Sandhage.
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The principles of treatment of diphtheria are discussed: in the present epidemic situation, diphtheritic children must be admitted to a pediatric hospital. The children need at least 3 to 4 weeks, to a large extent strict, bed rest. The basic concepts of the treatment of both peripheral circulatory weaknesses and of myocardial damage are communicated. Glucocorticoids have proved their value in myocarditis. Prophylactic digitalization is to be rejected. Confirmed heart failure is a binding indication for digitalization. A causal therapy for para- and metadiphtheritic paralysis does not exist. All forms must be treated with antibiotics nowadays. In croup, tracheotomy must not be delayed too long. The nursing must be left the best staff only and requires, in addition to a fundamental knowledge of the disease picture, an exceptional empathy in the particular, especially psychic, situation of the sick children.
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It was shown that bilirubin in its unconjugated form does not only harm the central nervous system. Clinical observations indicate that the toxic effect under certain conditions affects also the heart. In a simple experimental model the influence of free bilirubin on the activity of the heart was investigated. In 69 adult frogs the heart was isolated and exposed sequentially to solutions of different bilirubin concentrations while the heart actions were registered. There was no significant change in the activity of the heart under the influence of bilirubin although concentrations were reached which according to the results of other authors harm cell cultures or evoke in the newborn disturbances in various organs. As a possible explanation, the nonsusceptibility of the heart muscle to bilirubin, the short duration of exposure, and the different behavior of newborn and adult organs is discussed.
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