Biomedical subjects

L Orellano

Publications and source records attributed to L Orellano.

16 recordsLinked to original sources

PubMed1991

[Enoximone in postoperative "low-output syndrome"--comparison with dobutamine].

Low output syndrome sometimes complicates early postoperative states following cardiac surgery. A comparative study of hemodynamic responses to enoximone and dobutamine was carried out in two groups of 20 patients each, during a 22-24 hour postoperative observation period. Enoximone, 1 mg/kg i.v. total dose, was given in the first 20 minutes. The infusion was then reduced to 2-10 micrograms.kg-1.min-1 for the next 22-24 hours. Dobutamine was administered in a dose of 4-7 micrograms.kg-1.min-1 over the same period. After 15 minutes of therapy with enoximone cardiac index increased by 42% (initial value 2.31 +/- 0.34 l/min/m2), after 30 minutes by 50%, after 120 minutes by 65% and after 24 hours by 91% from the initial value. At the same time the pulmonary capillary wedge pressure decreased from the initial value of 15.21 +/- 1.65 mmHg by 20%, 25%, 26% and by 43% (22 hours). After dobutamine cardiac index increased from 2.23 +/- 0.6 l/min/m2 by 30% (15 minutes), 47% (30 minutes), 57% (2 hours) and by 85% (22 hours). The pulmonary capillary wedge pressure decreased from 15.70 +/- 3.14 mmHg by 13% (15 minutes), 17% (30 minutes), 22% (2 hours) and by 43% (22 hours). The enoximone group showed a diminution of systolic arterial pressure of 14% in the first 120 minutes, with a return to initial values after 22 hours. Dobutamine produced an increase in systolic arterial pressure of 23% after 2 hours, maintaining increased values of approximately 20% during the observation period. Heart rate increase slightly in both groups in a similar way.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1990

Comparison of dobutamine and enoximone for low output states following cardiac surgery.

Low output syndrome sometimes complicates early postoperative states following cardiac surgery. A comparative study of haemodynamic responses to enoximone and dobutamine was carried out in two groups of 20 patients each, during a 24-hour postoperative observation period. Parameters in addition to routine measurements were determined using a pulmonary artery catheter. Enoximone, 1 mg/kg i.v. in total, was given in the first 20 minutes. The infusion was then reduced to 3-20 micrograms/kg/minute for the next 24 hours. Dobutamine was administered in a continuous dose of 5-7 micrograms/kg/minute over the same period. After 15 minutes' therapy with enoximone, cardiac index increased from 2.31 +/- 0.34 litres/minute/m2 to 3.30 +/- 0.38 litres/minute/m2; after 120 minutes to 3.83 +/- 0.60 litres/minute/m2 and after 24 hours to 4.34 +/- 0.50 litres/minute/m2. Pulmonary capillary wedge pressure at the same intervals decreased from 15.21 +/- 1.65 mm Hg initially to 12.11 +/- 2.83, 11.2 +/- 4.50 and 8.77 +/- 2.98 mm Hg. After dobutamine, cardiac index rose from 2.33 +/- 0.60 litres/minute/m2 to 2.90 +/- 0.81 (15 minutes), 3.52 +/- 0.74 (120 minutes) and 4.12 +/- 1.07 litres/minute/m2 (24 hours). The pulmonary wedge pressure values decreased in this group, from 15.20 +/- 3.14 mm Hg at the beginning to 13.74 +/- 3.02 (15 minutes), 12.17 +/- 5.25 (120 minutes) and 9.81 +/- 4.23 mm Hg (24 hours). The enoximone group showed a diminution of systolic arterial pressure of 14% in the first 120 minutes, with a return to initial values after 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1988

[Digital subtraction angiography of acquired arteriovenous fistulas of the extremities].

The signs of arterio-venous fistulae in the extremities have been evaluated by DSA in 20 patients. Angiographic signs for the presence of A-V fistulae are the following findings: dilatation of the supplying artery, elongation of the supplying artery, solitary A-V aneurysm, angiomatous A-V aneurysm, reduced blood flow distal to the A-V fistula, early venous filling, development of a venous collateral circulation and demonstration of retrograde venous flow. Angiography remains the method of choice for demonstrating A-V fistulae.

Angiography↗

PubMed1988

[Acute renal failure in a prominent aneurysm of the iliac artery].

This is a report on a patient of 64 years of age who was admitted to hospital as an inpatient thirteen years after obliteration of the iliac artery with an extension plasty. He complained of irregular stools and occasional abdominal pain. Imaging methods were employed on account of a drop in the haemoglobin count, progressive renal insufficiency and a palpable tumor in the lower abdomen. These methods supplied evidence of a false aneurysm originating from the iliac endarterectomy, combined with compression of the ureter and small intestine. Based on the present case report, the general complex of problems in diagnosing aneurysms of the iliac artery is discussed.

Acute Kidney Injury↗

PubMed1987

[Computed tomography and angiography in aortic dissection].

The authors report on 32 patients with dissecting aneurysm examined via computed tomography, 21 of whom were also additionally examined by means of angiography. Whereas CT with contrast medium bolus resulted in a diagnosis in dissecting aneurysm in all the cases, aortography failed in 2 patients because of a thrombosed dissection. Aortography offers clear advantages over CT, besides better spatial representation, in respect of clarification as to which aortic branches are involved, especially in the region of the aortic arch. On the other hand, the advantages of CT are lower invasiveness, high sensibility and the possibility of including concomitant complications when establishing the diagnosis.

Aortic Dissection↗

PubMed1987

[CT findings in ruptured abdominal aortic aneurysms].

In nine patients with ruptured aneurysms of the abdominal aorta and in one patient with a ruptured aneurysm of a common iliac artery who also had an abdominal aortic aneurysm, CT was performed. Three of the nine patients were also examined by sonography. CT proved to be the method of choice in the diagnosis of ruptured abdominal aortic aneurysms. The most important CT signs are: demonstration of an aortic aneurysm; haematoma usually unilateral and retroperitoneal; ventral or ventro-lateral displacement of a kidney; enlargement of the psoas, which may be indistinguishable from the haematoma, possibly with direct penetration of the psoas fascia; indistinct margin of the aortic wall at the rupture site.

Aged↗

PubMed1987

[PMN elastase in extracorporeal circulation procedures].

Proteolytic enzymes released by polymorphonuclear neutrophils are assumed to be important mediators in the development of shock-induced and sepsis-induced organ failure, especially of ARDS. The most remarkable of these enzymes is elastase because of its relatively high intracellular concentration and low substrate specificity. The release of elastase can be monitored by measuring the plasma concentration of elastase-proteinase inhibitor complex. In this study, the elastase concentration pointed towards side effects of methods of extracorporeal circulation. The elastase concentration rose more than sixfold in 20 patients during membrane oxygenation (mean time 124 min) and 15 patients during bubble oxygenation (mean time 77 min). We found that the elastase concentration was affected by the kind of foreign material surface, the time of perfusion and the perfusion volume. The comparison of in-vitro and in-vivo circulation underlines the importance of the terminal capillary bed (in the lung) and of a pre-existent activation of leukocytes, since elastase levels rose only insignificantly during in-vitro recirculation. These results confirm that extracorporeal circulation seems to be able to induce harmful disturbances of the ARDS type. This fact should be taken into consideration when using methods of extracorporeal gas exchange.

Adolescent↗

PubMed1986

[Successful treatment of a massive pulmonary embolism after 90-minute external heart massage].

A 27-year-old woman sustained a massive pulmonary embolism (cause unknown) with circulatory arrest. She was intubated and ventilated while external cardiac massage was performed and urokinase was infused (1.5 X 10(6) U/h). These resuscitative measures were continued while she was transferred by helicopter to the nearest cardiothoracic surgical centre, 40 km away. Thrombectomy was successfully accomplished under extracorporeal circulation after (from its onset) 90 minutes of external cardiac massage. No neurological or other sequelae occurred. This case demonstrates that early and continuous resuscitative measures in a general hospital, followed by rapid transfer to a cardiothoracic surgical centre with immediate operation, can achieve a successful outcome.

Adult↗

PubMed1986

[Digital subtraction angiography in traumatology].

The methods, indications and results of digital subtraction angiography in traumatology are presented, based on 56 examinations. The different use of intravenous or intraarterial DSA will be discussed with respect to expanding and localisation of traumatic vascular injury. DSA is recommended as the method of choice for follow-up after vascular reconstructive procedure.

Angiography↗

PubMed1986

[Accuracy of cardiac CT and echocardiography in the diagnosis of space-occupying processes in the heart].

CT of the heart and echocardiography was performed on 107 patients with various space-occupying lesions of the heart. In addition, 27 patients were subjected to angiocardiography. A comparison of the findings has shown that cardio-CT is superior to two-dimensional echocardiography for demonstrating pericardial masses and intracavity thrombi. There was no significant difference as far as intracavity or intramural tumours were concerned. CT and sonography are superior to angiography in the diagnosis of cardiac space-occupying lesions.

Adolescent↗

PubMed1983

[Aneurysm of the ascending aorta with aortic valve insufficiency].

Nine cases are reported who had aneurysms of the ascending aorta and aortic valve incompetence and in whom aortic valve prostheses and aortic prostheses had to be implanted. Two patients had dissecting aneurysms. In five patients, the origins of the coronary arteries were involved, and these had to be implanted into the prostheses. Chest x-rays in two planes, kymograms and CT provided the diagnosis. The most important pre-operative examination in order to assess valve function and the origins of the coronary arteries is catheter angiography.

Adult↗

PubMed1983

[Clinical aspect and noninvasive diagnosis of cardiac myxomas].

The alteration of cardiac function in the presence of intracardiac tumors varies considerably according to their localization, size, and mode of insertion. Various cardiovascular diseases can be mimicked, e.g., primary valve dysfunction, cardiomyopathy, intracardiac shunts. Embolic events are frequent secondary symptoms. However, subtle noninvasive techniques such as M-mode and sector echocardiography, pulsed Doppler echocardiography, digital video subtraction angiography (DVSA), and computed tomography permit a thorough diagnosis of intracardiac tumorous masses without heart catheterization and catheter angiography. In this paper, myxomas within the left atrium (LA) and the right ventricle (RV) are described. Leading symptoms were systemic embolism and mitral stenosis (LA localization), low cardiac output and right to left shunt (RV localization). First suspicion of intracardiac tumor was raised by M-mode and sector echocardiography, whereas the diagnosis of LA myxoma was in one case missed by computed tomography and the RV myxoma was missed by right ventricular catheterization. In that case, only the four-chamber subxiphoidal sector echogram substantiated the diagnosis and explained the hemodynamic constellation of very low pulmonary pressures combined with right to left shunt. By the new technique of DVSA, all three tumors were plainly visualized. Nevertheless, echocardiography proved to be the most reliable technique of detecting intracardiac tumors.

Aged↗

PubMed1980

[Computer tomography of aorto-coronary bypass (author's transl)].

Computer tomography is a non-invasive method for demonstrating occlusion or patency of an aorto-coronary bypass. The early results of computer tomographic investigations of 77 bypasses in 51 patients are described. CT diagnosis of bypass patency is well established, but further work will be required to determine the accuracy of computer tomographic diagnosis of bypass occlusion.

Arterial Occlusive Diseases↗

PubMed1976

[Surgical considerations on levo-atrial systemic vein (author's transl)].

The levo-atrial systemic vein is a special type of persistent left superior vena cava and is associated with other intracardiac lesions most often. Hemodynamically there is a right to left shunt. The operative procedure may consist in a ligature in relation to the anatomic situation. The intraatrial correction intends a drainage to the right atrium. Of 7 cases four times a intracardiac rerouting was achieved but two times a ligation was performed.

Child↗

PubMed1976

[Intraventricular conduit for complex forms of transposition of great vessels (author's transl)].

Complex forms of transposition of great vessels necessitate different approaches to correction. In a case of double outlet right ventricle with d-transposition and atrioventricular concordance and a subvalvular pulmonary stenosis an intraventricular conduit with a 16 mm Dacron vascular prosthesis was used. This was anastomosed in an acute angular manner with the muscular margins of the VSD and routed to the base of the aorta. Surgical and anatomic implications are discussed.

Cardiac Catheterization↗

PubMed1975

[Comparison of tolerance to ischemia in human and animal myocardium during various forms of induced cardiac arrest (author's transl)].

In a total of 16 patients the tissue pH was determined on myocardium both during surgery and on isolated samples. Cardiac arrest was induced by hypothermal infusion cardioplegia and external cooling. In the isolated human myocardium section pH values were continuously determined at 15 degrees C. Parallel to these measurements samples were taken for electron microscopic examinations. In this way the pH limit under which the human myocardium cannot be revived could be visualized by additional morphologic examination. These results and those from the intrasurgical measurements with a fixed heart muscle surface probe were compared with each other and with results from animal experiments.

Adenosine Triphosphate↗