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Biomedical subjects

L Teba

Publications and source records attributed to L Teba.

17 recordsLinked to original sources
PubMed1992

Understanding circulatory shock. Is it hypovolemic, cardiogenic, or vasogenic?

Circulatory shock comprises a group of complex circulatory syndromes that result from a variety of conditions. It alters the function of most organ systems and has very high mortality. Identification of the type of shock (hypovolemic, cardiogenic, vasogenic, or a combination) and optimal treatment are aided by hemodynamic monitoring, including determination of preload, cardiac output, and systemic vascular resistance. Experimental studies and isolation of bioactive substances have improved understanding of the mechanisms involved in shock. Restoration of intravascular volume, cardiac contractility, and vascular tone and control of the underlying septic process when applicable are the basis of current therapy. Close monitoring and support of the affected organ systems in an intensive care environment facilitate recovery. Encouraging results with new treatments indicate improved chances for a satisfactory outcome in patients with circulatory shock.

Humans↗
PubMed1990

Positive-pressure ventilation with positive end-expiratory pressure and atrial natriuretic peptide release.

The effect of positive-pressure ventilation (PPV) with PEEP on the release of alpha-atrial natriuretic peptide (ANP) was investigated in both humans and an experimental model. In the human study, systemic artery blood samples from 22 critically ill patients were analyzed for ANP. Seventeen of these patients received PPV with different levels of PEEP (5 to 15 cm H2O). The remaining five patients were breathing spontaneously (0 PEEP). There was no significant difference in plasma levels of ANP obtained at different levels of PEEP, and no correlation between ANP vs. wedge pressure or CVP was found. For the experimental group, in six dogs a PEEP dose-response curve was established (PEEP 0, 5, 10, 15, 0 cm H2O every 45 min). Blood samples from pulmonary and systemic arteries were obtained for ANP determination, and urine and Na excretion were measured at the end of each period. Neither significant interaction between PEEP and ANP was observed, nor did levels of this peptide correlate with the decrease in cardiac output (p less than .05) and urine output (p less than .05), or with the increase in CVP (p less than .05) observed during PEEP. ANP concentrations in the pulmonary and systemic arteries were similar. In 14 human samples, ANP was determined by radioimmunoassay and radioreceptor assay systems, but the level obtained by both methods did not significantly correlate.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Beneficial effect of norepinephrine in the treatment of circulatory shock caused by tricyclic antidepressant overdose.

The beneficial effect of dopamine in circulatory shock induced by tricyclic antidepressants (TCA) overdose may be decreased due to compromise of the endogenous stores of norepinephrine caused by TCA. The successful outcome of two cases of TCA overdose complicated by hypotension, unresponsive to an initial treatment with physostigmine fluid challenge and dopamine (greater than 15 micrograms/kg/min) but subsequently responsive to an infusion of norepinephrine is reported.

Antidepressive Agents, Tricyclic↗
PubMed1988

Long-term survival after endobronchial fire during treatment of severe malignant airway obstruction with the Nd:YAG laser.

We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor in which an endobronchial fire occurred. The patient survived without complications of the fire and was followed-up until death over 22 months after the fire. The events leading to the fire are presented and recommendations provided to prevent similar occurrences.

Aged↗
PubMed1988

Cardiac arrest after acute hyperphosphatemia.

Symptoms of hyperphosphatemia usually relate to the associated hypocalcemia. In a 33-year-old patient accidental infusion of a bolus of potassium phosphate (5 ml intravenously) was immediately followed by cardiac arrest. During CPR, clinically important hypocalcemia or hyperkalemia was not detected, but serum phosphorus was significantly increased. Because acute phosphate load can precipitate life-threatening cardiac arrhythmias, familiarity with doses and rate of infusion of phosphate is extremely important.

Acute Disease↗
PubMed1987

Beneficial effect of thyrotropin-releasing hormone in canine hemorrhagic shock.

The effects of thyrotropin-releasing hormone (TRH) on hemodynamic variables, oxygen delivery (DO2), and oxygen consumption (VO2) variables in canine hemorrhagic shock were studied. Anesthetized adult dogs were bled over 30 min to a mean arterial pressure (MAP) of 50 mm Hg. Shock was maintained at this level for half an hour. The animals were divided alternatively into two groups. In the first group (n = 5) a bolus of TRH (2 mg/kg) was given intravenously. The second group (n = 5) served as control and received equal amounts of D5W. Blood samples were obtained regularly up to 120 minutes after TRH or placebo. Differences in the two groups were statistically tested. After TRH, MAP pressure, cardiac output, and systemic vascular resistance increased significantly. DO2 improved after TRH but VO2 remained unchanged. In all dogs, sequential beta endorphin level were measured and were shown to rise after induction of shock. This data indicates that TRH may be of therapeutic benefit in the treatment of hemorrhagic shock and that beta endorphin may be an important pathophysiologic factor.

Animals↗
PubMed1986

Spermine decreases peripheral vascular resistance in the dog and relaxes the isolated aorta of the guinea pig.

Polyamines, found in all nucleated cells, have been shown to relax uterine, gastrointestinal, and respiratory tract smooth muscle. When parenterally administered to the rat or dog they cause hypotension. To determine the range of the relaxing effect of polyamines on smooth muscle and the mechanism of the hypotensive effect anaesthetised dogs were infused with increasing intravenous bolus doses of spermine while cardiovascular measurements were made. At doses of greater than or equal to 2 mg X kg-1 spermine a reversible hypotensive effect was produced that is accounted for by changes in peripheral vascular resistance. It is unlikely that this effect was due to the known propensity of polyamines to release histamine because the hypotensive action of 2 mg X kg-1 spermine was unaltered by pretreatment with the H1 and H2 blockers, diphenhydramine and cimetidine. Evidence that the spermine effect is not mediated by circulating agents was shown by the ability of spermine to relax the precontracted guinea pig isolated aorta. These results in vascular smooth muscle may be added to those in other types of smooth muscle shown to be relaxed by polyamines; the polyamine effect on smooth muscle may be ubiquitous. These data also raise the possibility that changing concentrations of tissue polyamines may play a role in the regulation of tissue blood flow.

Animals↗
PubMed1986

Evolution of cardiorespiratory variables in myxedema coma--a case report.

Normalization of hemodynamic, oxygen transport and oxygen consumption indices occurred within a week of treatment in a patient with myxedema coma. Ventilatory weaning and extubation was achieved using aminophylline, physical therapy and pleural drainage. Before extubation, naloxone was administered without any significant ventilatory improvement or change in endorphin levels.

Coma↗
PubMed1985

Effect of nifedipine on TRH stimulation of TSH and PRL release by the pituitary gland.

Studies in vitro and in vivo have shown that thyrotropin-releasing hormone (TRH)-induced calcium ion changes in the adenohypophysial cells play an important role in release of hormones by the anterior pituitary. To determine the effect of the calcium blocker nifedipine on TRH-induced thyroid-stimulating hormone (TSH) and prolactin (PRL) release, TRH stimulation tests were performed before and after 74 hours of nifedipine therapy in ten patients. Although the magnitude of the TSH and PRL mean peak increase above baseline was slightly lower during calcium blocker administration (TSH 14.1 +/- 4.8 SEM v 16.4 +/- 4.5 SEM; PRL 37.7 +/- 4.5 SEM v 41.7 +/- 5.4 SEM), this was not statistically significant. Use of nifedipine in clinically effective doses does not appear to significantly interfere with TRH-stimulated release of TSH or PRL, in vivo.

Adult↗
PubMed1985

Chylothorax review.

Chylous leakage from the thoracic duct into the pleural space may occur after any type of thoracic surgery; however, there are few reports of this condition after coronary artery bypass grafting. A case of chylothorax after combined coronary bypass and mitral valve replacement is reported to illustrate a discussion of its pathologic basis, diagnosis and management.

Chyle↗