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Biomedical subjects

M Zindler

Publications and source records attributed to M Zindler.

At least 19 recordsLinked to original sources

[Hypothermia for cardiac surgery with cessation of circulation--start of open heart surgery in Germany].

The first surface hypothermia with cessation of the circulation in Europe has been performed in Duesseldorf on February 9, 1955 for the direct suture of an atrial septal defect. Risks and insufficient basic knowledge are mentioned and the procedure is described with a protocol of anesthesia, cooling in ice water and rewarming in a water mattress. Eighth weeks later, the first series of 7 patients with closure of an atrial septal defect were presented at the congress of the German Society of Surgery. One patient died on the 13th postoperative day due to a cerebral thrombosis, unrelated to hypothermia. After 4 years a pump oxygenator became available and hypothermia was reduced to about half of the open heart procedures for 5 years and decreased further. Until 1978 with more than 1800 hypothermias for open heart surgery and some aneurysms of the aorta and cerebral arteries without the aid of a pump oxygenator the largest series in the world could be attained. As most important success was regarded that in none of our patients with cessation of circulation, which was repeated up to three times, a lasting cerebral damage occurred.

Anesthesia↗

Whole body oxygen consumption in awake, sleeping, and anesthetized dogs.

To study the metabolic effects of anesthesia, whole-body oxygen consumption (VO2) was compared on 242 occasions in six dogs under standard conditions while awake, sleeping, or anesthetized. The dogs were trained to lie unrestrained in the lateral position for the measurement of VO2 (STPD) in the unanesthetized state. Arterial blood gas tensions, pHa, heart rate, and blood pressure also were determined. The maximum VO2 of the alert resting and the minimum of the drowsy resting state averaged (+/- SE) 5.57 +/- 0.48 and 3.97 +/- 0.41 ml X kg-1 X min-1, respectively. VO2 was lowest and least fluctuating during natural sleep (2.46 +/- 0.2 ml X kg-1 X min-1). During deep anesthesia with methohexital, thiopental, and etomidate, VO2 averaged (+/- SE) 4.68 +/- 0.26, 4.26 +/- 0.28, and 4.77 +/- 0.35 ml X kg-1 X min-1 during spontaneous ventilation (open-circuit flow-through technique) and 3.54 +/- 0.27 ml X kg-1 X min-1 during controlled ventilation (open-circuit collection technique) with 2% halothane. Anesthesia reduces VO2 relative to the resting values of the alert state but increases it relative to that of natural sleep. Accordingly, anesthetics should not be considered general metabolic depressants without qualification.

Anesthesia, General↗

Etomidate, a new short acting, intravenous hypnotic.

Etomidate can be recommended for short procedures combined with fentanyl and for the induction of neuroleptanesthesia. It has advantages in poor risk patients because it has only negligible effects on the heart and the peripheral circulation. It has to taken in consideration though, that etomidate has only hypnotic and no analgesic action.

Anesthesia↗