PubMed Health⌕ Search

Biomedical subjects

O H Just

Publications and source records attributed to O H Just.

At least 19 recordsLinked to original sources
PubMed1990

[Continuous intragastric pH measurement in intensive care patients treated with ranitidine and tube feeding].

We studied 22 critically ill patients on long-term mechanical ventilation using continuous intragastric pH monitoring with an antimony electrode. Intragastric pH profiles were established for the duration of mechanical ventilation (mean: 7 days). The aim of our study was to achieve a gastric pH between 3.0 and 4.5 utilizing the H2-receptor antagonist ranitidine and nasogastric feeding with Nutricomp F. Patients were divided into three groups which were given (A) ranitidine boluses, (B) continuous ranitidine infusions, or (C) continuous ranitidine infusions together with enteral nutrition via the nasogastric tube. In group B we were able to obtain a pH value between 3.0 and 4.5 only in 11.6% of the observation period. With ranitidine boluses, there were even less measurements (9.3%) in the "optimal" pH range. The combination of continuous ranitidine application together with enteral alimentation made our attempts slightly more successful (20.0%). This failure to achieve the desired pH range encourages airway colonisation and nosocomial pneumonia at gastric pH greater than 4.5. At pH less than 3.0 there is a significantly higher incidence of acute stress ulcerations. Other therapeutic regimens e.g. the application of pirenzepine and sucralfate offer adequate protection of the gastric mucosa without raising the pH level.

Adult↗
PubMed1986

[The history of anesthesia at the Heidelberg University].

An account is given on the development of general anaesthesia at the university clinics of Heidelberg. During the last century mainly chloroform was employed for general anaesthesia. Important events were the first demonstration of Koller's local anaesthesia in the eye in 1884, the first intubation for anaesthesia in Heidelberg, performed by F. Kuhn of Kassel and the development by M. Neu of a rotameter apparatus for nitrous oxide/oxygen anaesthesia in 1910. From 1932 on the surgeon M. Kirschner advanced the methods of high pressure infiltration for regional anaesthesia and segmental hypobaric spinal anaesthesia. In 1951 K. H. Bauer requested R. Frey to set up an "anaesthesia squad" consisting of 2 physicians and 3 nurses to become the nucleus of today's Institute of Anaesthesiology, with O. H. Just as its first professor and chairman.

Anesthesia↗
PubMed1980

[Barbiturate infusion in severe brain trauma (preliminary report) (author's transl)].

The pathophysiology of brain trauma regarding disturbances of energy and transmitter metabolism, development of intra- and extracellular cerebral oedema are briefly outlined. Possible mechanisms of action of barbiturates in amelioration of cerebral ischaemia, decrease of cerebral metabolism, preservation of membrane stability, reduction of cerebral oedema and intracranial pressure are reviewed. We report on 6 patients with severe brain trauma due to head injury whose intracranial pressure despite conventional treatment with hyperventilation, steroids and osmotic diuresis remained above 25 mm Hg. They were infused with thiopentone 6--12 mg/kg x h for 6 to 15 days, to reduce cerebral electrical activity to the point of "burst suppression" in the electroencephalogram. Three patients survived, two of them regaining their previous good health. The results in these patients are discussed as regards thiopentone dosage and severity of trauma. Marked cardiovascular instability in one case and cholostatic jaundice due to barbiturate administration in two cases were the most important side effects. Barbiturate infusion seems to be indicated in brain trauma with sustained elevation of intracranial pressure above 25 mm Hg despite vigorous conventional therapy. Monitoring most essential to this aggressive treatment scheme comprises measurement of intracranial pressure and continuous observation of the EEG.

Adult↗
PubMed1979

[Clinical uses of electrostimulation anaesthesia (author's transl)].

Since 1972 electrostimulation anaesthesia (ESA) has been employed in an attempt to reduce the amount of anaesthetic agents needed. In the beginning the Chinese combination of acupuncture points was used; at a later stage Benzer et al. inserted the needles paravertebrally and Abdulla replaced the needles by contact electrodes for ophthalmic operations. At the Department of Anaesthetics, Hamburg, the same course was followed, i.e. the classic acupuncture points were used originally, then the acupuncture points were used originally, then the technique was changed to paravertebral insertion of the needles and now only paravertebrally placed contact electrodes are being employed for inducing ESA for various surgical operations. All three techniques of ESA have proved satisfactory; but ESA with contact electrodes is considered the method of choice on account of both practical considerations and success rate.

Acupuncture Therapy↗
PubMed1979

[Electrostimulation anaesthesia for surgery of the limbs (author's transl)].

In Germany electrostimulation anaesthesia (ESA) has, so far, not been considered suitable for surgical operations on the extremities. An attempt was made to develop a combination of acupuncture points that would allow the use of ESA for this type of surgery. Based on the experience gained with ESA in abdominal surgery the suitability of paravertebral contact electrodes for operations on the limb was studied. Because of its simplicity and efficacy this technique of ESA is highly recommended.

Acupuncture Therapy↗
PubMed1978

[A new method for the transcutaneous measurement of deep body temperature during anaesthesia and intensive care (author's transl)].

A new method for monitoring deep body temperature is described. It is based on the establishment, by means of electronic appliances, of a zone without heatflow from the deep tissues. The method is simple and the results compare favourably with those obtained by other procedures for measuring core temperature. The uses of this transcutaneous mehtod are discussed and its advantages and reliability in the operating theatre and intensive care unit are emphasized. It becomes less reliable if it is employed during and after extracorporeal circulation in hypothermia on account of the temperature gradient.

Anesthesia↗
PubMed1977

[Infusion therapy in cardio-pulmonary insufficiency (author's transl)].

The pathogenesis of cardiopulmonary insufficiency in intensive-care patients is reviewed, with special reference to the development of interstitial pulmonary oedema. Measures designed to control the condition and compensate for the increased post-operative and post-traumatic calorie and aminoacid requirements are: 1. restricted fluid intake; 2. digitalization and administration of diuretics; 3. administration of highly concentrated human albumin. Potential pulmonary reactions to, and possible beneficial effects of, parenteral fat administration are discussed.

Angiotensin II↗
PubMed1977

[A special technique of neurolept analgesia for thermocoagulation of the gasserian ganglion (author's transl)].

A special technique of neurolept analgesia for electrocoagulation of the gasserian ganglion is described which has been used since 1974. Induction is by means of Fentanyl and Valium. The dosis is sufficiently low for the patient to remain responsive and co-operative but practically painfree. The actual thermocoagulation is performed in intravenous methohexital sodium anaesthesia. The dosis is kept so low that the patient wakes up within 2--3 minutes and is able to inform the surgeon of the success or failure of the operation. If no relief from pain has been obtained a further 20 mg of methohexital are injected and the operation is repeated.

Diazepam↗