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Biomedical subjects

O Reinmuth

Publications and source records attributed to O Reinmuth.

8 recordsLinked to original sources

Predictors of electromechanical dissociation during cardiac arrest.

ECG patterns observed during cardiac arrest were analyzed in 261 comatose cardiac arrest survivors. Forty-seven patients (18%) exhibited electromechanical dissociation (EMD) at some point before restoration of stable spontaneous circulation. These patients had a higher mortality (P = .05) and a lower rate of cerebral recovery (P = .01) during the one-year follow-up than study patients who did not exhibit EMD. Patients who developed EMD subsequent to defibrillation had better outcome than patients presenting with EMD. Multivariate analysis revealed that age more than 70 years old (P = .007), pulmonary disease (P less than .001), diabetes (P = .013, in-hospital arrests only), and prearrest hypoxemia (P = .013, outside-hospital arrests only) were independently predictive of the occurrence of EMD. Although the generalizability of these findings is limited, they may offer new clues to the pathophysiology of EMD.

Aged↗

An international collaborative clinical study mechanism for resuscitation research.

Recent experimental and clinical studies of cardiac arrest, suggesting a brain damage ameliorating effect of thiopental loading, stimulated the development of an international randomized clinical trial of brain resuscitation. Twelve collaborating hospitals in 9 countries are testing the efficacy of post-cardiac arrest thiopental loading (30 mg/kg body wt). The methodology for assessing insult and outcome data, as well as risk and benefit monitoring, is described. This clinical trial will be completed in 1983 and is expected to provide valuable data about the efficacy of thiopental loading. The study mechanism is now well-established and ready for the evaluation of future promising brain resuscitation therapies.

Clinical Trials as Topic↗

Cerebral blood flow and metabolism in the Wernicke-Korsakoff syndrome.

Cerebral blood flow and metabolism were measured by the iodoantipyrine-4-(131)I method in nine patients and by the nitrous oxide method in three patients with the Wernicke-Korsakoff syndrome.Cerebral blood flow and cerebral oxygen and glucose consumption were strikingly reduced from the normal, whereas cerebral vascular resistance was increased. Total cerebral metabolism and blood flow may be greatly reduced even though the cerebral metabolic defect is confined to circumscribed anatomical areas. Profound reduction in brain metabolism is not necessarily reflected in alterations of consciousness or awareness as has been previously suggested, or in electroencephalographic abnormalities. This appears to provide cogent support for the neurophysiological principle that disturbance of consciousness is a function of the location of the lesion, not the over-all degree of metabolic defect. The absence of improvement of cerebral metabolic functions in two patients who were restudied after an additional 2 to 3 weeks of treatment confirms the clinical impression of incomplete recovery in many such patients.

Adult↗