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Biomedical subjects

P Lust

Publications and source records attributed to P Lust.

16 recordsLinked to original sources
PubMed1993

Incidence of nosocomial pneumonia in ICU patients.

EURO.NIS, is conceived as a multicentric, prospective evaluation of the real incidence of pneumonia in I.C.U.'s all over Western Europe. As one of the 29 Belgian participants in this study, we performed the registration as required by the standard protocol, but also investigated our local incidence of nosocomial pneumonia in more detail. All patients hospitalized in the ICU for more than 24 hours during a survey period of 1 month are included. Recorded at the end of the first 24 hours are sex, year of birth, clinical classification, risk factors, severity score; at discharge from the ICU are recorded: mechanical ventilation and humidification equipment, sedation and relaxation, gastrointestinal bleeding prophylaxis and SDD, data on pneumonia and outcome; finally three days after discharge are clinical signs of pneumonia and survival status recorded. The overall European incidence rate of pneumonias acquired in the ICU's is 11.8%; the incidence rate in the Belgium ICU's is 10.2% and as for Bruges it is 12.8%. The incidence rate of deaths associated with pneumonia is respectively 3.5%, 3% and 3.2%. These results warrant further study of causes and prevention of nosocomial infections in our ICU.

Aged↗
PubMed1988

Bilateral ulnar nerve injury after high abdominal surgery.

We report a case of bilateral injury to the ulnar nerve above the level of the elbow due to a particular retractor used for high abdominal surgery. Possible mechanisms of pathogenesis and predestinating conditions are discussed.

Abdomen↗
PubMed1985

Exotic snakebite, an unusual emergency. A case report and therapeutic considerations.

Envenomation by exotic poisonous snakes constitutes a rare emergency in Western Europe, but which in the future may be seen more frequently due to the increasing number of captive specimens in private collections. A case report of moderate envenomation by a viper is described. Diagnostic problems and therapeutic management are discussed for viper envenomation. The importance of differentiating between local and systemic poisoning is emphasized.

Adult↗
PubMed1984

Brain protection in the immediate post-resuscitation phase.

There is a type of cerebral lesion, which kills neuronal cells at a later stage (greater than 48 hrs) post CA, while the systemic circulation is functioning normally. Although this lesion is probably dependent on multiple factors (----multiple therapies), a keyfactor in the pathogenesis is the loss of autoregulation and "finetuning" of the cerebral bloodflow according to local tissue metabolic needs. Although beneficial effect of almost none of the following therapies has been documented in randomised clinical studies, the following suggestions are made: a) In the CA-CPR phase: efficient respiratory care and external cardiac compressions (ECC), especially during bicarbonate administration; consider open chest CPR early, especially in cases of long arrest time and ineffective ECC. The socalled new CPR does not improve neurological outcome. b) In the post CPR phase: The non-autoregulated brain (cfr. focal ischemia) is kept preferentially at pCO2 values 25-30 mmHg, pO2 values greater than 100 mmHg, and normotension. Some form of stress, seizure and hyperthermia control prevents further imbalance metabolism/bloodflow. Relative dehydration, oncotic balance, steroids, early control of sepsis and uremia, early CT scan and measurement/control of ICP. All the above is currently grouped under "standard neuro-intensive therapy". Some other therapies, presently suggested by animal research are not very obvious, need first randomised clinical studies and are not suggested at this stage for clinical use: barbiturate coma, diphantoine, streptokinase, multifaceted therapy including hemodilution-brainflushing, Ca++ influx blocking drugs (lidoflazine). One such "innovative" therapy, barbiturate coma, has already been proven to be relatively ineffective (BRCT I) (Acta anaesth. belg., 1984, 25, suppl., 219-226).

Animals↗
PubMed1980

Cerebral resuscitation. A review.

The brain is the target organ of resuscitology. Besides known cardiopulmonary optimalisation, new therapeutic modalities--in particular barbiturate therapy--are introduced in the intensive care of patients with various syndromes of postischemic encephalopathy. An overview of animal research and our clinical experience in "cerebral resuscitation" is discussed.

Animals↗
PubMed1980

Hemodynamic monitoring and vasodilator therapy in acute left ventricular failure. Preliminary report on a new vasodilator, tolmesoxide.

Data, obtained by invasive hemodynamic monitoring, are now routinely available in our Intensive Care Unit, and are processed by means of a small calculator to a cardiovascular profile, including O2 transport/consumption, vascular resistance and ventricular work values. Patients with clinically persistent shock states, after 12-24 hours optimal classical cardiovascular therapy, are invasively studied. Vasodiltor therapy frequently improves not only hemodynmic parameters, but also oxygen delivery to the tissues. Tolmesoxide, a new peripheal vasodilator, has been used in eleven patients. Preliminary results are discussed.

Acute Disease↗
PubMed1978

[Clinical use of thiopental in post-ischemic encephalopathy; preliminary report].

Twenty patients suffering from post-ischaemic encephalopathy were treated with high doses of barbiturates during the period immediately following resuscitation. The duration of cerebral ischaemia was assessed retrospectively. The degree of ischaemic damage was evaluated on the one hand by the pupillary signs seen 10 minutes after the reestablishment of the circulation and secondly by enzyme levels in the CSF. This barbiturate load was not associated with major complications and the excretion of barbiturate continued for several days. The clinical signs seen 12 hours after ischaemia and continuous observation of the tracing of the cerebral function monitor made it possible to give an early favourable prognosis from a neurological standpoint. In all the patients (apart from one) in whom there was total cerebral ischaemia for less than 10 minutes, neurological recovery was complete.

Adolescent↗
PubMedDate not supplied

Mobile resuscitation. A review of 200 calls attended by anaesthetists.

Evaluation of practice in a mobile resuscitation unit, staffed routinely by anaesthetists, over a 3 month period is described. Of 200 calls attended, the doctor was considered to have played a necessary role in sixty-seven, and in seven patients the doctor's attendance was considered to have contributed significantly to the patient's survival.

Anesthesiology↗