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Biomedical subjects

P Satter

Publications and source records attributed to P Satter.

At least 109 records · Page 6Linked to original sources

[Results of embolectomy in massive pulmonary embolism (author's transl)].

In ten patients successful embolectomy after acute massive pulmonary embolism was performed. Clinical symptoms included circulatory arrest and shock as well as collaps, syncope and dyspnoe. Pulmonary angiography regularly showed massive, bilateral emboli. In 9 patients more than one half of the pulmonary artery system was involved (perfusion defect more than 50%). Right heart catheterization demonstrated pulmonary hypertension in all cases. In 8 patients the pulmonary artery mean pressure (PAm) exceeded 30 mm Hg. In 9 patients there were signs of right heart failure (RVEDP more than 11 mm Hg). At recatheterization 6 to 30 (mean 19) days after operation using cardiopulmonary bypass there was a marked improvement of pulmonary angiograms, which were normal in 3 cases. PAm decreased from 34.3 mm Hg to 14.6 mm Hg postoperatively and RVEDP from 14.4 to 5.1 mm Hg (p less than 0.001). These results confirm, that pulmonary embolectomy leads to a good functional results.

Acute Disease↗

[Prevention using cephalothin in open-heart surgery].

To assay the efficiency of cephalothin prophylaxis in open-heart surgery, bacteriological examination of pressure-measurement units, intravenous catheter tips, and urine were made in 211 consecutive patients as well as blood cultures and sputum in suspected postoperative sepsis. Furthermore, cephalothin concentration in serum and tissue was determined in 12 consecutive adults with intact kidney function. Samples were taken before, during, and after the cardiopulmonary bypass, the tissue from the right atrium only before and after cardiopulmonary bypass. A high serum cephalothin level (80.04 +/- 23.35 microgram/ml) was measured 30 min after administration of 2 g cephalothin given as a 15-min-long i.v. infusion on induction of anesthesia. An antibiotic regimen - 4 X 2 g dose of cephalothin daily (first dose on induction of anesthesia) - provides a serum cephalothin level which is significantly higher than the cephalothin minimum inhibitory concentrations for most gram-positive organisms (0.475 microgram/ml) and so ensures an adequate antibiotic coverage throughout the surgical procedure and during the early postoperative phase of open-heart surgery.

Adult↗

[Surgical intensive care].

Patients for intensive care in surgery can be divided into 3 groups: 1. Patients in poor preoperative conditions which should be corrected before surgery is performed; 2. Patients with extensive operations and expected or unexpected postoperative complications; 3. Patients with extensive traumas. --In the postwar period medicine developed at a tremendous speed. Modern intensive treatment of those patients with managed by a new group of doctors who had based their primary training in Surgery and continued their professional career in Anaesthesiology. In the last two decades, however, pathophysiologic thinking found its way and a new type of surgeon emerged. Special fields such as cardiovascular-endocrinological-gastroenterological surgery etc, appeared. Nowadays preoperative as well as postoperative treatment is considered to be an important factor in surgery and applied by all specialists. --Anaesthiologists however still play a major role in intensive medicine for surgical patients. But due to the fact that surgical training only plays a little or no part in their professional training, their role is hardly more than that of an important and necessary consultant. A new type of a doctor for surgical intensive medicine may perhaps develop somewhere in the future, but at present successful intensive care in surgical patients can only be achieved by perfect cooperation.

Anesthesiology↗

[Surgical treatment of cerebrovascular insufficiency due to extracranial obstruction of the carotid artery(author's transl)].

Reconstruction of the carotid artery was performed in 41 patients (between 1967 and 1974). All had had signs of cerebrovascular insufficiency. There was angiographic evidence of obliterating arteriosclerotic lesions in the carotid artery of 32 patients, carotid aneurysm in two, kinking of the internal carotid artery in four, and acute thromboses of the carotid artery in three. Early and late results indicate that best chances of success exist for stage II and III a cases. The high mortality rate in stages III b and IV (five of twelve patients) clearly shows that in these reconstruction of the carotid artery should be embarked on with caution, especially in the early stages.

Adult↗

[Total electrode retraction (Twiddler syndrome) in infection of the pacemaker system].

We report upon a case of total retraction of an electrode (Twiddler syndrom) in an infected pacemaker battery. The silk-thread fixation was still fastened at the right place on the electrode; the tissue owing to the inflammation was no longer sufficient as a fixation point. The casues of this total retraction of the electrode are the following factors: the battery hat sufficient freedom of movement for rotation following exudation into the pacemaker cavity, the electrode was elastic and above all the pacemaker system was infected which could no longer guarantee a sufficient fixation of the electrode in the infected tissue. Attention is drawn to the necessity to remove an infected pacemaker system.

Aged↗

[The effect of ischemic and cardioplegic heart standstill on the myocard metabolism in normal and less perfused heart (author's transl)].

The tolerance of ischemia in normal and less perfused myocard during an ischemic and cardioplegic heart standstill was investigated. A decrease of ATP and ADP and an increase of the lactate, pyruvate and AMP was established during an ischemia of 20 minutes. The less perfused hearts gave considerably worse results regarding the energy transformation than normal hearts. In less perfused hearts the energy reserve of myocardial metabolism showed a considerably better behaviour during a cardioplegic heart standstill of 45 minutes than an ischemic one of 20 minutes. During the recuperation period this trend was emphasised.

Adenosine Diphosphate↗

[Chances of reducing the formation of immune antibodies after massive transfusions in open heart surgery (author's transl)].

Children, young people and women at the age of possible maternity form the majority of patients operated by extracorporal circulation. A longterm planning of these operations should also have donor in call, who are compatible with the patients' Rh groups and Kell antigens. Having practiced such a selection of donors we succeeded in reducing the formation of immune antibodies. 6 out of 330 patients had antibodies, but 4 had been sensibilized before operation. In the case of the other 2 it would not be excluded that they might have been immunized a long time ago. We emphasize the importance of hemodilution, strict indication of every postoperative therapy with red cells and the autologous transfusion.

ABO Blood-Group System↗