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R I Wesdorp

Publications and source records attributed to R I Wesdorp.

At least 37 records · Page 2Linked to original sources
PubMed1991

Total body blood volume redistribution in porcine E. coli septic shock: effect of volume loading, dobutamine, and norepinephrine.

The purpose of the present study was to determine the effect of volume loading alone (CONTR) vs. volume loading in combination with dobutamine (DOBU) or norepinephrine (NOR) on total body blood volume distribution in septic shock. After instrumentation, injection of in vitro labelled 99mTc red blood cells, and baseline measurements, anesthetized, ventilated pigs (n = 21) received 3-4.10(8).kg-1 live E. coli bacteria intravenously. Images of thorax, abdomen, and hindlimb were obtained by using a gamma camera simultaneously with hemodynamic measurements. E. coli infusion resulted in a decrease in arterial pressure, ventricular filling pressures, and cardiac output with a concomitant increase in pulmonary arterial pressure. Blood volume was redistributed from the heart, lungs, spleen, abdomen, and leg to the liver. After randomization, the CONTR group (I, n = 5) was subjected to volume loading, and treatment groups (each n = 8) received volume loading in combination with DOBU (group II, 5-10 micrograms/kg/min) or NOR (group III, 0.25-0.50 micrograms/kg/min). As compared to volume loading alone, DOBU and NOR increased cardiac output but only NOR restored arterial pressure. Volume loading increased blood volume in all regions studied; however, it was unequally distributed amongst organs with a preference for the liver. Neither DOBU nor NOR influenced the partitioning of the infused volume between organs. However, NOR prevented pooling of blood in the leg.

Animals↗
PubMed1990

Tubular colonic duplication: report of two cases.

Colonic duplication is a rare congenital abnormality frequently associated with multisystemic malformations. Colonic duplication presents diagnostic and therapeutic difficulties especially in neonates. We report on two patients, a child and an adult with tubular duplication. Treatment consisted of using the duplicated loop for a pull-through procedure in the first patient and resection of the duplicated loop in the second. The results of the surgical treatment in these two patients have been satisfactory.

Adult↗
PubMed1985

The value of objective measurements to select patients who are malnourished.

Several studies have attempted to define nutritional parameters that can be used to select malnourished hospitalised patients for nutritional support. A combination of objective nutritional parameters was evaluated in a group of 50 patients selected for total parenteral nutrition on clinical grounds only and compared with a control group. This control group consisted of 38 patients who were admitted for elective minor surgical procedures such as varicectomy and hernia repair. On a subset of 18 objective nutritional measurements, discriminant analysis was performed. In the evaluation it was shown that a combination of albumin (ALB), prealbumin (PALB), total lymphocyte count (TLC) and the percentage of ideal weight (PIW) was the most useful combination of nutritional tests in discriminating a chosen malnourished (M) group and a control group who were declared not malnourished (NM). With this combination the patients were correctly classified in 93% with a sensitivity of 93% and a specificity of 94%.

Journal Article↗
PubMed1985

Complications of central venous catheterization of the subclavian vein: the influence of a parenteral nutrition team.

Early and late complications of central venous catheterization were investigated in 488 consecutive catheters, 389 introduced in the subclavian vein by a percutaneous puncture technique, 84 by a cut down technique of the cephalic vein, and 15 by a peel away technique. Care and introduction of the catheters was controlled by the parenteral nutrition team in 239 cases. Immediate and late complications were found using both the puncture and venous cut down techniques, but immediate complications differed in the two groups due to the different methods of insertion. The rate of catheter related sepsis (CRS) did not differ significantly when the group under control of the nutrition team was compared with the group without nutritional control (5.9 vs. 6%). The rate of CRS was 1 CRS/220.7 days of therapy in the puncture group and 1 CRS/342.2 days of therapy in the venous cut down group. Catheter tips and blood were cultured from both CRS and non-CRS patients, and the micro-organisms identified. Catheters were withdrawn, under supervision of the nutrition team, for a number of reasons including death, thrombosis, and technical problems, but suspicion of CRS accounted for a high percentage of withdrawals (18% in the puncture group, 16.6% in the venous cut down group). It is suggested that, when CRS is suspected, removal of the catheter should be delayed until all other possibilities have been investigated.

Catheterization↗
PubMed1984

Energy replacement during parenteral nutrition in surgery, sepsis and cancer.

For many years, the increased nutritional requirements of surgical, septic and cancer patients were identified, but no effective therapy existed for averting their negative calorie and nitrogen balance. Parenteral nutrition offered an answer in many of these situations. However, abnormalities in liver function, ventilatory load, hyperglycemia and a disturbed metabolic homeostasis showed that in excessive amounts, glucose can behave as a relatively toxic substance. For cases with increased energy expenditure, new alternatives had to be devised in order to avoid excessive glucose intakes. One obvious possibility in these cases was to refrain from offering more than the basal caloric needs, until the patient had passed the period of acute injury, or other measures had effectively controlled the sepsis or cancer. Other options included the partial substitution of glucose by lipids or amino acids. Preliminary information suggests that this approach could lead to better nutritional outcome and survival rates, but additional studies are required.

Journal Article↗
PubMed1984

A palliative percutaneous drainage procedure for proximal bile duct carcinoma.

Proximal bile duct carcinoma is surgically irresectable in most patients and some form of palliative drainage is necessary. Percutaneous transhepatic drainage for this condition has been performed in eight patients through internal and external drainage. Five patients had an adequate drainage with a mean palliative drainage period of 11 months, the longest period being 21 months. The other three patients, with a mean age of 88 years, died within four weeks due to terminal disease. The direct transhepatic approach seems an attractive alternative to surgical bypass procedures as a palliative treatment. In particular, if the tumor involves both hepatic ducts, combined left and right hepatic duct drainage offers a new possibility in palliative treatment.

Aged↗
PubMed1983

Percutaneous transhepatic drainage and insertion of an endoprosthesis for obstructive jaundice.

As a consequence of the good results with percutaneous transhepatic cholangiography using the Chiba needle, a similar technique was employed for percutaneous transhepatic drainage and insertion of a percutaneous transhepatic endoprostheses. Herein we have described the technique and results of percutaneous transhepatic cholangiography with the Chiba needle in 45 patients and of combined percutaneous transhepatic drainage and insertion of an endoprosthesis in a consecutive group of 69 patients with obstructive jaundice. In the latter group, 50 patients had a malignant lesion. Of these, 38 were subject to continuous drainage, 14 externally and 24 with an endoprosthesis. The percutaneous transhepatic drainage and insertion of an endoprosthesis procedure brings a new dimension to preoperative decompression of the bile ducts and palliative treatment of obstructive jaundice in high-risk patients.

Adenoma, Bile Duct↗
PubMed1981

Gastrin and gastric acid secretion in renal failure.

In 10 anephric patients awaiting transplantation, 15 patients with chronic renal failure and 30 patients with acute renal failure, daily basal plasma gastrin levels and basal and stimulated gastric acid secretion were measured. Significant elevated plasma gastrin levels were found in all of the anephric patients and in 50 percent of the patients with acute and 55 percent of those with chronic renal failure. Elevated plasma gastrin levels decreased to normal after kidney transplantation or when kidney function returned to normal in the patients with acute renal failure. Gastric acid secretion studies showed a consistent pattern in all three groups of patients with a low basal acid output, a high basal intragastric pH and a very significant peak acid output, perhaps secondary to elevated plasma gastrin levels due to inadequate renal inactivation of gastrin. This may partly explain the increased incidence of gastrointestinal bleeding and gastritis seen in patients with different degrees of renal failure.

Acute Kidney Injury↗
PubMed1980

Pseudomembranous colitis after whole gut irrigation with neomycin and erythromycin base.

An unprecedented fatal case of pseudomembranous colitis (PMC) is described, associated with the use of topical antibiotics (neomycin and erythromycin base) during whole gut irrigation. This case was one of a cluster of five, occurring within a period of 4 months in 1978. These observations tend to support the hypothesis that disturbances in bacterial flora give rise to PMC and furthermore that the short-term use of antibiotics does not prevent the occurrence of PMC.

Colon↗