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Biomedical subjects

R J Kahn

Publications and source records attributed to R J Kahn.

At least 91 records · Page 5Linked to original sources
PubMed1983

Serial lactate determinations during circulatory shock.

The time course of lactacidemia was studied prospectively in 17 patients during fluid resuscitation for an episode of noncardiogenic shock, in 5 patients after grand mal seizures, and in 5 patients after successful CPR for cardiac arrest. The 9 patients in whom shock was reversed with fluid administration demonstrated a regular decrease in lactate concentrations, which exceeded 5% of the initial value during the first 60 min of treatment. In the other patients who expired despite similar therapy, lactacidemia was not significantly affected. During circulatory shock, repeated lactate determinations represent a more reliable prognostic index than an initial value taken alone. Changes in lactate concentration can provide an early and objective evaluation of the patient's response to therapy.

Adult↗
PubMed1982

Acetate-induced myocardial depression during hemodialysis for acute renal failure.

We studied the cardiovascular effects of hemodialysis in five critically ill patients with ultrafiltration using, alternately, bicarbonate and acetate in the dialysate. After 3 hr of dialysis with acetate, significant decreases in both arterial pressure and stroke volume resulted in lowered left ventricular stroke work (P less than 0.025). This effect persisted 30 min after the end of the dialysis (P less than 0.025). Differences in the patients' cardiac preload were ruled out by similar pulmonary artery balloon-occluded pressures during both types of dialysis. These observations suggest that dialysis with acetate can result in myocardial depression. The use of bicarbonate dialysate is thus advisable for acute hemodialysis in critically ill patients.

Acetates↗
PubMed1982

Influence of incentive spirometry on pulmonary volumes after laparotomy.

Twenty patients undergoing an upper abdominal procedure were randomly assigned in two groups. One group was treated with both chest physical therapy and incentive spirometry and the other was treated with chest physical therapy alone. Spirometric values, respiratory rate, tidal volume and vital capacity were determined during the postoperative course. We observed that patients treated with incentive spirometry bad a faster return to preoperative pulmonary volumes. This observation confirms the prophylactic role of incentive spirometry in the prevention of pulmonary complications after laparotomy.

Adult↗
PubMed1981

Tricyclic antidepressants and peripheral anticholinergic activity.

Peripheral anticholinergic activity of single acute doses of three tricyclic antidepressants (amitriptyline 50 mg, desipramine 50 mg, doxepin 100 mg) and placebo was assessed by several physiologic measures in normal male volunteers. Amitriptyline and doxepin produced similar significant depressions in salivary flow and finger sweating compared to placebo, while desipramine produced no change. Supine and standing blood pressures and standing pulse yielded significant differences among the drugs. Measures in at least three areas (salivation, perspiration, and pulse-blood pressure) offer a simple and reliable battery of tests for the peripheral autonomic effects of tricyclic antidepressants.

Adolescent↗
PubMed1981

Efficacy of intravenous disopyramide in acute cardiac arrhythmias.

The efficacy of intravenous disopyramide was studied during 200 episodes of supraventricular and ventricular arrhythmias in 160 patients, mainly presenting with acute myocardial infarction or cardiac failure. Disopyramide 50 mg was administered in a few seconds and any remaining dose within 2 to 5 min. The overall success rate was 80.5%. Intravenous disopyramide was more effective in patients with ventricular arrhythmias (85%) than in those with supraventricular arrhythmias (76%). Dose dependent prolongation of the PR interval, QRS time and the QT interval occurred in 16.32 and 20% of the cases, respectively. The adverse effects were aggravation of the arrhythmias, decrease of blood pressure and anticholinergic activity.

Acute Disease↗
PubMed1981

Incentive spirometry. Prevention of pulmonary complications after abdominal surgery.

The postoperative period after laparotomy is characterized by a decrease in pulmonary volumes combined with a maldistribution of the ventilation and the perfusion. Together with manual techniques, intermittent pressure breathing and incentive spirometry have been suggested to maintain open alveoli and to prevent atelactasissis. The shortcomings related to the use of pressure-controlled devices include patient's resistance to the technique, overinflation of normal alveoli, excessive total ventilation, decrease in venous return and various gastrointestinal side effects. The incentive spirometry has been designed to promote sustained maximal inspirations and reproduce sighing mechanisms. The decrease in pleural pressure can result in high transpulmonary pressures. For many investigators, incentive spirometry represents a very easy and efficient method to prevent atelectasis.

Abdomen↗
PubMed1980

[Adult respiratory distress syndrome and military tuberculosis (author's transl)].

A patient with miliary tuberculosis developed the adult respiratory distress syndrome. The diagnosis of tuberculosis was not made especially because of several negative bacteriological examinations and of initial radiological aspects. Patient died of respiratory failure complicated with disseminated intravascular coagulation. This straightens the hypothesis of a physiopathological relationship between the two syndromes. The necessity of anti-tuberculous therapy should be evocated in every situation of adult respiratory distress syndrome of unknown origin.

Adult↗
PubMed1979

Cardiac tamponade with renal failure due to hemangioma of the heart.

In a 18 year-old woman, an isolated benign hemangioma of the right atrium led to cardiac tamponade and acute renal failure. After 8 days of anuria, the tumor was excised and replaced by a pericardial patch. The persistence of severe renal shutdown necessitated further hemodialysis during 22 days postoperatively. The patient was discharged on the 45th day in good hemodynamic and renal condition. Thirteen cases of benign hemangioma of the heart have been reported in the literature: 12 were found at autopsy; only 4 were complicated by hemopericardium but none of these survived.

Acute Kidney Injury↗
PubMed1976

Respiratory failure and cardiac disturbances in myotonic dystrophy.

Cardiopulmonary abnormalities are frequently encountered in myotonic dystrophy. We present five patients with myotonic dystrophy who entered the intensive care unit in acute respiratory failure. The possible etiologic factors of pulmonary complications are reviewed. The most important is probably aspiration pneumonia. The difficulties in the treatment of the respiratory failure are emphasezed. Myotonia of the chest muscles and diaphragm make artificial ventilation difficult. Recovery is delayed chiefly by swallowing disturbances. General anaesthesia is hazardous. Four patients presented cardiac arrhythmias and/or conduction abnormalities which were transient.

Adolescent↗