Biomedical subjects
S B Jepsen
Publications and source records attributed to S B Jepsen.
[Symptomatic helium treatment of upper and lower airway obstruction].
Since 1934 several clinical trials have been performed to investigate the effect of helium in the symptomatic treatment of upper and lower airway obstructions, especially in children. Controlled studies have only been produced during the last decade. Heliox, a mixture of helium and oxygen, has a significantly lower density than N2/O2-mixtures. This produces better flow and hence a decrease in respiratory work, improvement of distal gas exchange and theoretically less tendency to air-trapping and hyperinflation. When holding more than 40% O2 the clinical effect decreases. There are case reports of rapid subjective release, less stridor, lower respiratory rate and a normalization of hypercapnia and acidosis. Controlled studies confirm this and demonstrate a decrease in the need for intubation and mechanical ventilation. Time is bought until conventional therapy with steroids, epinephrine and beta 2-agonist inhalation works. Helium has its place in treatment of airway obstructions, but more clinical trials are needed to define the indication for symptomatic heliox treatment.
Continuous veno-venous haemodiafiltration in an infant with a stage ivs neuroblastoma and acute renal failure.
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[Intensive treatment of newborns with severe respiratory failure].
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[Pharmacological pain relief in newborn and premature infants].
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[Inhalation therapy with nitric oxide--an evaluation of a dosage system and clinical examples].
In 1987 it was discovered that nitric oxide is a very potent vasodilator and in fact a natural mediator for vasodilatation. The effects of inhalation of nitric oxide on pulmonary vascular resistance were described in 1988 and a new therapeutic possibility for artificially ventilated patients with pulmonary hypertension has arisen. However, the administration of nitric oxide has to be performed with high accuracy and without reaching toxic levels of nitrogendioxide. We have evaluated a system using conventional air and oxygen rotameters for administration of nitric oxide via a ventilator. A comparison of the chemiluminescence technique with a technique based on fuel cells was also performed. With the system it was possible to administer nitric oxide with high accuracy within the range of 10-60 ppm without exceeding values for nitrogendioxide above 0.4 ppm. The analysis of nitric oxide and nitrogendioxide based on electrochemical cells proved to be comparable with the chemiluminescence technique within the same range. Nitric oxide inhalation was used in six patients with severe hypoxia and seemed to have a favorable effect on most of the patients.
Postoperative pleural effusion following upper abdominal surgery.
Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum amylases, sex, smoking habits, or weight. There was no correlation between the localization of the pleural effusions and that of the abdominal incisions. There was a positive correlation between atelectasis and pleural effusion, but no evidence of a causal relationship. Pleural effusions might be related to postoperative sodium and water retention, and aggravated by an age-related relative cardiac decompensation. Early postoperative pleural effusions are common and do not require specific treatment.