PubMed Health⌕ Search

Biomedical subjects

S Konstadt

Publications and source records attributed to S Konstadt.

15 recordsLinked to original sources
PubMed1998

Intraoperative transesophageal echocardiography during noncardiac surgery.

OBJECTIVE: To investigate the use and impact of transesophageal echocardiography (TEE) during noncardiac surgery. DESIGN: Retrospective study. SETTING: A university teaching hospital. PARTICIPANTS AND INTERVENTIONS: The medical records and the videotapes of 123 intraoperative TEE examinations were reviewed. MEASUREMENTS AND MAIN RESULTS: TEE was used for non-consultative indications in 68 patients and in consultation in 55 patients. Information that would not have been detected intraoperatively by other means included intracardiac defects, valvular and aortic pathology, the presence or absence of ventricular dysfunction or intracardiac thrombi, and embolization during surgery. Findings during the initial TEE examination and the TEE evaluation of intraoperative events resulted in a major impact on patient management in 15% of patients. The majority of patients in whom TEE had any impact (the sum of major, minor, and limited impact groups) were classified as American Society of Anesthesiologists (ASA) class 3 or 4. Patients in whom TEE had any impact were significantly older than patients in whom TEE had no impact (66.5 +/- 13.4 years v 58.1 +/- 16.2 years; p < 0.05). No patient experienced a complication related to intraoperative TEE. CONCLUSION: It appears that TEE in patients undergoing noncardiac surgery is efficacious in rapidly disclosing new findings and information during periods of hemodynamic instability. It may have a significant impact on intraoperative patient management and may be beneficial in patients older than 66 years of age.

Adolescent↗
PubMed1996

Intraoperative transesophageal echocardiography during liver transplantation.

OBJECTIVE: To investigate the safety, value, and impact of transesophageal echocardiography during liver transplantation. DESIGN: Retrospective. SETTING: University teaching hospital. PARTICIPANTS AND INTERVENTIONS: The medical records of 346 patients and the videotapes of 100 intraoperative transesophageal echocardiography examinations were reviewed. MEASUREMENTS AND MAIN RESULTS: Transesophageal echocardiography was indicated for intraoperative monitoring in 62 patients, 41 of whom had pertinent findings, and for diagnostic purposes in 38 patients, 14 of whom had the expected diagnosis verified. Thirty-one patients had no intraoperative findings. Information that would not have been detected intraoperatively by other means included intracardiac defects, the potential for transpulmonary air passage, valvular regurgitation, the presence or absence of ventricular dysfunction, and embolization occurring at allograft reperfusion. Unanticipated findings during the initial transesophageal echocardiography examination as well as evaluation of intraoperative events resulted in a major impact on patient management in 11% of patients. Preoperatively, 64 patients had a prothrombin time greater than 14 seconds; 56 had a platelet count less than 100,000/mm3; and 23 had esophageal varices, 7 of whom had not had variceal sclerotherapy. Two patients had a complication possibly caused by transesophageal echocardiography (sinus bradycardia and upper gastrointestinal bleeding). No patient experienced documented variceal hemorrhage, esophageal or gastric perforation, and/or oropharyngeal trauma. CONCLUSIONS: It appears that transesophageal echocardiography can be performed safely in patients undergoing liver transplantation, is efficacious in rapidly disclosing new information and monitoring during periods of hemodynamic instability, and may have a significant impact on intraoperative patient management during liver transplantation.

Adolescent↗
PubMed1983

The effect of limb immobilization on muscle function and protein composition.

The treatment of skeletal injuries often requires immobilization for extended periods. Immobilization causes muscle disuse atrophy, which extends the duration of incapacitation following the healing of the skeletal injury. To evaluate the role of immobilization position on the skeletal muscle, an experimental study using an animal model was undertaken. Cats were divided into four groups, with one hind limb immobilized in a plaster spica cast such that the gastrocnemius and soleus muscles were held in either a stretched, shortened, or neutral position. After four weeks of immobilization, functional and quantitative assays of muscle tissue were obtained and correlated. The shortened muscles weighed less, had a lower total content and concentration of myofibrillar proteins (the contractile protein of muscle tissue), and generated less maximum tetanic tension than either the muscles held in neutral or stretched length position. Decreased maximum tetanic tension resulted from the preferential loss of contractile protein. The remaining myofibrillar protein in the shortened muscle showed contractile dysfunction. The ability to maintain initial twitch strength (an endurance function) for five minutes varied with position but was not statistically significant in this study. The data suggest that muscle maintained in a shortened position atrophies more rapidly, with greater loss in contractile function and myofibrillar and sarcoplasmic proteins than the stretched and neutrally positioned muscles.

Animals↗