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Biomedical subjects

W Behrendt

Publications and source records attributed to W Behrendt.

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

How reliable are short-term measurements of oxygen uptake in polytraumatized and long-term ventilated patients?

O2-uptake was measured continuously in 18 polytraumatized and 21 long-term ventilated patients. All patients were on assisted ventilation with sufficient sedation and analgesia. O2-uptake was measured every minute, the values were recorded over 24 h and the mean O2-uptake/min was calculated. At the same time, the O2-uptake of the last 15 min of every hour was measured separately (e.g. 7.45-8.00, 8.45-9.00, etc.). The mean O2-uptake/min measured continuously was compared and correlated with the mean O2-uptake per day, calculated on the basis of each of the short-term measurements. There were only slight differences between the mean values of the two procedures: In the group of long-term ventilated patients the mean O2-uptake was found to be 364 ml/min in continuous measurements and 363 ml/min in short-term measurements. This O2-uptake corresponded to an energy expenditure of 2360 kcal/day. The mean correlation coefficient was 0.89 (range: 0.79-0.96). If O2-uptake was measured over 2 periods of 15 min each, e.g. in the late morning and in the afternoon, the mean correlation coefficient improved to 0.94 and the standard deviation was reduced. Comparable results were obtained in the group of polytraumatized patients. This study shows that under certain preconditions short-term measurements of O2-uptake of 2 x 15 min allow sufficiently reliable predictions of the daily O2-uptake and energy expenditure in severely traumatized or critically ill patients.

Adult↗
PubMed1991

Posttraumatic hypocaloric parenteral nutrition--development and clinical application.

The use of hypocaloric parenteral nutrition (HPN) is very common in surgical medicine because it allows for a standardized peripheral venous supply of nutrients. HPN causes very little stress to the posttraumatically labile carbohydrate metabolism-this applies to the use of glucose as well as to sugar substitutes: For example, mean glucose concentrations in serum on glucose administration of 2-3 g/kg/day are between 5.5 and 8.4 mmol/l. The mean dose of amino acids of 1.0-1.2 g/kg/day commonly used in HPN leads to a 50-67% improvement in the N-balance compared to an exclusive water/electrolyte supply or the administration of 2 g of carbohydrates per kg and day. Even a high caloric nutritional therapy leads to no significantly improved N-balances on the first posttraumatic days. HPN is recommended after major surgery and severe trauma in order to better estimate the individual metabolic reaction to nutritional supply prior to any consumption-orientated parenteral nutrition. HPN is also important as an adjunct to early-phase enteral nutrition. Its value after moderate surgical interventions is questionable because studies have yet to confirm HPN's clinical efficacy. HPN should not be used after minor surgery or brief periods of fasting. A possible, but as yet uncertified indication for HPN is the longer-term nutrition of very obese patients.

Energy Intake↗
PubMed1990

The influence of posttraumatic parenteral calorie and nitrogen supply upon the cumulative nitrogen balance.

The aim of the study was to describe the influence of posttraumatic calorie and nitrogen (N) supply upon the cumulative N-balance by analyzing the literature of the past 18 years. Three groups of patients were formed, in which nutritional therapy was performed following trauma of differing severity: (1) patients following moderate trauma-N-losses 10-15 g/day; (2) patients following severe trauma--N-losses 15-20 g/day; and (3) polytraumatised patients--N-losses more than 20 g/day. The data gained for the calorie and N-supplies as well as for the N-balances in each group of patients served as a basis for the calculation of regression analyses of higher order; in these the cumulative N-balance was regarded as a function of the calorie and the N-supply: NBcum = f (C, N) Whilst for the group of polytraumatized patients only statements for a nutrient supply of about 20-30 kcal/kg BW/day and 0.2-0.3 g N/kg BW/day are possible, due to the limited data available, general statements about the different influence of calorie and N-supply can be made for nutritional therapy after moderate and major trauma; the calculated functions reveal that the N-supply influences the N-balance decisively, whereas the calorie supply exerts only a slight N-sparing effect. The mathematically calculated optimum of the N-supply after severe trauma is 0.2 g/kg BW/day, corresponding to an amino acid supply of 1.25 g/kg BW/day.

Algorithms↗
PubMed1988

Glucose, fructose, and xylitol in postoperative hypocaloric parenteral nutrition.

The aim of the study was to use glucose, fructose and xylitol as alternative carbohydrates in hypocaloric parenteral nutrition (HPN) and to investigate their different nutritional effects. Twenty-four patients who had undergone elective gastrointestinal resection were examined in a prospective randomized study. Only metabolically normal patients between 30 and 65 years of age were admitted to the study. No patient with a body weight more than 20% above or below the normal weight of the patients was admitted. The study period extended from the operation day to the fifth postoperative day. The patients were given approximately 1.1 g amino acids and approximately 2.9 g carbohydrates per kg/B.W. and day using either glucose, fructose or xylitol as carbohydrates. The mean plasma glucose concentrations ranged between 6 and 8 mmol/l without insulin being supplied. There were no significant differences between the groups. However, the administration of glucose led to a somewhat larger dispersion range of the values. The labile plasma proteins (transferrin, prealbumin, retinol-binding protein) in the 3 groups revealed almost identical concentration courses. With N-losses between 51 and 57 g/4 days, only slightly negative cumulative N-balances were calculated (-4 to -13 g/4 days). No significant differences were observed between the 3 groups in the level of the urea-N production rates. Advantages which favor a general administration of fructose/sorbitol or xylitol in HPN could not be found in our investigation.

Adult↗
PubMed1987

Continuous measurement of oxygen uptake. Evaluation of the Engström metabolic computer and clinical experiences.

A new system for continuous measurement of oxygen uptake was tested. The tidal volumes delivered by the system, the accuracy of the oxygen sensor cell, measurement of the oxygen uptake at different inspired oxygen concentrations, and comparative tests of oxygen uptake using the Fick principle were studied. Judging from our results, even thorough maintenance could not entirely prevent leakages. Due to a construction error, there was a large increase in measured oxygen uptake if inspired oxygen concentration was increased. While carbon-dioxide output was constant, this led to respiratory quotients of less than 0.5. By modifying the system with a mixing chamber for the inspiratory gas, new tubing to the oxygen sensor cell and changes in the computer software, these errors have been corrected in the meantime. In comparative tests of oxygen uptake using the Fick principle (cardiac output and arteriovenous oxygen content difference), we found a mean difference between EMC and the Fick principle of about 6.6% (P less than or equal to 0.001, r = 0.91) with nearly identical standard deviations for both values. Our experience indicates that the EMC is suitable for continuous measurements of oxygen uptake. Additional technical improvements seem to be possible.

Anesthesiology↗
PubMed1985

[Continuous measurement of oxygen uptake using the Engström Metabolic Computer].

A new system for continuous measurement of oxygen uptake was tested (EMC). Delivered tidal volumes of the system, the accuracy of the oxygen sensor cell, measurement of the oxygen uptake related to different inspiratory oxygen concentrations as well as comparative tests of oxygen uptake according to Fick's principle were studied. Furthermore, we looked for possible leakages in the system. Following to our results even thorough maintenance could not entirely prevent leakages. There was a remarkable increase in measured oxygen uptake if inspiratory oxygen concentration was increased. While carbon-dioxide output was measured at constant levels this led to low respiratory quotients, some of these were less than 0.5. This was caused by a construction error of the system which could be corrected in the meantime. In 70 comparative tests of oxygen uptake between EMC and Fick's principle (measurement of cardiac output and arteriovenous oxygen content difference) we found a mean difference of about 10% (p less than or equal to 0.001) with nearly identical standard deviations. The EMC measured the higher oxygen uptake. Based on our experience the EMC is suitable for continuous measurement of oxygen uptake but it needs good knowledge of the system and the underlying measuring procedures. Additional technical improvements seem to be possible.

Adolescent↗
PubMed1984

[Cytodiagnostic studies of the laryngeal mucosa in chronic laryngitis].

Cytological diagnostic aids in chronic inflammation of the larynx have been rarely employed so far. A study was conducted to prove whether there is any possibility of larnygeal cytological diagnosis and whether there are any premalignant changes. In view of the results obtained by gynaecological exfoliative cytology, attention was focussed on the metaplastic cells. The frequent incidence of metaplasias was highly significant, whereas dysplasias occurred only in chronic laryngitis besides in tumours. One trend occupying higher cytological diagnostic groups in the Papanicolaou pattern was seen in chronic laryngitis. In our opinion, cytological diagnosis in laryngeal investigation is an aid in the followup control in chronic laryngitis, which is a repeatable procedure without unduly stressing the tissue. Recording of cellular changes in chronic laryngitis can enable a prospective appreciation of morphological changes, which can be useful as diagnostic tool for examining suspicious findings.

Chronic Disease↗
PubMed1984

[Parenteral feeding following heart surgery operations].

After aorto-coronary bypass operations 40 patients were treated in a prospective-randomized study with 3 types of hypocaloric parenteral nutrition consisting of the same content of amino acids (75 g/day) but different amounts of carbohydrates: 120 g dextrose, 120 g or 200 g dextrose/fructose/xylitol (1:2:1) per day. 18 patients received only 75 g/day of dextrose (controls). The fluid volume for parenteral nutrition did not exceed 1500 ml/day. Changes in carbohydrate and protein metabolism were investigated. Because of restricted carbohydrate dosage, we needed no insulin to keep blood glucose within values of about 7-10 mmol/l. Postoperative serum insulin levels were significantly raised to 4-5 fold of preoperative values in all groups. Serum potassium concentrations remained normal under a supply of 80-100 mmol/day. Cumulative nitrogen balances were improved by about 48-58% in groups receiving parenteral nutrition despite a calorie/nitrogen ratio of 40:1 or 66:1 respectively. The expected beneficial effects on the concentrations of visceral serum proteins (transferrin, prealbumin, retinolbinding protein, cholinesterases) could not be found.

Blood Glucose↗
PubMed1983

[Catamnestic studies in sub- and infertile couples].

310 infertile couples have been studied retrospectively over a 15-year period from the andrological and gynaecological view. Teratozoospermia in men and tubal disturbances in women respectively turned out to be the most common causes. Isolated male infertility was found in 33%, that of the female partner in 19%. Both partners were involved in 40%. 93 women (30%) finally gave birth to a child after successful treatment.

Adult↗
PubMed1983

[Postoperative changes of plasma amino acids following abdominal and vaginal hysterectomy].

This study on the metabolism of amino-acids following gynaecological operations confirms, that abdominal and vaginal hysterectomies cause a so-called post-aggression metabolism. The majority of the aminograms showed changes in the metabolism of nitrogen. The aminograms were carried out by the Stein-Moore chromatography. The administration of a 3% complete solution of aminoacids changed the metabolism of the short time enzyme proteins into an anabolic phase and therefore diminished complications such-as paralytic ileus impaired wound healing, infections, and edema.

Amino Acids↗
PubMed1983

[A rare complication following the insertion of a bleier-secu-clip].

A case of bilateral torsion of the fallopian tubes, the right with a hydro-salpinx is reported. This occurred 8 months following tubal sterilization following by the Bleier Secu-clips in a case of acute abdominal pain following tubal sterilization the differential diagnosis of a torsion of the fallopian tube with swelling of the infracted tube must be considered in addition to a torsion of an ovarian cyst.

Abdomen, Acute↗