Biomedical subjects

W Beuster

Publications and source records attributed to W Beuster.

3 recordsLinked to original sources

PubMed1999

[Severe decompression sickness in divers].

The term "decompression illness (DCI)" is a disorder which arises from the presence of ectopic gas bubbles following decompression. Scuba diving poses the risk of two typically clinical syndromes: decompression sickness (DCS) and arterial gas embolism (AGE). DCS results from the formation of gas bubbles in the tissues of the body and in the blood due to rapid reduction of the environmental pressure. AGE is caused by pulmonary overinflation if the breathing gas cannot be exhaled adequately during the ascent. Although the pathophysiological mechanisms of these two disorders are quite different, both of them lead to the same result: inert gas bubbles that may cause impairment of vital functions due to hypoxia. Recognizing the signs and symptoms of DCI is the first step of the therapy. The emergency treatment contains: basic life support, advanced life support--if necessary, horizontal positioning of the victim, administration of 100% normobaric oxygen via face mask or endotracheal tube, rehydration, rapid transportation to the nearest emergency department/hyperbaric facility for definitive treatment in order to prevent serious neurological sequelae.

Barotrauma↗

PubMed1995

Application of the mechanical oscillator technique to the investigation of EVA decompression.

The ultrasonic bubble detection technique has been used as a versatile tool in the investigation of hypobaric decompression procedures for the last two decades. However, this method can only detect relatively large bubbles > 30-50 micrometers (usually in venous blood) and not the very first stages of bubble formation. Recently, the mechanical oscillator technique has been applied in air diving trials in order to detect small blood density changes due to hypothetical fluid shifts. However, sharp density drops were found in the decompression process, and these have been attributed to gas bubble formation. In this study, this method was applied together with Doppler controls to a series of altitude decompressions to 300 and 500 hPa, which represents the range of EVA operational pressures currently used or planned. Six subjects participated in both series; the oscillator sample tube could be pressurized. By the application of pressure on a blood sample containing questionable gas bubbles, these are reduced in volume, like in recompression therapy, and thus the density of the sample is increased. This effect has been shown in all 6 subjects undergoing decompression to 300 hPa, whereas in the 500 hPa series only 3 out of 6 subjects corresponded with gas phase formation immediately after decompression. Typically, Doppler bubbles appeared only after some latency time between 20 and 60 min; after this time, the density effect had nearly vanished. It is concluded that the mechanical oscillator technique represents a complementary research instrument to the Doppler method, because it is able to deliver a quantitative resolution of the early stage of gas phase formation.

Aerospace Medicine↗

PubMed1992

Open-window thoracostomy in pleural empyema.

Open-window thoracostomy (OWT) was performed in 21 cases of empyema. The indications were postpneumonectomy empyema with (n = 6) or without (n = 1) fistula, early recurrent empyema after decortication (n = 6), chronical empyema in ill elderly patients with (n = 5) or without fistula (n = 2), and total unilateral lung gangrene with a large fistula of the main bronchus after radiotherapy and chemotherapy (n = 1). All cases presented with severe sepsis, eight of them with acute septic shock, and six with signs of multiorgan failure. Three to five ribs were resected, the muscles and skin were sutured to the ribs confining the window located at the lowest point of the empyema cavity, while the intercostal muscles of the resected ribs were used to close fistulae. The cavity was packed with dressings every day. In all cases, the sepsis subsided immediately after OWT. With the exception of one patient with postpneumonectomy empyema, who died of contralateral pneumonia on day 36, no surgery-related complications were seen. Four further patients died of unrelated causes 2, 4, 5, and 7 months, respectively, after OWT. In one of them, the OWT had been closed. Up to this time, obliteration and closure of the cavity has been carried out in 7 cases by using thoracoplasty (n = 2) or predicted muscle flaps (n = 5) either in the early course or after a delay of 11 to 23 months, with fair functional and cosmetic results. In one further case, operative closure has been planned. In seven of the eight remaining patients, four of whom declined further operations, the cavities closed spontaneously, despite their initial size after intervals of between 11 and 21 months.

Adult↗