[Successful treatment of a most severe therapy-refractory status asthmaticus by extracorporeal CO2 elimination].
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Adult↗
Biomedical subjects
W Höltermann
Publications and source records attributed to W Höltermann.
[Experience with extracorporeal CO2 elimination].
The method of extracorporeal CO2-elimination (ECCO2-R) as described by L. Gattinoni [2] and Kolobow [5] is reported in ten patients with severe ARDS in whom conventional respirator therapy had failed. The method itself as well as important pulmonary function parameters, e.g. changes in gas exchange (Fig. 3), extravascular lung fluid (Fig. 6), and chest radiographs are explained. After 7-17 day treatment with the Life-Support System (LSS), seven patients were in satisfactory condition to allowing weaning from the ventilator (Responder). In three cases the lung mechanics and gas exchange were unchanged by the therapy with CO2 removal and high PEEP (Nonresponders). In the responders, oxygenation improved and the intrapulmonary shunt Qs/Qt (Fig. 4) decreased, followed by extravascular lung water and mean pulmonary arterial pressure (Fig. 5). Towards the end of the therapy we could find normalization of the compliance (Fig. 7) and chest X-rays, which may be interpreted as a cure. The results confirm our theory that ECCO2-R in combination with high PEEP and low-frequency ventilation seems to be an important method for future therapy of acute pulmonary failure.
Acute Disease↗
[Tracheal compression caused by a paratracheal cyst: a rare cause of fatal airway obstruction].
We report on a previously asymptomatic paratracheal cyst leading to an acute airway obstruction. The possibility of clinical misinterpretation of this rare, congenital malformation is emphasised.
Adult↗
[ARDS in Mycoplasma pneumonia].
In this paper we describe a case of bilateral broncho-pneumonia due to invasion by mycoplasma pneumoniae, leading to ARDS. A high serum level of cold agglutinins, a mild haemolysis and a rash resembling that of an erythema multiforme were noted. The initial treatment was non-specific. After pathogen identification tetracycline therapy was initiated. Bacterial superinfections were treated with appropriate antibiotic schemas. The observed biphasic clinical course could be explained as an immunological phenomenon.
Adult↗
[Development of a malignant non-Hodgkin lymphoma in chronic active hepatitis].
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Adolescent↗
[Oxygen-dependent influence of lipopolysaccharide endotoxin on polymorphonuclear leukocytes (author's transl)].
In in vitro experiments the effect of bacterial endotoxin (Lipopolysaccharide E. coli O 26 :B 6) on the ingestion, NBT reduction, and the formation of cytoplasmic vacuoles of polymorphonuclear leukocytes in the atmosphere of 21 vol-% O2 and 99.9 vol-% N2, respectively, was tested. High concentrations of endotoxin in O2-atmosphere cause an inhibition of the functions and a stimulation of vacuole formation, N2 atmosphere shows these effects of endotoxin on the ingestion and vacuole formation, if at all, in a lesser degree. These results show that endotoxin in high concentrations possibly causes an auto-oxidation of the polymorphonuclear leukocytes. This interpretation of the results is in accord with findings of other authors.
Endotoxins↗