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Biomedical subjects

W Haider

Publications and source records attributed to W Haider.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Forced diffusion ventilation (FDV). Bases and clinical application (author's transl)].

A new concept for an alternative gastransport mechanism in the lungs is introduced. It is based on an enhancement of diffusive processes in the bronchial tree and allows gas exchange under quasi apnoic conditions. This enhancement is achieved by a modified high frequency jet ventilation technique utilizing frequencies up to 3000/min. The technical equipment used for this so called forced diffusion ventilation consists of a solenoid valve that interrupts the flow from a high pressure source with adjustable frequencies and impulse pause ratios. A special tracheal tube with an additional jet line implement in its wall carring a nozzle at its tip had to be developed. Animal experiments demonstrate that a sufficient gas exchange even with frequencies of 3000/min can be achieved with this FDV. Under this conditions the lung can be kept in its expiratory inflation level. This technique using frequencies of 350/min has been successfully applied to a patient suffering from multiple bronchopleural fistulas over 16 days. Also the mechanism of FDV is jet not quite clear, penetration of fresh gas into further generation of the bronchial tree, axial diffusion and convective transport due gas oscillations and the volume displacement of the beating heart seem to be responsible for the gas exchange.

Adult↗
PubMed1979

[The alveolar-arterial oxygen quotient. standard norms, clinical findings (author's transl)].

From the practical standpoint of view the A-aDO2 proved to be a good parameter for evaluation of global gas exchange. The endexspiratory oxygen pressure, recorded by mass spectrometry, is set equal to the alveolar oxygen pressure. Therefore it is possible for clinical use to have an on line monitoring of PETO2--PaO2. It is necessary to specify the pressure difference in dependence of the inspiratory oxygen pressure since the alveolo-arterial oxygen pressure difference increases with increasing inspiratory oxygen pressure concentration. For practical clinical purposes we come out with the relative ratio of the difference adjusted to the alveolar oxygen pressure. The alveolar-arterial oxygen quotient also called "quotient": formula: (see text) has proved to be a clinical suitable figure. For this quotient are no standard norms reported in the literature. This study was set up to evaluate the quotient in 9 healthy volunteers. The standard norms, found in our study, can basically used for practical clinical purposes. This quotient is demonstrated to be practicable in intensive care medicine (obstructive pulmonary disease, acute pulmonary failure, positive pressure ventilation).

Adult↗
PubMed1977

[Influencing of the kininogen-Kinin-System by means of a kallikrein-inhibitor during extracorporeal circulation in open heart surgery (author's transl)].

During extracorporeal circulation for open heart surgery an activation of the kininogen-kininsystem occurs with a decrease in plasma-kininogen-levels significantly exceeding the effect of haemodilution, and thus being due to an increased liberation of kinin. This effect could be suppressed by kallikrein inhibition by means of a protease-inhibitor.

Adult↗
PubMed1977

[Ophthalmodynamic findings during cardiac surgery with extracorporeal circulation (author's transl)].

Neurological disturbances were seen in patients who underwent open heart surgery with prolonged extracorporeal circulation. These were found mainly in patients older than 50 years and when episodes of hypotension lower than 50 mm Hg occurred during cardiopulmonary perfusion. A method of recognizing cerebral hypoperfusion would be most helpful to prevent brain damage. According to the experimental and clinical findings of Hager the method of ophthalmodynamography allows some conclusion of analogy in relation to the reaction of the brain vessels. The intraoperative ophthalmodynamogram was recorded in 8 patients undergoing surgery using extracorporeal circulation. The ophthalmodynamograms seen during surgery on the beating heart showed changes associated with surgical manipulation. When the arterial pressure fell the orbital pulsation was decreased. The orbital pulsation stopped when the spontaneous heat beat was replaced by extracorporeal circulation. There was no change attributable to the perfusion pressure produced by the roller pump. Cessation of the orbital oscilogram during extracorporeal circulation does not indicate a cerebral hypoperfusion. No neurological lesion was seen in our patients. We were able to show that amplitude of the ophthalmodynamogram is influenced more by the blood pressure amplitued than the mean arterial pressure.

Adult↗
PubMed1977

[Rheographic monitoring of lung ventilation (author's transl)].

Electrical conductivity changes are measured with rheography. Changes of conductivity on the thorax caused by respiration, superimpose and exceed those caused by different circulatory conditions. Therefore rheography was adapted for monitoring of respiration. Changes in electric conductivity can be explained by the inflow of air to the alveoli, by increase of the distance between electrode, and by changes of the intrathoracic blood volume. Rheography developed by Polzer and Schuhfried was tested in the intensive care unit and the respiration therapy department. It was shown that this method is suitable for control of respiration, for demonstrating regional differences of pulmonary ventilation, for checking of respiration therapy and for monitoring the ventilated patient.

Asthma↗
PubMed1976

[Evaluation of exanthemas following high-dosage intravenous penicillin combinations in intensive care].

118 patients of a non specialized intensive care unit have been studied, all of them under high dose bactericidal cover (10 MIU of Na-Penicillin G and 2,0 Ciclacillin q 12 hrs.) for a period of days to 4 weeks. In 17 (14,4%) a skin rash was observed. 10 of these could be studied using special techniques (radial immunodiffusion, passive hemagglutination, RIST and RAST), however in none of these cases there was a hint of the existence of penicillin specific antibodies. In 6 patients also skin tests were performed. There was no immediate type reaction, only twice delayed type reactions occured to Na Pencillin G.6 patients had continuing treatment on spite of the rash and without further steps the effluorescences vanished within 3-6 days. Therefore continuation of the antibiotic therapy in spite of rash along with strict clinical and laboratory monitoring seems to be preferable to a hastened change of antibiotic regime

Adolescent↗
PubMed1975

[The influence of acupuncture analgesia on the sensation and feeling of pain and the autonomic state of the organism (author's transl)].

This study reports the effect of acupuncture on the sensation of pain, feeling of pain and on the autonomic state of the organism. In order to elucidate the problem physiological and psychological parameters were employed. It was observed that the insertion of the needles with electrical stimulation raised the pain threshold. The rise occurred whether a classical acupuncture point or a placebo acupuncture point was used. When the pain was assessed subjectively, it was found that the needling of a classical acupuncture point favourably influenced the experience of pain. Furthermore, persons in whom acupuncture worked well were characterized by a low subjective and objective pain threshold, a slow pulse rate and a high anxiety score.

Acupuncture Therapy↗
PubMed1975

Urinary catecholamine excretion and thyroid hormone blood level in the course of severe acute brain damage.

Urinary catecholamine excretion and thyroid hormone blood level were studied in 16 patients following severe cerebral trauma. Increased excretion rates of epinephrine and norepinephrine were found. There was no significant difference in the catecholamine excretion when compared with generally traumatized patients. The relationships between catecholamine excretion, increased metabolic rates, and negative nitrogen balance indicate that in patients with a midbrain syndrome there exists an additional diencephalic metabolic factor, which leads to a rise in fat oxidation and perpetuation of catabolism. Early high caloric parenteral nutrition seems to inhibit the initial increase of catecholamine excretion and thus protects the body from an unnecessary breakdown of its own reserves. If the course is classified according to neurological stages, it can be shown that patients with a traumatic apallic syndrome in poor condition have a high increase of catecholamine excretion. Secretion of thyroid hormones is not influenced significantly by cerebral trauma.

Adolescent↗
PubMed1975

[The treatment of respiratory failure in severe chest injury (author's transl)].

The use of artificial ventilation versus conservative treatment in 101 patients with severe chest injuries is reconsidered, because major ventilation therapy carries a high incidence of complications. This technique within the past few years has increasingly been replaced by differentiated conservative respiratory treatment. On the basis of a retrospective study it is concluded that under special conditions even the unstable chest accompanied by respiratory insufficiency may be treated successfully by this technique.

Adolescent↗
PubMed1975

[Prevention of stress reactions by influencing energy metabolism using the extracorporeal circulation as a model (author's transl)].

Following a brief discussion of the principles and pathophysiology of energy metabolism, the effects of high free fatty acid (FFA) levels upon the organism and the possibilities of preventing their accumulation are commented on. Furthermore, the question of whether extracorporeal circulation (ECC) is comparable to a stress situation is analysed. In a review of previous studies the concept is introduced that the prompt exogenous administration of adequate calories can inhibit the endogenous mobilization of energy in a stress situation. An attempt was already been made to demonstrate this point in relation to catecholamine excretion. The calories should primarily consist of easily-utilizable carbohydrates (concentrated glucose with high doses of insulin), a regimen enabling the administration also of fat emulsions as an additional source of calories even at an early stage. Patients with severe brain injuries received this treatment as from the first day of admission. Evidence that glucose metabolism impairment was successfully overcome after severe shock was obtained in 40 patients receiving glucose-insulin solutions. It was deduced from this study to prevent a stress reaction by the administration of an augmented dose of insulin before ECC. The blood levels of glucose, insulin, lipids (FFA, triglycerides, cholesterol) and heparin, as well as some routinely-determined parameters (coagulation, haematocrit, haemolysis, potassium) were studied in 31 adults undergoing open heart surgery for congenital or acquired diseases of the heart. The incidence of cardiac arrhythmias was also recorded. The metabolic influence of glucose-insulin administration on these parameters was studied in one group of the patients who received 250 ml of 33% glucose (82 g) along with 40 units of insulin-MC (24 U insulin/50 g glucose) over an average period of 80 minutes (0.9 g glucose/kg/h) before heparinization for the ECC, whereas the second group of patients served as controls. The following effects of the administration of insulin plus glucose before the period of ECC were demonstrated: Blood glucose levels were elevated throughout the infusion; within the period of ECC, however, these levels were similar to the control group. Insulin levels were distinctly elevated and remained significantly higher until after the ECC as compared with the controls. Hence, the stage of insulin suppression appears to be surpassed by these means.

Arrhythmias, Cardiac↗