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W Oettinger

Publications and source records attributed to W Oettinger.

32 records · Page 2Linked to original sources
PubMed1987

Profiles of endogenous prostaglandin F2 alpha, thromboxane A2 and prostacyclin with regard to cardiovascular and organ functions in early septic shock in man.

15 out of 68 patients with severe sepsis were examined in an early stage of shock and analyzed for objective hemodynamic and functional shock criteria. These data were correlated to endogenous plasma concentrations of the vasoactive arachidonate derivatives: prostaglandin F2 alpha (PGF2 alpha), thromboxane A2 (TXA2) and prostacyclin (PGI2). Marked differences in invasively measured data of cardiac, pulmonary and renal functions divided clinically otherwise comparable patients into group I and II. Group I was characterized by a hypodynamic response as compared to group II which was hyperdynamic. In spite of similar levels of PGF2 alpha (570 +/- 80 vs. 560 +/- 103 pg/ml) in both groups indicating a comparable state of arachidonate turnover, opposing profiles with regard to the TXA2/PGI2 ratio as measured from their stable degradation products were found (TXB2 [I]: a 740 +/- 184; TXB2 [II]: 280 +/- 75; 6-k-PGF1 alpha [I]: 260 +/- 117; 6-k-PGF1 alpha [II]: 940 +/- 190 pg/ml). It is concluded that early sepsis in man leads to variable profiles of endogenously released prostaglandins and thromboxane in which the predominance of PGI2 over TXA2 is associated with better cardiovascular performance and organ functions, and vice versa.

Adolescent↗
PubMed1986

[The eventration syndrome: prostacyclin liberation and acute hypoxemia due to eventration of the small intestine].

In 13 patients undergoing infrarenal aortic bypass operation under neuroleptic anaesthesia, prostaglandins (KH2PGF2 alpha, PGF2 alpha, 6-keto-PGF1 alpha) and thromboxane (TXB2) were measured immediately prior to, 5 min after and 15 min after eventration of the gut. Blood gas analyses were performed at the same points in time. The levels of PGF2 alpha, although slightly elevated, remained stable, as did the levels of TXB2 (more than half the values being below the limit of detection). In 9 patients there was an immediate increase in the level of 6-keto-PGF1 alpha (a stable metabolite of prostacyclin), associated with a significant fall in the arterial oxygen tension. In 4 patients, the levels of 6-keto-PGF1 alpha remained low and no decrease in arterial oxygen tension was observed. KH2PGF2 alpha levels remained within the normal range, indicating that there was no stimulation of general prostaglandin secretion, but an isolated release of prostacyclin. In 7 patients, a mild, moderate or pronounced flush developed which did not, however, correlate to increases in the concentration of 6-keto-PGF1 alpha. These findings indicate that eventration of the gut is followed by prostacyclin liberation in considerable amounts due to the manipulation involved or to the impairment of the intestinal circulation. The concomitant fall in the oxygen tension is caused by pulmonary vasodilation, which increases the perfusion of underventilated parts of the lung.

Adult↗
PubMed1985

Total gastrectomy. A 15-year experience with particular reference to the patient over 70 years of age.

Between 1969 and 1984, a total of 186 patients underwent total gastrectomy. Seventy-four patients were more than 70 years of age. Surgical mortality was 13.4%, with only minor differences between those patients younger than 70 years and older patients--12.5% and 14.8%, respectively. Moreover, there was no major difference if surgery was curative or merely palliative. Of 27 patients with tumors at TNM stage IV, only one died. Of the 100 patients who were operated on during the five-year period between 1979 and 1984, only four died, for an operative mortality of 4%. These results suggest that this remarkable decline of mortality is due to a precise standardization of surgical technique and improvements in preoperative patient management and aftercare. The five-year survival was 15.9%; again, there was no major difference between the group of patients older than 70 years and those younger than 70 years (19.4% and 14.5%, respectively). The ten-year survival was 4.9%.

Age Factors↗
PubMed1984

Hypoxic pulmonary vasoconstriction and endogenous prostaglandin (PG) and thromboxane (TX) release in anesthetized pigs.

Products of the arachidonate cascade are known to be released from pulmonary tissue in normal and abnormal states, contributing to the regulation of pulmonary vascular resistance. To what extent hypoxic pulmonary vasoconstriction is affected by prostaglandin imbalances is still controversial. To evaluate PG and TX release, we measured plasma levels of TXA2, PGI2, PGF2a, and 13,14-dihydro-15-keto-PGF2a in healthy pigs undergoing normobaric hypoxic ventilation. Plasma levels of TXA2, PGI2, and PGF2a did not change during 10 minutes of hypoxia, whereas 13,14-dihydro-15-keto-PGF2a, the stable metabolite of PGF2a, was significantly elevated after 2, 5 and 10 minutes. Hemodynamic parameters showed an increase in heart rate and pulmonary vascular resistance. Our results suggest that alveolar hypoxia releases PGF2a from lung tissue, being rapidly metabolized to 13,14-dihydro-15-keto-PGF2a and that prostaglandins, at least in part, contribute to hypoxic pulmonary vasoconstriction.

Anesthesia, General↗
PubMed1982

[Physiopathological significance of prostaglandins in septic shock. Clinical and experimental indications].

3 collectives of a total of 22 surgical patients demonstrate massive release of vasoactive prostanoids accompanying clinical septic shock. PGF2 alpha serves as an example for impaired pulmonary prostaglandin metabolism under this condition. Moreover, divergent profiles consisting of PGF2 alpha, thromboxane and prostacyclin can be attributed to divergent shock parameters revealing that the thromboxane/prostacyclin-ratio might be of crucial significance on whether the prostanoid profile exerts toxic or rather beneficial effects. This is demonstrated clinically by means of renal function. The clinical hypotheses are subsequently evaluated in a porcine endotoxic shock model: Comparable stimulation of endogenous prostanoids is detected. The beneficial effects of prostacyclin are concluded from objective hemodynamic and functional data of lung and kidney.

Adult↗
PubMed1980

[The significance of exogenous sodium uptake in the perioperative homeostasis of the water and electrolyte balance].

In 13 surgical patients who underwent abdominal surgery of moderate degree it has been shown that postoperative sodium substitution of normal range (1.5 m eq/kg bw. .24 h) led to hyponatremia and aldosteronism with Na+ and water retention. Aldosteronism was strongly correlated to increased activity of the renin-angiotensin-system, both anteceded by restriction of the extracellular space and expansion of total body water. These were controlled by a high sodium input (5 m eq/kg bw. .24 h) without changing the volume infusion, which is demonstrated by suppressed renin and aldosterone secretion rates, improved diuresis and subsequent reduction of total body water in favor of a preserved functional extracellular space. In order to avoid inadequate fluid redistribution it seems reasonable to meet the patient's postoperative sodium requirements by increased sodium input.

Abdomen↗