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At least 163 records · Page 9Linked to original sources
PubMed1995

[Induction of impaired hepatic microcirculation by in situ hilus preparation in liver explantation].

AIM: Usually, in-situ preparation of the hepatic hilar structures is performed prior to the perfusion with preservation solution. Aim of this study was to investigate mechanical effects of liver preparation on the hepatic microcirculation. METHODS: 16 pigs (German landrace) were randomized in two groups. In both groups, laparotomy was performed after intratracheal intubation. Subsequently, a thermal diffusion probe was implanted into the medial left liver lobe for quantification of microperfusion. In group A (n = 8), bile duct, hepatic artery, and portal vein were exposed and the lesser omentum transsected thereafter. Ultrasound-volume-probes were placed around the hepatic artery and portal vein. Simultaneous measurement of hepatic microperfusion and total liver blood flow was performed five minutes after the end of liver preparation. In group B (n = 8) hepatic microperfusion was quantified 45 minutes after laparotomy without further manipulations. RESULTS: By the preparation, liver perfusion was significantly reduced in group A from 78 +/- 13 ml/100g/min to 61 +/- 16 ml/100g/min. After preparation a total liver blood flow of 137 +/- 46 ml/100g/min was recorded indicating a shunt fraction of 51 +/- 21%. In contrast, hepatic microperfusion in group B remained at baseline during the whole observation period (79 +/- 3 ml/100g/min vs. 78 +/- 5 ml/100g/min). CONCLUSION: In-situ liver preparation induces a relevant disturbance of hepatic microcirculation. Preservation perfusion shortly after surgical manipulation could become ineffective because of an increase in shunt flow. If the regeneration period is too short, e.g. lack of heart explantation, the quality of the liver graft could be limited.

Animals↗
PubMed1995

[Purulent neuroinfections in the course of septicemia in the years 1988-1992: personal experience].

Between 1988 and 1992 thirty patients with purulent infections of central nervous system in the course of bacterial septicaemia were treated in the Intensive Care Unit of the I Clinic of Infectious Diseases of Silesian School of Medicine in Bytom. These cases made about 32% of the total bacterial neuroinfections treated in the Clinic during that time. Imminent or existing acute respiratory insufficiency, increasing intracranial pressure, intensification of haemorrhagic diathesis and imminent septic shock were the indications to the hospitalization in the Intensive Care Unit. Neisseria meningitidis, Streptococcus pneumoniae and Escherichia coli were the most often found etiological factors in subsequently 53.33%, 33.33% and 3.34% of patients. In 10% of cases the etiological factors remained unknown. Intratracheal intubations and/or tracheotomies were carried out in over 60% of patients. About 40% of cases required assisted or controlled mechanical ventilation with the aid of ventilator (on the average 5 days). Mean time of hospitalization in the Intensive Care Unit closed in the period of 7 days. Mortality in the analyzed group was 23.33% (7 cases). Bacterial septicaemia with purulent infections of central nervous system often leads to the directly life threatening complications. Hospitalization in conditions of Intensive Care Unit affords possibilities for effective treatment and improvement of prognosis in patients suffering from these diseases.

Adult↗
PubMed1994

[Effects of support pressure ventilation with facial mask in patients with chronic respiratory failure in acute decompensation].

BACKGROUND: In previous nonrandomized studies the efficacy of ventilation with back up pressure with face mask (BUPM) in the treatment of patients with chronic obstructive pulmonary disease (COPD) in acute decompensation has been demonstrated. This study analyzes the acute effects and the clinical efficacy of BUPM in a group of patients with COPD in acute respiratory failure comparing the same with conventional therapy (CONV). METHODS: A prospective randomized study including patients with COPD in acute decompensation was carried out comparing treatment with BUPM (n = 9) with CONV treatment (n = 9). Back up pressure was fixed at 20 cmH2O. Acute gasometric effects were analyzed as well as the need for intratracheal intubation, mortality and hospital stay. RESULTS: No clinical or gasometric differences were found between either group of patients upon admission. Only the patients of the BUPM group presented a significant improvement from gaseous exchange and respiratory frequency from the first hour of treatment. Three of the nine patients (33%) of the BUPM group and nine of the CONV group of patients (100%) required intubation and mechanical ventilation (p = 0.001). CONCLUSIONS: Back up pressure face mask is the technique of choice in patients with chronic obstructive pulmonary disease in acute decompensation given that this technique leads to a rapid and significant improvement of gaseous exchange and avoids the need for intubation and mechanical ventilation in most of these patients.

Acute Disease↗
PubMed1993

[The importance of capnometry and pulse oximetry in laparoscopic cholecystectomy].

Recently the number of surgical and gynaecological operations performed via laparoscope has increased. The authors looked for the answer whether the carbon dioxide insufflated into the abdominal cavity during laparoscopy could cause significant change in the amount of carbon dioxide expired per minute. They measured the concentrations of carbon dioxide at the end of expiration, the amount of carbon dioxide produced per minute and the oxygen saturation during ataranaesthesia, muscle relaxation, intratracheal intubation and controlled mechanical ventilation in 20 cases of laparoscopic cholecystectomy. According to the results the amount of carbon dioxide exhaled per minute increased 1-3 minutes after insufflation and its maximum value was reached within 15-30 minutes (120-140% of the basic value). The continuous pulsoxymetrical examination showed that the constant intraperitoneal pressure equal or higher than 13-15 Hgmm could lead to the increase of the intrapulmonal shunt-circulation due to dystelectasis of the pulmonary bases. This could be prevented by increasing the respiratory pause-pressure to the level corresponding to the intraperitoneal pressure. In order to decrease the intraoperative anaesthesiological risks associated with the procedure the authors propose the use of capnometer and pulsoxymeter for the mentioned operation; this will keep level up with the relatively small risks associated with the postoperative period of the laparoscopic operations.

Adult↗
PubMed1993

[Anaesthetic management of pediatric renal transplantation for chronic renal failure].

We evaluated the preoperative and intraoperative general condition of 33 pediatric kidney recipients. Eighteen patients were anaesthetized with lumbar epidural anaesthesia. Ten patients were with nitrous oxide-oxygen-halothane, 5 cases were with NLA. Preoperatively many children had cardiovascular and metabolic complications. For example 39% of patients had history of hypertension. Sixty-seven percent of patients were found to have cardiomegaly (cardio-thoracic ratio > 50%) with chest X-ray film. Seven of 9 patients undergoing echocardiogram had abnormality of cardiac wall motion, valvular impairment, pericardial effusion. In forty-eight percent of patients, hyperlipidemia was found. During operation we could not maintain the cardiovascular stability following intratracheal intubation and manipulation of vena cava or abdominal aorta under NLA or nitrous oxide-oxygen-halothane anesthesia. Epidural analgesia inhibited the cardiovascular fluctuation following these surgical stresses. We concluded that epidural analgesia is the best anaesthesia for pediatric renal transplantation and phentolamine or PGE1 are useful to maintain cardiovascular stability and transplanted kidney function.

Adolescent↗
PubMed1978

Delay in the development of the allergic response to metals following intratracheal instillation.

Intracheal intubation with the soluble metal salts potassium dichromate (K2Cr2O7) and nickel sulphate (NiSO4) causes a delay of up to 8 weeks in the development of delayed hypersensitivity to the specific agent. It is suggested that absorption of sensitizers by the respiratory route may, under certain circumstances, induce a state of specific immunological unresponsiveness, rather than necessarily lead to the development of a state of allergic sensitivity.

Animals↗
PubMed1990

[An adapter for the intratracheal administration of a bronchodilator in intubated patients].

To relieve intraoperative bronchospasm, bronchodilators are often given via endotracheal tube. Most anesthetic adapters for dose-metered inhalers deliver the agent into the anesthesia circuit outside the tube. An unpredictable loss of drug due to sedimentation on the inner wall of the tube results. A simple and cost-effective device for delivering the agent near the tip of the tube is presented.

Anesthesiology↗
PubMed2001

Oral endotracheal intubation of rats for intratracheal instillation and aerosol drug delivery.

As reported in the literature, oral endotracheal intubation of rats is considered to be very difficult. Specialised equipment and complicated techniques have been described to perform this procedure. In our experiment we adopted a simple method, which allowed-without any complicated equipment-the insertion of a relatively wide tube into the trachea of rats, allowing drug administration.

Administration, Inhalation↗