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Anasthesie, Intensivtherapie, Notfallmedizin最新文献

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[Fiber bronchoscopy as an aid in placing and monitoring double lumen tubes in thoracic anesthesia]. 纤维支气管镜在胸麻双腔管放置和监测中的辅助作用。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-12-01

H Schottke-Hennings, H J Klippe, B Schmieding

{"title":"[Fiber bronchoscopy as an aid in placing and monitoring double lumen tubes in thoracic anesthesia].","authors":"H Schottke-Hennings, H J Klippe, B Schmieding","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>100 thoracic surgery patients were intubated by means of a left-hand Broncho-Cath PVC Double-Lumen Tube (DLT) and 10 further patients with a right-hand tube. In 76 of the 100 left-hand DLT's safe conventional placement of the tube was successful, oriented exclusively by auscultation findings and positive pressure respiration. However, fibre-optic control showed that only 44 of these tubes were correctly positioned (57.1%). 25 DLT's were too high and 24 too low, whereas the right main bronchus had been intubated in 6 cases. 1 DLT was endoscopically correctly placed although the positioning of the tube had been considered unsatisfactory during conventional examination. Only 2 right-hand DLT's fulfilled the conventional and endoscopic criteria for correct placement of the tube. All malpositionings could be corrected via fibre optics. Recurrent tube dislocations occurred both after lateral repositioning of the patients (so that they were now lying sideways) (27.3% of all patients) and intraoperatively (24.6% of all patients). Besides, intraoperative obstructions of the tube/bronchus lumen due to blood/coagulates (49.1% of the patients) and/or secretion (46.4% of the patients) could be demonstrated and eliminated by endoscopy. Fibre bronchoscopy proved to be a decisive help to reduce the possibilities of complications associated with the use of the Broncho-Cath PVC-DLT in thoracic surgery.</p>","PeriodicalId":7813,"journal":{"name":"Anasthesie, Intensivtherapie, Notfallmedizin","volume":"24 6","pages":"327-33"},"PeriodicalIF":0.0,"publicationDate":"1989-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13761241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Acute respiratory distress syndrome of the adult (ARDS) and artificial respiration--results in surgical intensive care patients]. [成人急性呼吸窘迫综合征(ARDS)和人工呼吸-手术重症监护患者的结果]。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

A Deller, F Konrad, D Spilker, J Kilian

{"title":"[Acute respiratory distress syndrome of the adult (ARDS) and artificial respiration--results in surgical intensive care patients].","authors":"A Deller, F Konrad, D Spilker, J Kilian","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A prospective clinical trial was performed in an operative intensive care unit to examine the incidence and outcome of patients with adult respiratory distress syndrome (ARDS) and the outcome of intensive care patients on mechanical ventilation and the incidence of barotrauma and pulmonary infection. 161 mechanically ventilated patients showed an overall mortality of 19.9%. The mortality rate in the ARDS patients was 11 of 26. Most of these patients with ARDS died from multiorgan failure. Pulmonary infection was the most frequently registrated complication of mechanical ventilation. We conclude from these data that --according to the literature the outcome of surgical ICU patients on mechanical ventilation with and without ARDS is more favourable than that of medical ICU patients; --the interpretation of therapeutic results and of epidemiological data in ARDS patients is possible only by providing exact and detailed criteria; these should include compliance data; --evaluation of present ARDS therapy by comparison to previous data, even when the same criteria are applied, e.g. ECMO-criteria, may fail as the outcome of conventional therapeutic measurements - mechanical ventilation - may have improved. A controlled randomised trial might be more suitable for evaluation of alternative therapy in ARDS.</p>","PeriodicalId":7813,"journal":{"name":"Anasthesie, Intensivtherapie, Notfallmedizin","volume":"24 5","pages":"277-82"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13955108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[In vitro studies of the effect of flunitrazepam on cellular immune parameters]. 氟硝西泮对细胞免疫参数影响的体外研究

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

J Nadstawek, P Mallmann, P M Lauven, A Koenig

引用次数: 0

[Return of motor and mental functions following enflurane-nitrous oxide anesthesia of 1.3 MAC in various age groups]. [安氟醚-氧化亚氮麻醉后各年龄组运动和精神功能的恢复]。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

J Nadstawek, D Hausmann, A Bartsch, M Födisch, H Stoeckel

{"title":"[Return of motor and mental functions following enflurane-nitrous oxide anesthesia of 1.3 MAC in various age groups].","authors":"J Nadstawek, D Hausmann, A Bartsch, M Födisch, H Stoeckel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recovery of motor and mental functions we investigated in 60 patients at different age ranges (Group 1: 20 young patients between 20 and 35 years; Group 2: 20 middle-aged patients between 40 and 55 years) after nitrous oxide-oxygen anaesthesia in combination with enflurane of 1.3 MAC for lumbar nucleotomy. The following parameters were investigated before and up to 80 minutes after anaesthesia: simple and discriminating motor activities, the vigilance and the short and long term memory. In simple motor actions we noticed no significant differences between the three groups. By examination of discriminating motor activity, the functional capacity of Group 3 was significantly reduced in comparison to Groups 1 and 2. Nevertheless the efficiency in Group 2 was also decreased in comparison to Group 1. The postoperative vigilance was especially impaired in the elderly patients. Only 50% of the old patients were able to satisfy the asked requirements 60 minutes after extubation. The vigilance in Group 2 showed a better improvement compared to the elderly patients but was in comparison to the young patients significantly decreased. The long term memory of the old patients pointed out a considerable reduction after this kind of anaesthesia. While no distinct differences could be found between Group 1 and 2 40 minutes after extubation, a significant difference could be observed between Group 1 and 3 even after 60 minutes. The short term memory of the elderly and the middle-aged patients was considerably reduced 60 minutes after extubation.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":7813,"journal":{"name":"Anasthesie, Intensivtherapie, Notfallmedizin","volume":"24 5","pages":"293-7"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13955743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Personal experiences with extracorporeal CO2 elimination in patients with severe ARDS--a current review]. [严重急性呼吸窘迫综合征患者体外CO2消除的个人经验——一项最新综述]。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

M Knoch, E Müller, W Höltermann, H Lennartz

引用次数: 0

[Adult respiratory distress syndrome--still an unsolved problem]. [成人呼吸窘迫综合征——仍未解决的问题]。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

K Geiger

引用次数: 0

[Principles of acute management of the severe diving accident]. [严重潜水事故急性处理原则]。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

L Lampl, G Frey, T Dietze, K H Bock

引用次数: 0

[Photoplethysmography evaluation of collateral blood flow before puncture of the dorsalis pedis artery]. [足背动脉穿刺前侧支血流的光容积脉搏波评价]。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

M Bund, B Panning

引用次数: 0

[Psychophysiologic reaction patterns in coping with events by intensive care patients]. [重症病人应对事件的心理生理反应模式]。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

R Wensing, H J Hannich, S Rummel, C Becker-Carus, P Lawin

{"title":"[Psychophysiologic reaction patterns in coping with events by intensive care patients].","authors":"R Wensing, H J Hannich, S Rummel, C Becker-Carus, P Lawin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study was to demonstrate the clear relations between psychological and physiological parameters determined in intensive care patients. For this purpose, heart rate, salivary-cortisol secretion and blood pressure were measured as physiological stress indicators; psychological parameters were covered by examining the patients' way of coping, that is to contrast emotional with rational coping. By comparison, the equivalent parameters were determined in a group of healthy patients. When comparing both groups, we found a higher salivary-cortisol secretion and an increased heart rate in the group of intensive care patients, with the circadian rhythm of the cortisol-secretion remaining almost stable. When examining the patients' group according to the way of coping, we found a higher activation of the sympathetic nervous system in those patients who coped with their situation emotionally than in those who faced their problems rationally. The level of physiological excitation significantly decreased after the patients had been transferred from the ICU to the normal ward. The increased physiological excitation of ICU patients serves to release energies that help them to cope with their situation and can likewise be associated with emotional reactions such as being extremely watchful and in a state of mobilization as well as feeling particularly helpless. The extent of physiological irritation is modified by the way of intrapsychical coping.</p>","PeriodicalId":7813,"journal":{"name":"Anasthesie, Intensivtherapie, Notfallmedizin","volume":"24 5","pages":"298-302"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13955744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Role of the endothelium in adult respiratory distress syndrome (ARDS): the present and future]. 内皮在成人呼吸窘迫综合征(ARDS)中的作用:现在和未来。

Anasthesie, Intensivtherapie, Notfallmedizin Pub Date : 1989-10-01

C J Kirkpatrick, C Mittermayer

{"title":"[Role of the endothelium in adult respiratory distress syndrome (ARDS): the present and future].","authors":"C J Kirkpatrick, C Mittermayer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Various morphological studies indicate that the microcirculation plays a vital role in the development of ARDS. The significance of the structural and functional integrity of the endothelium for normal pulmonary function is supported by cell biological data. Biochemical studies in bronchoalveolar lavage and blood from ARDS-patients, coupled with studies in animals and endothelial cell cultures support the role of a variety of mediators such as complement factors, products of the coagulation cascade and fibrinolytic system, enzymes, endotoxins and metabolites of arachidonic acid. Of particular importance is the interaction between neutrophilic granulocytes and the endothelium, although the individual components of this interaction and the relationship between cellular and humoral factors remain unclear. Furthermore, the literature shows that it is still uncertain, how the data obtained from studies in vivo and in vitro can be applied to ARDS in humans. Future research in this field must come to terms with the cell biology and pathobiology of the pulmonary endothelium, a hitherto neglected aspect. In addition, studies are essential to investigate possible additive or synergistic effects of mediators on inflammatory and endothelial cells. Finally, the role of more recently discovered inflammatory mediators and modulators in the pathogenesis of ARDS requires clarification.</p>","PeriodicalId":7813,"journal":{"name":"Anasthesie, Intensivtherapie, Notfallmedizin","volume":"24 5","pages":"261-9"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13825532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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