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  • 1995-1999  (4)
  • 1998  (4)
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  • 1995-1999  (4)
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  • 1
    Electronic Resource
    Electronic Resource
    Failed intubation and emergency percutaneous tracheostomy (1998)
    Oxford : Blackwell Science Ltd, UK
    Anaesthesia 53 (1998), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Failed intubation associated with difficulty with ventilation is rare. Cricothyrotomy may provide a means of oxygenating the patient, but in practice it may be difficult to perform and does not establish a definitive airway. We report two patients in whom percutaneous tracheostomy was used as an emergency procedure. In both cases placement was extremely rapid and salvaged the situation, leaving a definitive airway.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1998.00253.x
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Serum albumin: touchstone or totem? (1998)
    Oxford : Blackwell Science Ltd
    Anaesthesia 53 (1998), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A decrease in serum albumin concentrations is an almost inevitable finding in disease states, and is primarily mediated in the acute phase by alterations in vascular permeability and redistribution. This change is not disease specific but marked changes that persist are generally associated with a poorer prognosis. Critical appraisal of long-standing practices and the availability of alternative colloid solutions have led to a reduction in albumin replacement therapy, and a widespread tolerance of lower albumin concentrations in patients. The factors determining serum albumin concentrations, their measurement and the implications of hypoalbuminaemia are reviewed. The clinical value of serum albumin measurement is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.1998.00438.x
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Dopamine clearance in critically ill patients (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1217-1220 
    Details
    ISSN: 1432-1238
    Keywords: Key words Dopamine ; Steady-state clearance ; Renal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To examine the validity of the low-dose “renal” dopamine regimen in critically ill patients by investigating the steady-state clearance of dopamine. Design: A prospective clinical study. Setting: Teaching hospital intensive care unit. Patients: 48 haemodynamically stable patients receiving a dopamine infusion. Interventions: Sampling of arterial blood and dopamine infusates. Measurement and results: Plasma and infusate dopamine levels were measured by liquid chromatography with electrochemical detection. Steady-state clearance was determined by dividing the actual infusion rate by the steady-state plasma concentration. Dopamine clearance for the whole group was 46.4 ± 35.9 ml/kg per min (mean ± SD), which is significantly lower than 70 ± 15.2 ml/kg per min reported for elective surgical patients (p = 0.01). Twelve patients with renal dysfunction had significantly lower dopamine clearances (36 ± 16.6 ml/kg per min) than the remaining 36 patients (61 ± 38.5 ml/kg per min, p = 0.022). There was a very poor correlation between plasma dopamine level and infusion rate for the group as a whole (r = 0.47), and this worsened (r = 0.31)when only those patients on a “renal” dose of 2–5 μg/kg per min were considered (n = 30). Conclusion: Plasma dopamine clearance is lower in critically ill patients and there is a large interindividual variation. It is therefore impossible to predict the plasma level from the infusion rate. Consequently, the concept of a selective renovascular low-dose dopamine infusion is invalid in critically ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050747
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    The effects of low-dose dopamine infusions on haemodynamic and renal parameters in patients with septic shock requiring treatment with noradrenaline (1998)
    Springer
    Intensive care medicine 24 (1998), S. 564-568 
    Details
    ISSN: 1432-1238
    Keywords: Key words Dopamine ; Haemodynamic ; Renal ; Sepsis ; Shock ; Noradrenaline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate whether low-dose dopamine (LDD) has a significant effect on systemic haemodynamic variables and renal function when used in conjunction with high-dose noradrenaline in optimally volume-resuscitated patients with septic shock. Design: A prospective clinical study in which each patient acted as his/her own control. Setting: Teaching hospital Intensive Care Unit. Patients: Twenty-one patients with septic shock treated with high-dose noradrenaline were studied, 17 patients completed the study. Interventions: Fluid loading to an optimal left ventricular stroke work index (LVSWI) whilst on more noradrenaline than 10 mcg/min and dopamine of 2.5 mcg/kg per min. Three study periods each of 2 h with LDD present, withdrawn and restarted. During each period a complete haemodynamic profile and measurement of urine flow rate, creatinine clearance and sodium excretion was performed. Measurement and results: Removing and restarting LDD caused marked changes in cardiac index (CI, 17 % fall, p 〈 0.01: 23 % rise, p 〈 0.01), stroke volume (SV, 11 % fall, p 〈 0.05: 14 % rise, p 〈 0.05) and systolic blood pressure (SBP, 11 % fall, p 〈 0.05: 14 % rise, p 〈 0.05). Urine volume fell by 40 % (p 〈 0.05) when dopamine was withdrawn. Significant reductions in sodium excretion (p 〈 0.05) and fractional sodium excretion (p 〈 0.05) also occurred on stopping LLD. Changes in creatinine clearance were not statistically significant. Conclusion: Low-dose dopamine causes significant increases in SBP SV, cardiac output and urine flow during treatment with noradrenaline.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050616
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    Paper (German National Licenses)
    Fulltext
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