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  • 1
    Electronic Resource
    Electronic Resource
    Postoperative 12-lead ECG predicts peri-operative myocardial ischaemia associated with myocardial cell damage (2004)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 59 (2004), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Peri-operative myocardial ischaemia is the single most important risk factor for an adverse cardiac outcome after non-cardiac surgery. The present study examines whether intermittent 12-lead ECG recordings can be used as an early warning tool to identify patients suffering from peri-operative myocardial ischaemia and subsequent myocardial cell damage. Fifty-five vascular surgery patients at risk for or with a history of coronary artery disease were monitored for peri-operative myocardial ischaemia using intermittent 12-lead ECG recordings taken pre-operatively and at 15 min, 20 h, 48 h, 72 h and 84 h postoperatively. The effectiveness of the 12-lead ECG was gauged by examining concordance with continuous 3-channel Holter monitoring and capturing peri-operative myocardial ischaemia by serial analyses of creatine kinase myocardial band isoenzyme and cardiac troponin T and I. The incidence of peri-operative myocardial ischaemia detected by 12-lead ECG was 44% and was identifiable in most patients (88%) 15 min after surgery. The incidence of peri-operative myocardial ischaemia detected by continuous monitoring was 53%, with the most severe episodes occurring intra-operatively and during emergence from anaesthesia. The concordance of the 12-lead method with continuous monitoring was 72%. The concordance of creatine kinase myocardial band isoenzyme activity with the 12-lead method was 71% and with Holter monitoring 57%. The concordance of mass concentration of creatine kinase myocardial band with 12-lead ECG recordings was 75%, and the corresponding value for Holter monitoring was 68%. The concordance of cardiac troponin T and I levels with the 12-lead method was 85% and 87%, respectively, and concordance with Holter monitoring was 72% and 66%, respectively. The postoperative 12-lead ECG identified peri-operative myocardial ischaemia associated with subsequent myocardial cell damage in most patients undergoing vascular surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2004.03960.x
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  • 2
    Electronic Resource
    Electronic Resource
    A reply (2004)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 59 (2004), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2004.04004.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Cerebral and extracerebral release of protein S100B in cardiac surgical patients (2004)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 59 (2004), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Although several clinical studies have shown that increased serum concentrations of protein S100B predict ischaemic brain damage after cardiac surgery, S100B may also be released from the heart or other injured tissue. We therefore investigated the correlation between serum S100B levels and those of the specific cardiac marker troponin I in order to assess the cerebral vs. extracerebral origin of S100B. In 64 cardiac surgical patients, serial blood samples were drawn for the measurement of S100B and troponin I before surgery and for seven days after surgery. Neurological function was assessed before with the National Institutes of Health Stroke Scale and the Folstein Mini Mental Test. The data show that a sustained increase in serum S100B levels is associated with neurological dysfunction, as witnessed by a positive correlation between S100B values and the results of the neuropsychological tests. In contrast, the early postoperative increased levels of protein S100B derive from cardiac tissue, as shown by the positive correlation between S100B and cardiac troponin I levels.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2004.03663.x
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  • 4
    Electronic Resource
    Electronic Resource
    Erstes kontinuierliches Nerven-Monitoring in der Schilddrüsenchirurgie (2000)
    Springer
    Der Chirurg 71 (2000), S. 551-557 
    Details
    ISSN: 1433-0385
    Keywords: Keywords: Thyroid ; Recurrent laryngeal nerve ; Paralysis ; Intraoperative monitoring system. ; Schlüsselwörter: Schilddrüse ; Nervus laryngeus recurrens ; Parese ; intraoperatives Monitoring.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Ein neuartiges „all in one“ Monitoringsystem für den N. laryngeus recurrens (NLR) erlaubt sowohl eine kontinuierliche, atraumatische Überwachung des NLR als auch eine in situ Detektion des Nerven. Patienten und Methode: Das System basiert auf einem Doppelballontubus mit integrierten Oberflächenelektroden zur transtrachealen Stimulation und Ableitung des Erfolgsorgans. Fakultativ kann über eine elektrische Stimulationsnadel der NLR im OP-Feld identifiziert werden. Die Signalverarbeitungs-Software stellt eine Neuentwicklung unserer Arbeitsgruppe dar und führt eine Echtzeit-Signalanalyse mit akustischer Rückkoppelung durch. 55 Patienten wurden in die klinische Zulassungsstudie eingebracht, 35 Primäreingriffe, 20 Sekundäreingriffe, davon 10 Halsausräumungen. Ergebnisse: Die Plazierung des EMG-Tubus ist mit der Routineintubation abgeschlossen und erfordert keinen zusätzlichen Zeitbedarf. Das System ist außerhalb des OP Feldes lokalisiert und beeinträchtigt daher nicht den OP Ablauf. Die akustische Rückkoppelung wurde von allen 8 Operateuren als hilfreich und nicht störend beurteilt. Die phoniatrische und HNO-ärztliche Analyse erbrachte keine permanenten Beeinträchtigungen. Schlußfolgerung: Das neue kontinuierliche Monitoringsystem ermöglicht erstmals eine atraumatische nebenwirkungsfreie Dauerüberwachung des NLR. Es ist einfach anzuwenden, arbeitet außerhalb des OP-Gebiets und ist so sensitiv, daß auch reversible Irritationen erkannt werden können.
    Notes: Abstract. A new „all in one“ sensing device was developed for continuous transtracheal intraoperative monitoring and in situ detection of the recurrent laryngeal nerve (RLN) during thyroid surgery. Patients and methods: The new system is based on a double-balloon endotracheal tube with integrated atraumatic stimulating and tracing electrodes. The recurrent laryngeal nerve is stimulated transtracheally and compound action potentials are recorded from the laryngeal muscles. Fifty-five patients were introduced into a phase-one clinical trial. Thirty-five patients with primary thyroid operations, 20 patients with reoperations, 10 of whom had neck dissections. All patients were evaluated laryngoscopically and phoniatrically by an ENT specialist before and after surgery. Results: Compound muscle action potentials were recorded continuously during the whole operation and responded sensitively to tension and pressure to the nerve. There were no accidental permanent RLN palsies. Conclusion: The new system offers five advantages: (1) it is atraumatic; (2) it is easy to use; (3) it can monitor continuously with an audio feedback to the surgeon; (4) it works outside the operation field; and (5) it is highly sensitive, even indicating reversible irritation to the nerve.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040051101
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    Paper (German National Licenses)
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