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  • 1
    Electronic Resource
    Electronic Resource
    Transgastric, pulsed doppler echocardiographic determination of cardiac output (1996)
    Springer
    Intensive care medicine 22 (1996), S. 34-38 
    Details
    ISSN: 1432-1238
    Keywords: Cardiac output ; Transesophageal echocardiography ; Doppler ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective The aim of this study was to evaluate the accuracy of cardiac output measurement with transesophageal echocardiography (TEE) using a transgastric, pulsed Doppler method in acutely ill patients. Design Cardiac output was simultaneously measured by thermodilution (TD) and a transgastric, pulsed Doppler method. Setting The study was carried out in a surgical intensive care unit as part of the management protocol of the patients. Patients Thirty consecutive acutely ill patients with a Swan-Ganz catheter, mechanically ventilated, sedated and with a stable hemodynamic condition were included. Measurements Pulsed Doppler TEE was performed using a transgastric approach in order to obtain a long axis view of the left ventricle. Cardiac output was calculated from the left ventricular outflow tract diameter, the velocity time integral of the blood flow profile and heart rate. Results One patient was excluded because of the presence of aortic regurgitation and another, because of the impossibility of obtaining a transgastric view. Twenty-eight simultaneous measurements were performed in 28 patients. A clinically acceptable correlation and agreement were found between the two methods (Doppler cardiac output=0.889 thermodilution cardiac output +0.74l/min,r=0.975,p〈0.0001). Conclusion Transgastric pulsed Doppler measurement across the left ventricular outflow tract with TEE is a very feasible and clinically acceptable method for cardiac output measurement in acutely ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728328
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Left ventricular function after severe trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 439-442 
    Details
    ISSN: 1432-1238
    Keywords: Severe trauma ; Myocardial dysfunction ; Fractional area changes ; Transesophageal echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate cardiac function at the early phase of severe trauma. Design Prospective, clinical study. Setting Anesthesiological Intensive Care Unit. Patients 7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease. Interventions Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. Measurements and results All of the patients had a low FAC value 〈50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%,p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg,p=0.02). Conclusion The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712161
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Left ventricular function after severe trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 439-442 
    Details
    ISSN: 1432-1238
    Keywords: Key words Severe trauma ; Myocardial dysfunction ; Fractional area changes ; Transesophageal echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective:To evaluate cardiac function at the early phase of severe trauma. Design: Prospective, clinical study. Setting: Anesthesiological Intensive Care Unit. Patients: 7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease. Interventions: Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. Measurements and results: All of the patients had a low FAC value 〈50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%, p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg, p=0.02). Conclusion: The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712161
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Contribution of bronchoalveolar lavage to the diagnosis of posttraumatic pulmonary fat embolism (1995)
    Springer
    Intensive care medicine 21 (1995), S. 973-980 
    Details
    ISSN: 1432-1238
    Keywords: Bronchoalveolar lavage ; Fat embolism ; Trauma ; Lung injury ; Hypoxemia ; Intensive care unit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To verify whether the determination of the percentage of cells recovered by bronchoalveolar lavage and containing fat inclusions is a useful diagnostic tool of posttraumatic pulmonary fat embolism. Design Prospective study. Setting Surgical Intensive Care Units in two university hospitals. Patients 56 successive trauma patients needing prolonged postinjury mechanical ventilation, including 4 with clinical definite fat embolism syndrome, 5 in whom the diagnosis had been clinically suspected but was impossible to confirm or exclude before bronchoscopy, and 47 with no clinical evidence of the syndrome. Control groups included 8 patients without previous trauma who developed ARDS and 6 healthy surgical patients. Methods Bronchoalveolar lavage was performed within the first posttraumatic 3 days in trauma patients, at the beguining of the pulmonary disease in non trauma ARDS patients and just after anesthesic induction in healthy ortopedic patients. The magnitude of lipid content in alveolar cells was compared with the clinical pattern of the pulmonary fat embolism syndrome retrospectively evaluated at the seventh day postinjury in trauma patients. Results All the patients with definite fat embolism syndrome had more than 70% of lavage cells containing fat droplets. The group of patients in whom the diagnosis of the fat embolism syndrome was suspected had percentages of fat cells above 30% in 4 out of 5 patients. A percentage of fat cells above 30% was only observed in 7 out of the 47 patients without clinical evidence of the syndrome. The percentage varied between 0% to 35% in the group of non trauma ARDS patients and between 0 to 5% in healthy surgical patients. Conclusion Lipid inclusions in alveolar cells are common during traumatic and non-traumatic respiratory failure. Determination of the percentage of cells recovered by bronchoalveolar lavage and containing fat droplets may contribute to the diagnosis of the fat embolism syndrome in mechanically-ventilated trauma patients with respiratory failure provided that the significant threshold would be 30%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700658
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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