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  • Key words: Oesophageal aspiration of foreign bodies – Respiratory depression – Epilepsy  (1)
  • Spectral analysis  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 43 (1994), S. 671-673 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter:Ösophageale Fremdkörperaspiration – Atemnot – Epilepsie ; Key words: Oesophageal aspiration of foreign bodies – Respiratory depression – Epilepsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. We report an oesophageal foreign body in a patient with a seizure disorder secondary to encephalitis disseminata who was transferred to our department of neurosurgery because of rising intracranial pressure. He presented with confusion, motor aphasia, and dysphagia. However, the diagnosis of increased intracranial pressure could not be confirmed clinically or by computed tomography. A routine chest X-ray film showed a dental prosthesis projecting on the area of the hypopharynx. Bronchoscopy and oesophagoscopy showed the denture to be lodged in the hypopharynx, but it was impossible to remove it endoscopically. Therefore, an oesophagopharyngotomy was performed and the foreign body extracted. The postoperative course was complicated by pneumonia, which responded well to antibiotic treatment. The patient made an otherwise uneventful recovery and was able to eat without difficulty.
    Notes: Zusammenfassung. In der vorliegenden Kasuistik wird eine Fremdkörperaspiration in den Ösophagus beschrieben, die initial zur Desorientiertheit, Schluck- und Sprachstörungen des Patienten geführt hatte. Da der Patient unter einem Anfallsleiden litt, das durch eine Encephalomyelitis disseminata ausgelöst worden war, wurde er zunächst unter dem Verdacht einer Hirndrucksteigerung in eine neurochirurgische Abteilung verlegt. Eine Computertomographie des Kopfes ergab aber keinen pathologischen Hinweis dafür. Per Zufall wurde bei einer Röntgenaufnahme des Thorax eine hoch zu Ösophagus sitzende Zahnprothese entdeckt, die konservativ nicht eliminiert werden konnte. Nach Ösophagopharyngotomie wurde die Prothese ausgeschält, die folgende Intensivtherapie war bis auf eine kurzzeitige Pneumonie problemlos. Mit reizfreien Wundverhältnissen wurde der Patient in sein Heimatkrankenhaus zurückverlegt.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-8491
    Keywords: Key words Coma ; Autonomous nervous system ; Neuromonitoring ; Heart rate variability ; Spectral analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The analysis of heart rate (HR) variability offers a noninvasive method to investigate autonomic nervous system activity in comatose patients. We analyzed three components of the HR variability in a group of comatose patients: the low-frequency band (LF), representing mainly sympathetic influence, the mid-frequency band (MF), representing sympathetic and parasympathetic influence, and the high-frequency band (HF), representing the parasympathetic influence. A value for sympathovagal balance was defined as LF/HF and MF/HF ratio. Moreover, the skin conductance level (SCL) and the skin conductance resistance (SCR) variability were recorded. The patient group consisted of 22 patients with traumatic brain injuries. Coma depth was assessed by the Glacow Coma Scale and artifact-free HR, SCL, and SCR were measured 75 times in the patient group. The results documented a significant gain in sympathetic nervous system activity corresponding with the state of emerging from coma. This gain was most pronounced in the HF component of the HR and in the sympathovagal balance between LF/HF. The findings in SCL and SCR variability endorsed this result. It is concluded that emerging from coma is accompanied by an increasing influence of the sympathetic nervous system on HR control. This leads to a change in the sympathovagal balance, i.e., a reintegration of parasympathetic and sympathetic activity.
    Type of Medium: Electronic Resource
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