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  • 1
    Electronic Resource
    Electronic Resource
    Hypovolaemic shock with oedema due to increased capillary permeability (1978)
    Springer
    Intensive care medicine 4 (1978), S. 159-163 
    Details
    ISSN: 1432-1238
    Keywords: Capillary permeability ; Idiopathic oedema ; Hypovolaemic shock ; Albumin metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of severe hypovolaemic shock related to idiopathic oedema was observed in a 37 year old woman. Large plasma volume expansion (nearly 121 over 9 hours) did not change the clinical status. Haemodynamic studies showed low cardiac index (1.1 1/min/m2), decreased left ventricular stroke work index (6.7 gm/m2), and high systemic arterial resistance (52 mmHg/1/min/m2). Dopamine infusion improved the haemodynamic condition which returned to normal 30 hours after the beginning of shock. After recovery, capillary permeability measured by a modification of Landis' method was markedly increased. A study of albumin metabolism showed a normal intravascular pool and a rapid exchange compartment with a twofold increase in slow exchange compartment. Hormonal levels and complement fractions were within normal limits. Serum protein immuno-electrophoresis showed an abnormal IgG. These results clearly demonstrate that hypovolaemia is related to increased capillary permeability and leakage of albumin out of the vascular space. When large infusions fail, inotropic agents, especially Dopamine, should be used in such cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700259
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Antibiotic levels in bronchial tree and in serum during selective digestive decontamination (1991)
    Springer
    Intensive care medicine 17 (1991), S. 215-218 
    Details
    ISSN: 1432-1238
    Keywords: Selective digestive decontamination ; Acquired pneumonia ; Antibiotic levels ; Mechanical ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Selective digestive decontamination has been found to prevent pulmonary infections in mechanically ventilated patients. The aims of this study were: 1) to determine whether detectable levels of antibiotics could be found in bronchial tree secretions of patients receiving SDD, and 2) to evaluate antibiotic serum levels. In 15 patients receiving mechanical ventilation and SDD for 10 days or more, tobramycin and amphotericin B levels were determined every 3 days in the following specimems: tracheal aspirates, distal bronchial secretions and blood samples. 82% of tracheal aspirates contained detectable (〉0.18 mg/l), tobramycin concentrations; the levels varied widely between patients and large day-to-day variations were observed. Every patient had at least 1 tracheal aspirate with tobramycin level higher than 0.5 mg/l during his course. 40% of distal specimens contained detectable tobramycin levels (10 patients). Serum determinations showed detectable concentration of tobramycin in 50% of the specimens (9 patients). Two patients with renal failure had serum tobramycin levels higher than 2 mg/l. In 13 tracheal aspirates cultures were positive and 15 species were isolated; 13 had a MIC higher than the corresponding tobramycin level in tracheal secretions. We conclude than substantial levels of antibiotics can be found frequently in respiratory tract specimens of patients receiving SDD. Therefore, the usual microbiological criteria used to assess respiratory tract infection may be unreliable in this setting and other criteria may be required. Follow-up of antibiotic serum levels is required, especially in patients with renal failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709880
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Serotonin syndrome due to an overdose of moclobemide and clomipramine (1997)
    Springer
    Intensive care medicine 23 (1997), S. 122-124 
    Details
    ISSN: 1432-1238
    Keywords: Key words Serotonin syndrome ; Moclobemide ; Dialysis ; Drug overdose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The serotonin syndrome is frequently characterized by minor neurologic manifestations that regress rapidly (such as confusion, tremor, ...). Many medications including tricyclic antidepressants, serotonin reuptake inhibitors, tryptophan and the association of monoamine oxidase inhibitors together with a serotoninergic agent have been implicated in this syndrome. In certain cases, and for poorly understood reasons, clinical manifestations can include circulatory collapse, malignant hyperthermia, convulsions and rhabdomyolysis. These forms are often fatal. Treatment, other than the withdrawal of the offending drug, is symptomatic. Dialysis may be of value in withdrawing the drug from the circulatory system. We report a patient with the serotonin syndrome of favorable outcome due to an overdose of moclobemide and clomipramine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050303
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    A simple radio-isotopic method for the detection of bronchial inhalation during intensive care (1984)
    Springer
    European journal of nuclear medicine 9 (1984), S. 343-344 
    Details
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The high incidence of pneumopathy in intensive care units might be due to the pulmonary aspiration of gastric juice following gastro-oesophageal reflux. The paper describes a radio-isotopic method using material easy to install at the patient's bedside. This technique demonstrated aspiration of gastric juice in the lungs of 8 of 25 intensive care patients investigated. Such a method might be useful later to demonstrate that silent bronchial aspirations of gastric juice are responsible for pulmonary complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252866
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    Paper (German National Licenses)
    Fulltext
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