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  • 1
    Electronic Resource
    Electronic Resource
    Independent right lung high frequency and left lung conventional ventilation in the management of severe air leak during ARDS (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric anesthesia 5 (1995), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Pulmonary air leaks are one of the most common problems in patients with the adult respiratory distress syndrome, ARDS. We report what we believe to be the first case in which unilateral high-frequency ventilation combined with contralateral conventional positive pressure ventilation has been used successfully to manage severe air leak in an infant with ARDS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1460-9592.1995.tb00276.x
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  • 2
    Electronic Resource
    Electronic Resource
    Verschluß einer Gaumenspalte bei einer Patientin mit Ebstein-Anomalie unter Hochfrequenzoszillationsbeatmung (1998)
    Springer
    Monatsschrift Kinderheilkunde 146 (1998), S. 212-216 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Hochfrequenzoszillationsbeatmung ; Hämodynamik ; Ebstein-Anomalie ; Gaumenspalte ; Key words High-frequency oscillatory ventilation ; Cardiopulmonary interactions ; Ebstein’s anomaly ; Cleft palate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background: We report on the unsuccessful attempt to put a young patient with Ebstein’s anomaly on conventional ventilation for maxillofacial surgery. Reduced pulmonary bloodflow and cardiac output were followed by arterial hypotension and reduction of oxygen saturation. Spontaneous breathing without positive pressure ventilation normalized of the hemodynamic situation. Operation: Two years later, using a high-frequency oscillatory ventilator (SensorMedics 3100A), with relatively constant intrathoracic pressures and avoidance of high inspiratory pressures, the patient was adequately ventilated and oxygenated during the operation.
    Notes: Zusammenfassung Hintergrund: Es wird über den zunächst nicht erfolgreichen Versuch der konventionellen Beatmung während eines kieferchirurgischen Eingriffs bei einer Patientin mit Ebstein-Anomalie berichtet. Verminderter pulmonaler Blutfluß und entsprechend verminderter linksventrikulärer Auswurf führten zu einer arteriellen Hypotonie mit Sauerstoffsättigungsabfall. Unter Spontanatmung normalisierte sich der kritische Zustand rasch. Operation: Der Einsatz eines Hochfrequenzoszillationsbeatmungsgeräts (SensorMedics 3100A) mit gleichbleibendem mittlerem Atemwegsdruck und Vermeiden inspiratorischer Spitzendrücke ermöglichte 2 Jahre später eine adäquate Ventilation und Oxygenierung der Patientin, so daß die Operation durchgeführt werden konnte.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050264
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  • 3
    Electronic Resource
    Electronic Resource
    Erste Erfahrungen mit einem neuen Therapiekonzept für die Schrittmacherbehandlung von Säuglingen und Kleinkindern (1998)
    Springer
    Monatsschrift Kinderheilkunde 146 (1998), S. 1074-1077 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Epikarde Elektroden ; Steroideluierende Elektroden ; Autocapture ; Frühgeborene ; Säugling ; Key words Epicardial pacing ; Steroid eluting electrodes ; Autocapture ; Infant
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A small pulse-generator is important in prematures and young infants. Objectives: Analysis of our experience with the smallest currently available pacemaker in the pediatric age group. Patients and methods: We report about the pacemaker therapy in two premature babies with symptomatic complete congenital AV-block and about an 8 year old boy with congenital AV-block and palliation of complex congenital heart disease by total cavo pulmonary connection. The currently smallest pulse generator was implanted for the first time with a steroid eluting epicardial bipolar lead. Due to the ’autocapture algorithm’ a smaller battery can be used with the same life span as a normal sized pulse generator. Results: A stable capture threshold with a high amplitude of the evoked response signal and regular function of the ’autocapture’ algorithm was documented during a followup of up to 1 year. This algorithm has been used so far only with endocardial leads. Conclusion: This new combination seems promising for pacemaker therapy in small children.
    Notes: Zusammenfassung Fragestellung: Für Säuglinge und Frühgeborene ist eine geringe Größe des Schrittmacheraggregats besonders wichtig. Unsere bisherigen Erfahrungen mit dem kleinsten, z.Z. verfügbaren Pulsgenerator bei Kindern wurden analysiert und hier vorgestellt. Methode: Bei 2 Frühgeborenen mit symptomatischem kompletten AV-Block und einem 8jährigen Patienten mit kongenitalem AV-Block bei komplexen Vitium und Palliation mittels totaler kavopulmonaler Anastomose wurde der kleinste z.Z. verfügbare Pulsgenerator erstmals mit bipolaren, epikardialen steroideluierenden Elektroden implantiert. Dieser Schrittmacher arbeitet durch den Autocapture-Algorithmus besonders energiesparend, so daß trotz geringerer Batteriekapazität eine Laufzeit wie bei einem normal großen Aggregat erzielt werden kann. Ergebnisse: Bei einer niedrigen Reizschwelle und einer hohen Amplitude des evozierten Potentials fand sich eine normale Funktion des Autocapture-Algorithmus des Schrittmachers bei einer Nachbeobachtung bis zu 1 Jahr. Ein solches Aggregat wurde bislang nur mit endokardialen Elektroden eingesetzt. Schlußfolgerung: Diese Schrittmacher-Elektroden-Kombination erscheint als neues Therapiekonzept insbesondere für Säuglinge gut geeignet zu sein.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050368
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  • 4
    Electronic Resource
    Electronic Resource
    Properties of the circulation classification scheme based on the rotated principal component analysis (1996)
    Springer
    Meteorology and atmospheric physics 59 (1996), S. 217-233 
    Details
    ISSN: 1436-5065
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geography , Physics
    Notes: Summary The study addresses some methodological issues of application of principal component analysis (PCA) to the classification of circulation patterns. The obliquely rotated PCA in T-mode (i.e. with time observations corresponding to variables and grid points to realizations) is applied to 500 hPa geopotential heights over Europe and adjacent parts of Atlantic Ocean. The solutions are examined for various numbers of principal components rotated, and for both raw and anomaly data, with the aim to find the way of determining the optimum number of circulation types. This is done, among others, by examining temporal and spatial stability of solutions, their compliance with simple structure requirements, and temporal behaviour of classifications. Some of the solutions that are pre-selected according to the rule based upon the separation between successive eigenvalues prove to perform considerably better than unselected ones; some of them do not. Which pre-selected solutions should be given preference is impossible to decide in advance, without a detailed scrutiny. Nevertheless, even after such a scrutiny is done, more than a single classification are acceptable. The final choice of the optimum solution depends on the aims of the intended study: It should balance the demands on statistical stability of types and on resemblance between types and daily patterns classified with them.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01030145
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  • 5
    Electronic Resource
    Electronic Resource
    Sudden pneumoscrotum in a ventilated infant (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 689-690 
    Details
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050912
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  • 6
    Electronic Resource
    Electronic Resource
    Continuous measurement of cardiac output by the Fick principle in infants and children: Comparison with the thermodilution method (1996)
    Springer
    Intensive care medicine 22 (1996), S. 467-471 
    Details
    ISSN: 1432-1238
    Keywords: Fick principle ; Thermodilution ; Cardiac output ; Infants ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. Design Prospective direct comparison of the above two techniques. Setting Pediatric intensive care unit of a university hospital. Patients 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. Methods The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20 s. Interventions In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. Results Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found:r 2=0.98;P〈0.001; SEE=0.14 l/min. The bias is absolute values and in percent of average cardiac output was −0.05 l/min or −4.4% with a precision of 0.32 l/ min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. Conclusion Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712169
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  • 7
    Electronic Resource
    Electronic Resource
    Successful treatment of a patient with ARDS after pneumonectomy using high-frequency oscillatory ventilation (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1173-1176 
    Details
    ISSN: 1432-1238
    Keywords: Key words High-frequency oscillatory ventilation ; HFOV ; Mechanical ventilation ; Adults ; Pneumonectomy ; Postoperative period ; Pneumonia ; ARDS ; Oxygenation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract High frequency oscillatory ventilation (HFOV) was used in a patient who developed the acute respiratory distress syndrome 5 days following a right pneumonectomy for bronchogenic carcinoma. When conventional pressure-controlled ventilation failed to maintain adequate oxygenation, HFOV dramatically improved oxygenation within the first few hours of therapy. Pulmonary function and gas exchange recovered during a 10-day period of HFOV. No negative side effects were observed. Early use of HFOV may be a beneficial ventilation strategy for adults with acute pulmonary failure, even in the postoperative period after lung resection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051032
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  • 8
    Electronic Resource
    Electronic Resource
    Continuous measurement of cardiac output by the Fick principle in infants and children: comparison with the thermodilution method (1996)
    Springer
    Intensive care medicine 22 (1996), S. 467-471 
    Details
    ISSN: 1432-1238
    Keywords: Key words Fick principle ; Thermodilution ; Cardiac output ; Infants ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective:To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. Design: Prospective direct comparison of the above two techniques. Setting: Pediatric intensive care unit of a university hospital. Patients: 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. Methods: The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20 s. Interventions: In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. Results: Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found: r 2=0.98; P〈0.001; SEE=0.14 l/min. The bias is absolute values and in percent of average cardiac output was −0.05 l/min or −4.4% with a precision of 0.32 l/min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. Conclusion: Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712169
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  • 9
    Electronic Resource
    Electronic Resource
    The effect of nifedipine alone or combined with low dose acetylsalicylic acid on endotoxin-induced pulmonary hypertension in the piglet (1988)
    Springer
    Intensive care medicine 14 (1988), S. 595-601 
    Details
    ISSN: 1432-1238
    Keywords: Endotoxin ; Pulmonary hypertension ; Nifedipine ; ASA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cardiovascular responses to the calcium antagonist nifedipine, alone and combined with low dose acetylsalicylic acid (ASA), were evaluated in a piglet model of endotoxin-induced pulmonary hypertension. All animals were anesthetized, paralyzed and mechanically ventilated. Cardiac output (CO), pulmonary artery pressure (PAP), aortic blood pressure (SAP), pulmonary capillary wedge pressure (PCWP), right strial pressure (RAPM) and arterial blood gases were measured before and after induction of pulmonary hypertension by E. coli endotoxin and after treatment. Results of treated groups were compared to a control group of piglets subjected to the same dose (0.15 μg/kg i.v.) of endotoxin. Control animals responded to a bolus injection of endotoxin within 15 min with an increase in mean PAP by 110%. Pulmonary vascular resistance (PVR) increased by 144%. Mean arterial pressure did not change significantly from baseline values. In animals treated with a single dose of 1 mg/kg ASA prior to endotoxin, the initial pulmonary response was not quantitatively different from control values, whereas ASA 20 mg/kg abolished the pulmonary vascular reaction. The increase of systemic vascular resistance (SVR) produced by endotoxin was aggravated by high dose ASA. In piglets treated with nifedipine (4 μg/kg/min) over 30 min after the application of endotoxin with and without additional infusion of nifedipine 60 min prior to endotoxin the PVR could be attenuated. The combination of nifedipine and low dose ASA showed synergistic effects compared to control. The increase of mean PAP was significantly reduced, the PVR remained in base-line range due to a marked elevation of cardiac output.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00256762
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  • 10
    Electronic Resource
    Electronic Resource
    Continuous monitoring of mixed venous oxygen saturation in infants after cardiac surgery (1989)
    Springer
    Intensive care medicine 15 (1989), S. 228-232 
    Details
    ISSN: 1432-1238
    Keywords: Infants ; Continuous SvO2 ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Continuous mixed venous oxygen saturation SvO2c was measured in 16 infants immediately after cardiac surgery. A polyurethane 4F, dual channel catheter (Opticath, Modell U440, Oximetrix) with fiberoptic filaments was introduced into the pulmonary artery during cardiothoracic surgery. The catheters were left in place for an average of 67.5 h (range 27 h – 125 h) and there were no catheter-related complications. Correlation between continuous in vivo SvO2 values and in vitro values was satisfactory (r=0.85), whereas a correlation between SvO2c and arterial oxygen saturation (SaO2) was not found (r=0.07). The sampled arterial lactate values were inversely correlated to the simultaneously measured SvO2c, but the corelation coefficient was only r=-0.4. There was an inverse correlation between SvO2c and arteriovenous oxygen content difference (Ca−vDO2c) (r=-0.82), and a marked inverse correlation to the calculated oxygen utilization ratio (r=-0.97). Therefore SvO2c continuously reflects the overall balance between oxygen consumption and delivery, but the use of SvO2 as a predictor of blood lactate levels is unreliable. A further purpose of the present study was to demonstrate the clinical applications and to show the usefulness of SvO2c-monitoring; particularly as a surveillance and early warning system, as a guide for assessing therapy and its relevance in interpreting other monitored parameters. In our opinion continuous SvO2 measurement is a reliable and valuable indicator of cardiopulmonary function in the immediate post-operative period, even in infants with complicated repair of cardiac malformations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00271056
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