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  • 1
    Electronic Resource
    Electronic Resource
    Haemodynamic effects of dopamine in septic shock (1977)
    Springer
    Intensive care medicine 3 (1977), S. 47-53 
    Details
    ISSN: 1432-1238
    Keywords: Dopamine ; Isoprenaline ; Septic shock ; Cardiac failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The Haemodynamic response to dopamine infusion has been assessed in 30 patients in septic shock with myocardial dysfunction. Dopamine infusion resulted in a haemodynamic improvement as indicated by significant increases in cardiac output of 38.4% (p〉.001), stroke volume 18.7% (p〈.001), and mean arterial pressure of 33% (p〈.001). Despite the inotropic effect, left ventricular filling pressure did not change in 20 cases and increased in 10 cases. Mean peripheral resistance remained unchanged with a scatter of individual responses depending upon factors such as dopamine dose and initial vascular resistance. Dopamine increased intrapulmonary shunting by 48% (p〈.001), insignificantly decreased PaO2, increased mixed venous oxygen saturation by 16% (p〈.02) and decreased pulmonary vascular resistance by 15% (p〈.02). Both isoprenaline and dopamine improve stroke volume by an inotropic action, with an increase in venous return in the case of the latter and a reduction in afterload in the former. It is cocluded that the usefulness of dopamine in septic shock may be limited in patients with previous myocardial disease because of the risk of increasing preload and in hypoxaemic patients because of the risk of increasing intrapulmonary shunting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01683060
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  • 2
    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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  • 3
    Electronic Resource
    Electronic Resource
    Pharmacological treatment of pulmonary oedema (1980)
    Springer
    Intensive care medicine 6 (1980), S. 113-122 
    Details
    ISSN: 1432-1238
    Keywords: Cardiogenic pulmonary oedema ; Non cardiogenic pulmonary oedema ; Vasodilator agents ; Inotropic agents ; Positive end-expiratory pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Introduction A pathophysiological approach to pulmonary oedema (PO), discriminating in particular between cardiogenic pulmonary oedema (CPO) and non-cardiogenic pulmonary oedema (NCPO) has greatly enhanced our knowledge of this disease in the last few years [68]. In addition, the use of bedside haemodynamic measurements now enables treatment of CPO by new, potent, drugs such as vasodilators and catecholamines, and allows haemodynamic support during the management of NCPO by mechanical ventilation with positive end-expiratory pressure (PEEP).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01683356
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Computed tomography and post-laparotomy intra-abdominal abscesses (1982)
    Springer
    Intensive care medicine 8 (1982), S. 193-196 
    Details
    ISSN: 1432-1238
    Keywords: Intra abdominal abscess ; Abdominal surgery ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thirty-one patients were prospectively studied and had abdominal computed tomography for post laparotomy sepsis. Computed tomography is of particular interest in seriously ill post-operative patients, 15 of our patients were on ventilators, and it enabled diagnosis and localization of abscesses in 15 patients. Drainage could therefore be achieved via a limited surgical approach, and extensive laparotomy was avoided. Of 16 patients without abscess, the abdominal computed tomogram was negative in 14 cases and there were two false positives. The overall accuracy was 0.94 with a sensitivity of 1 and a specificity of 0.88. The ability to screen the whole abdomen and exactly localize the lesion are the advantages of this non-invasive method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01725737
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Haemodynamic study of prolonged deep accidental hypothermia (1975)
    Springer
    Intensive care medicine 1 (1975), S. 65-70 
    Details
    ISSN: 1432-1238
    Keywords: Accidental Hypothermia ; Hypovolaemia ; Cardiac insufficiency ; Isoproterenol ; Rewarming
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Right heart catheterisation was undertaken in six patients with accidental deep hypothermia. Studies were carried out before and after rapid blood volume expansion, with and without Isoproterenol infusion, and were repeated at normal body temperatures. The initial haemodynamic pattern indicated a marked hypovolemia with a simultaneous decrease of both cardiac output and ventricular filling pressures, and a decreased measured total blood volume. Rapid correction of the hypovolemia revealed cardiac insufficiency, in part due to the persisting bradycardia. Left ventricular function was depressed in patients with prolonged cold exposure and normal in patients with short exposure. These abnormalities disappeared after Isoproterenol infusion during hypothermia, and spontaneously after return to normothennia. No imbalance existed between the decreased cardiac output and oxygen uptake in hypothermia, arterio-venous oxygen difference being within normal limits.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00626428
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    The role of drug-induced illness in admissions to an intensive care unit (1986)
    Springer
    Intensive care medicine 12 (1986), S. 43-46 
    Details
    ISSN: 1432-1238
    Keywords: Drug induced illness ; Adverse drug reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract All patients admitted during a 33-month period to a multidisciplinary intensive care unit were prospectively studied in order to determine the incidence and severity of drug-induced illness leading to the admission. The role of underlying diseases was assessed and the avoidability of drug-induced illness considered. Out of 1651 patients, 97 (5.88%) were admitted because of drug-induced illness; 74 of these had serious underlying diseases. 13 (13.4%) of the 97 patients died, but underlying diseases accounted for 4 of the 13 fatalities. In nearly half of the cases, the drug-induced illness appeared potentially avoidable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00315371
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    The ethics of intensive care (1987)
    Springer
    Intensive care medicine 13 (1987), S. 300-303 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An explanation is provided of the logical steps taken before assigning patients to critical care therapy in a major multidisciplinary intensive care unit of the University of Paris at the Hospital Henri Mondor. The factors considered by the staff in deciding to terminate intensive therapy are also enumerated. This system has not been influenced by the major legal pressures found in the United States but has been shaped by more chronic fiscal constraints.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00255783
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