Library

feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    ISSN: 1432-1238
    Keywords: Key words Infant ; Congenital heart disease ; ARDS ; Capillary leak ; Soluble l-selectin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: In critical care patients at risk of developing the acute respiratory distress syndrome (ARDS), low soluble l-selectin (sCD62L) plasma concentrations have been shown to be associated with progression to ARDS and prolonged subsequent mechanical ventilation. This study aimed to determine the usefulness of sCD62L plasma concentrations to identify infants undergoing cardiovascular surgery who are at risk for postoperative pulmonary dysfunction and capillary leaks. Design: Serial measurements of sCD62L plasma concentrations in a cohort of infants with congenital heart disease before, during, and after surgery for 4 consecutive days. Setting and patients: Infants aged 3–337 days undergoing cardiovascular surgery with (N = 27) or without (N = 12) cardiopulmonary bypass in a tertiary care center. Results: sCD62L concentrations before surgery showed a strong correlation with the infant's age (r = 0.77, p 〈 0.001). During surgery, sCD62L levels dropped from 9.0 ± 0.7 to 5.6 ± 0.4 nmol/l (mean ± SEM; p 〈 0.001). The minimum sCD62L concentration during and after surgery did not differ between infants operated upon with or without cardiopulmonary bypass (p 〉 0.1) or in infants who did (N = 10) or did not (N = 29) develop capillary leak syndrome. Whereas capillary leak syndrome was associated with prolonged mechanical ventilation (p 〈 0.01), there was no relationship between sCD62L concentrations at baseline or at any time thereafter and number of hours on the ventilator (p 〉 0.1). Conclusion: sCD62L concentrations before or after surgery are not apt to identify infants at increased risk of prolonged mechanical ventilation.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Zeitschrift für Herz-, Thorax- und Gefässchirurgie 14 (2000), S. 93-99 
    ISSN: 0930-9225
    Keywords: Schlüsselwörter Kardiopulmonaler Bypass ; Geschichte ; Bubble-Oxygenator ; Film-Oxygenator ; Key words Cardiopulmonary bypass ; history ; bubble-oxygenator ; film-oxygenator
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Historic development of extracorporeal circulation began with the perfusion of isolated organs by physiologists in the 19th century. Those experiments led to the development of the basic principles of the perfusion technique, such as bubble-oxygenation and film-oxygenation, systems for pulsatile pumping and the closed extracorporeal circuit. The idea for using extracorporeal circulation for cardiovascular surgery was born at the beginning of the 20th century.
    Notes: Zusammenfassung Die historische Entwicklung der extrakorporalen Zirkulation begann mit den isolierten Organperfusionen der Physiologen des 19. Jahrhunderts. Diese Experimente führten zur Entwicklung der Grundlagen der Perfusionstechnik, wie der Bubble- und Film-Oxygenation, sowie pulsatilen Pumpensystemen und dem geschlossenen extrakorporalen Kreislauf. Die Vorstellung, dass die extrakorporale Zirkulation im Zusammenhang mit herz- oder gefäßchirurgischen Eingriffen genutzt werden könnte, entstand schon zu Beginn des 20. Jahrhunderts.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 0930-9225
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 6-month-old infant was investigated for the first time at the German Heart Institute because of right ventricular insufficiency. The echocardiogram revealed right ventricular dilatation, severe tricuspid valve regurgitation, pulmonary hypertension and abnormal origin of the right pulmonary artery from the ascending aorta. The subsequent catheterization confirmed the diagnosis and the increased pulmonary vascular resistance in the right and left lung. The infant underwent immediate cardiac surgery and re-implantation of the right pulmonary artery in a newly created bifurcation using pericardial patch material. The postoperative course was complicated by persistent pulmonary hypertension, which was successfully treated with inhaled nitric oxide (NO).    The infant was discharged in good cardiorespiratory conditions on the 15th postoperative day.    Conclusion: Right ventricular failure and pulmonary hypertension in infancy can be associated with the rare malformation of abnormal origin of the pulmonary artery from the ascending aorta.
    Notes: Zusammenfassung Wir berichten über ein nunmehr 6 Monate altes Kind, welches im Alter von 2 Monaten durch eine Rechtsherzinsuffizienz unklarer Ursache auffiel. In der transthorakalen Echokardiographie und in der sich unmittelbar anschließenden Herzkatheteruntersuchung wurde eine fehlentspringende rechte Pulmonalarterie (RPA) aus der Aorta ascendens diagnostiziert. Die operative Korrektur erfolgte am Folgetag durch Re-implantation der RPA in den Pulmonalarterienstamm unter Erweiterung der Neo-Bifurkation mit Perikardflicken. Der postoperative Verlauf war komplikationslos.    Schlussfolgerung: Eine unklare RV-Dekompensation geht in einigen seltenen Fällen auf eine abnormal entspringende RPA zurück, die initialen Symptome hängen dabei entscheidend vom Ausmaß der sekundären pulmonalen Hypertension ab.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Zeitschrift für Herz-, Thorax- und Gefässchirurgie 12 (1998), S. 189-192 
    ISSN: 0930-9225
    Keywords: Schlüsselwörter Echokardiographie – Chirurgie angeborener Herzfehler ; Key words Echocardiography – Surgery of congenital heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose of this study was to evaluate the clinical utility of intraoperative echocardiography in the assessment of surgical repair of congenitally malformed hearts. In 235 of 508 patients who underwent cardiac surgery during a one year period transesophageal intraoperative echocardiography was performed. This was done to exclude residual ventricular septal defects or right ventricular outflow tract obstruction (n=84), to evaluate results of AV valve reconstruction (n=61), to assess ventricular function following arterial switch operation for complete transposition or in complex heart defects palliated by a Fontan-type procedure (n=50), to assess repair of left ventricular outflow obstruction (n=22) and for miscellaneous defects (n=18). Residual defects leading to immediate reoperation during the same surgical session were found in 4 patients (1.7%), minor residual defects not requiring reoperation were present in 6 patients (2.6%). In 2 patients with complete AV septal defect the left AV valves were only mildly regurgitant immediately after reconstruction but subsequent suture deshiscence required later reopoeration. Echocardiographic data were supplemented by direct pressure measurements in the ventricles and contrast injection into the left atrium. We conclude that intraoperative echocardiography can provide useful clinical informations, if its findings are interpreted in context with pressure measurements and contrast injections.
    Notes: Zusammenfassung Zweck dieser Studie war, den klinischen Nutzen der intraoperativen Echokardiographie bei Patienten mit angeborenen Herzfehlern zu untersuchen. Von 508 während des Zeitraumes eines Jahres durchgeführten Operationen bei angeborenen Herzfehlern wurde bei 235 (47%) eine intraoperative Echokardiographie durchgeführt. Die Indikationen waren Ausschluß von residuellen Ventrikelseptumdefekten und residuellen rechtsventrikulären Ausflußbahnobstruktionen (n=84), Evaluation von AV Klappenrekonstruktionen (n=61), vorwiegende Evaluation der Ventrikelfunktion nach arterieller Switchoperation bei kompletter Transposition oder bei Palliation komplexer Herzfehler durch eine Fontanoperation (n=50), Untersuchungen nach Operation einer linksventrikulären Ausflußbahnobstruktion (n=22), sowie sonstige Operationen (n=18). Residuelle Defekte, welche zu sofortiger Reoperation in der gleichen Sitzung Anlaß gaben, wurden bei 4 Patienten (1,7%) gefunden, unbedeutende residuelle Defekte, die keine Reoperation erforderlich machten bei 6 Patienten (2,6%). In 2 Fällen wurden bei korrigierten kompletten AV Septumdefekten unmittelbar postoperativ geringe Insuffizienzen der linken AV Klappe gesehen, welche später so an Schweregrad zunahmen, daß spätere Reoperationen notwendig wurden. Die durch die transösophageale Echokardiographie erhobenen Befunde wurden durch direkte blutige Druckmessungen und Kontrastinjektion in den linken Vorhof ergänzt. Wir schlußfolgern, daß die intraoperative Echokardiographie klinisch sinnvolle Informationen liefern kann, wenn die erhobenen Befunde im Kontext mit den oben aufgeführten anderen Messungen interpretiert werden.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    ISSN: 0930-9225
    Keywords: Schlüsselwörter Zyanotische angeborene Herzfehler – akutes Nierenversagen (ANV) – Nephropathie – Urinproteindiagnostik –β-N-Acetyl-glukosaminidase (NAG) ; Key words cyanotic congenital heart disease – acute renal failure (ARF) – nephropathy – urinary protein diagnostic –β-N-acetyl-glukosaminidase (NAG)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Patients with long-standing cyanotic congenital heart disease (CHD) are known for impaired renal function and increased risk of developing acute renal failure after open heart surgery. We prospectively studied urinary protein concentration in 6 patients with cyanotic CHD and 4 patients with acyanotic CHD before and during a 3 day-period after surgery. Three of six patients with cyanotic CHD had preoperatively overt glomerulopathy, presenting with elevated urinary albumin concentrations in all three and elevated transferrin and immunoglobulin G concentrations in two. They progressed to acute renal failure necessitating the institution of hemodialysis 1 and 4 days after surgery. In contrast, patients with cyanotic CHD but normal urinary albumin concentrations and patients with acyanotic CHD had no overt renal impairment after cardiopulmonary bypass. Urinary excretion of albumin, immunoglobulin G, transferrin, soluble L-selectin, α1-microglobulin, and β-N-acetyl-glucosaminidase remained normal throughout the postoperative period in acyanotic CHD patients and rose slightly in cyanotic CHD patients without acute renal failure. In cyanotic CHD patients with renal failure, urinary excretion increased to more than 1000 mg/g creatinine albumin, more than 150 mg/g creatinine transferrin and more than 200 mg/g creatinine IgG 24 h after surgery. α1-microglobulin increased to more than 1000 mg/g creatinine and β-N-acetyl-glucosaminidase activity to more than 100 U/g creatinine 48 h after operation, showing additional tubular damage. Patients with CCHD and pathological proteinuria are at high risk of developing acute renal failure within few days after surgery which is heralded by excessively high urinary protein excretion.
    Notes: Zusammenfassung Patienten mit einem unkorrigiertem zyanotischen Vitium können eine eingeschränkte Nierenfunktion entwickeln und tragen ein erhöhtes Risiko für die Entwicklung eines akuten Nierenversagens nach Operation am offenen Herzen. In einer prospektiven Studie untersuchten wir über einen Zeitraum von prä- bis 3 Tage postoperativ 6 adolezente oder adulte Patienten nach Operation eines zyanotischen Vitium cordis. Als Kontrollgruppe dienten adulte Patienten mit einem azyanotischen Vitium. 3 der 6 zyanotischen Patienten hatten präoperativ Zeichen einer renalen Glomerulopathie mit erhöhter Albuminkonzentration im Urin und in 2 Fällen auch mit erhöhten Urinkonzentrationen von Transferrin und Immunoglobulin G. Diese 3 Patienten entwickelten postoperativ ein akutes Nierenversagen mit Dialysepflichtigkeit am 1. und 4. Tag nach der Operation. Die übrigen 3 Patienten hatten präoperativ normale Urineiweißkonzentrationen und entwickelten postoperativ kein akutes Nierenversagen. Die Urinkonzentrationen von Albumin, L-Selectin (sCD62L), Transferrin, Immunoglobulin G (IgG), α1-Mikroglobulin (α1-M) und die Aktivität der β-N-Acetyl-Glukosaminidase (NAG) blieben in der postoperativen Periode bei den Patienten mit azyanotischen Vitien im Normbereich und waren bei den 3 zyanotischen Patienten ohne akutes Nierenversagen gering erhöht. Bei den 3 zyanotischen Patienten mit akutem Nierenversagen stiegen als Zeichen der vermehrten glomerulären Schädigung die postoperativen Urinkonzentrationen nach 24 Stunden auf über 1000 mg Albumin/gKrea, über 150 mg Transferrin/gKrea und über 200 mg IgG/gKrea. Als Zeichen zusätzlicher tubulärer Nierenschädigung war der Anstieg der β1-M-Urinkonzentration auf über 1000 mg/gKrea und der NAG-Aktivität im Urin auf über 100 U/gKrea zu werten. Patienten mit unkorrigiertem zyanotischen Vitium cordis und Proteinurie als Ausdruck eines “zyanotischen” glomerulären Nierenschadens haben ein hohes Risiko für die Entwicklung eines postoperativen akuten Nierenversagens in den ersten Tagen postoperativ. Diese Entwicklung kann früh postoperativ an einer exzessiven Proteinurie erkannt werden.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    ISSN: 1432-1238
    Keywords: Key words Peritoneal dialysis ; Acute renal failure ; Congenital heart disease ; Cardiac output measurements ; Open chest
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Evaluation of the acute hemodynamic changes during peritoneal dialysis in patients with low cardiac output syndrome and acute renal failure after open heart surgery.¶Patients: Three newborns and three infants after corrective surgery of congenital heart disease with post cardiotomy dialysis. Five of these had an open thorax during dialysis.¶Methods: Cardiac output measurements using the thermodilution technique on two consecutive days at four different times during the peritoneal dialysis cycle.¶Results: We did not find a deterioration of the cardiac index or systemic vascular resistance measured over two cycles in each of the six patients. Pulmonary artery pressure rose slightly after instillation of the dialysate solution in all patients. Changes in central venous pressure and left atrial pressure were not clinically meaningful. In all patients fluid removal by peritoneal dialysis was effective. All five surviving patients recovered renal function.¶Conclusions: Peritoneal dialysis can be performed in newborns and infants following cardiac surgery without causing acute hemodynamic imbalances. An open chest may have a significant impact on hemodynamic stability during peritoneal dialysis by blunting any possible negative alterations of increased intraabdominal pressure.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    ISSN: 1432-1238
    Keywords: Key words Nitric oxide ; Rebound ; Pulmonary hypertension ; Dynamic respiratory system compliance ; Interaction ; Congenital heart disease compliance ; Interaction ; Congenital heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To assess the interaction between pulmonary hemodynamics and respiratory mechanics during acute pulmonary hypertension. Patients: Ventilated and paralysed children treated with inhaled nitric oxide because of post-operative pulmonary hypertension. Interventions: Weaning of inhaled nitric oxide. Measurements: Air flow and airway pressure, calculation of dynamic respiratory system compliance and respiratory system resistance for each breath by multiple linear regression. Results: In four patients, increases in pulmonary arterial pressure from 26.1 to 56.7 mmg (p 〈 0.001) during weaning off nitric oxide were associated with decreases in tidal volume (from 9.7 → 8.2 ml/kg, p 〈 0.01) and reductions in dynamic respiratory system compliance (from 0.52 → 0.34 cmH20/ml/kg, p 〈 0.001), while respiratory system resistance was unchanged. Conclusions: Impaired ventilation during acute pulmonary hypertension is predominantly related to a reduction in respiratory system compliance.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Anomaler Abgang der rechten Koronararterie ; Bland-White-Garland-Syndrom ; Angeborene Herzfehler ; Key words Anomalous origin of the right coronary artery ; Bland-White-Garland-Syndrome ; Congenital heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Anomalous origin of the right coronary artery from the pulmonary trunk is rare, however, it is of considerable clinical significance. Discussion: We report of the findings in an asymptomatic child with anomalous origin of the right coronary artery from the pulmonary trunk and shortly review this entity.
    Notes: Zusammenfassung Der fehlerhafte Abgang der rechten Koronararterie aus der Pulmonalarterie ist selten, jedoch von erheblicher klinischer Relevanz. Diskussion: Wir berichten über die Befunde eines asymptomatischen Schulkinds mit diesem Krankheitsbild und geben einen Überblick über diese Fehlbildung.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...