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  • 1
    Electronic Resource
    Electronic Resource
    Sepsis nach Eigenbluttransfusion (1996)
    Springer
    Der Anaesthesist 45 (1996), S. 460-463 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Eigenbluttransfusion ; Bakterielle Kontamination ; Sepsis ; Key words Autologous blood transfusion ; Bacterial contamination ; Sepsis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Postoperatively, after an uncomplicated vaginal hysterectomy, a 58-year-old female patient developed the signs of disseminated intravascular coagulation and fever, which progressed to a septic shock. She received two units of autologous blood, one during and one after the operation. A blood culture from the patient and one unit of the autologous blood showed abundant growth of Pseudomonas cepacia and Serratia marcescens within 24 h and culture of this blood bag also showed slight growth of Staphylococcus epidermidis within 48 h. Culture of the second blood unit showed slight growth of Propionibacterium acnes. The source of bacterial contamination could not be identified. Autologous blood products thus also include a risk of infection that shouldn't be underestimated, and a strict medical indication to retransfusion is indispensable.
    Notes: Zusammenfassung Bei einer 58jährigen Patientin entwickelten sich in der frühpostoperativen Phase nach vaginaler Hysterektomie die Zeichen einer disseminierten intravasalen Gerinnung mit Verbrauchskoagulopathie sowie Fieber und im weiteren Verlauf das Bild eines septischen Schocks. Sie hatte intra- und postoperativ je eine Eigenblutkonserve erhalten. In der Blutkultur der Patientin und einer Eigenblutkonserve zeigte sich Wachstum von Pseudomonas cepacia und Serratia marcescens in hoher Keimzahl. In dieser Eigenblutkonserve konnte außerdem Staphylococcus epidermidis, in der zweiten Propionibacterium acnes nachgewiesen werden. Die Kontaminationsquelle der Konserven war nicht identifizierbar. Es zeigt sich, daß auch die autologe Hämotherapie ein nicht zu unterschätzendes Infektionsrisiko in sich birgt und die Retransfusion von Eigenblut einer strengen medizinischen Indikation bedarf.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050281
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Unbemerkte Nahtfixation eines Swan-Ganz-Katheters in der Arteria pulmonalis während Herzoperation (1995)
    Springer
    Der Anaesthesist 44 (1995), S. 782-784 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Swan-Ganz-Katheter ; Komplikation ; Nahtfixation ; Pulmonalarterie ; Key words Swan-Ganz catheter ; Complication ; Suture fixation ; Pulmonary artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract We report a patient undergoing redo cardiac surgery for combined replacement of the aortic and mitral valves. During the course of the operation, a Swan-Ganz catheter – positioned preoperatively – was accidentally fixed to the wall of the pulmonary artery. As this did not interfere with cardiac output measurement or the pulmonary artery pressure wave form, the fixation was not noticed until an attempt was made to remove the catheter. Fluoroscopy revealed both the catheter's immobility and the location of the suture fixation. The patient required a sternotomy to remove the catheter. In order to avoid this complication, the indications for pulmonary artery catheters during cardiac surgery should be carefully considered. If catheters are inserted, their mobility should by all means be ensured before the chest is closed.
    Notes: Zusammenfassung Der vorliegende Fallbericht beschreibt die Nahtfixation eines Swan-Ganz-Katheters in der A. pulmonalis während eines kombinierten Aorten- und Mitralklappenersatzes. Da die Funktionen des Katheters nicht eingeschränkt waren, blieb die Fixation bis zur beabsichtigten Katheterentfernung unbemerkt. Konventionelle Röntgenaufnahmen legten die Diagnose nahe. Die Katheterentfernung erfolgte operativ über eine Resternotomie des Patienten. Zur Vermeidung dieser Komplikation bei kardiochirurgischen Eingriffen sollte, neben einer strengen Indikationsstellung, vor Thoraxverschluß in jedem Fall die freie Beweglichkeit sämtlicher Katheter im Operationsgebiet geprüft werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050213
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    A simple method to estimate functional residual capacity in mechanically ventilated patients (1993)
    Springer
    Intensive care medicine 19 (1993), S. 372-376 
    Details
    ISSN: 1432-1238
    Keywords: Mechanical ventilation ; Respiration ; Functional residual capacity ; Lung volume
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective The aim of the present study was to evaluate a simplified method for FRC measurement.Design: Accuracy and precision of the method were assessed in a physical lung model; reproducibility was tested in 10 mechanically ventilated patients. In each patient FRC was measured at three PEEP levels.Setting: Post-operative intensive care unit in a university hospital. Measurements and results Gas flow, CO2 concentration, and O2 concentration were measured during in- and expiration by pneumotachography, a mainstream capnometer and a sidertream O2-analyser. For FRC-measurement inspiratory O2 concentration was changed by 30%. FRC was determined as mean value of a N2 washout and N2 washin procedure. Evaluation of this method in a lung model shows a good correlation between FRC set in the lung model and FRC measured (FRC measured =1.028*FRC model+22.92 ml;r 2=0.957;n=30). The mean difference was 4.4% of FRC-reference (range −8.4% to +21.7%). Duplicate determinations in 10 mechanically ventilated patients differed by an average of −2.7% (range −30.1% to +27.3%). Conclusion Our results suggest that the proposed method can be used in daily clinical work.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01724875
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    Paper (German National Licenses)
    Fulltext
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