Library

X
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
    Electronic Resource
    Electronic Resource
    Barbiturate coma for severe, refractory vasospasm following subarachnoid haemorrhage (1999)
    Springer
    Intensive care medicine 25 (1999), S. 406-409 
    Details
    ISSN: 1432-1238
    Keywords: Key words Subarachnoid haemorrhage ; Vasospasm ; Papaverine ; Barbiturate ; therapeutic use
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To document the outcome of patients treated with barbiturate coma for severe symptomatic angioplasty-resistant vasospasm. To compare mortality with that predicted by admission APACHE II score, and neurological outcome with that of historical controls treated with barbiturate coma for vasospasm, and with historical controls with delayed ischaemic deficits from vasospasm treated with nimodipine. Design: Cohort study. Setting: Neurosurgical Intensive Care Unit of tertiary referral university teaching hospital. Patients: Eleven (6.7 %) of 164 consecutive patients with aneurysmal SAH managed according to our protocol who were treated with thiopentone-induced burst suppression coma for severe symptomatic, angioplasty-resistant vasospasm. Interventions: Chart, database and literature review. Measurements and results: All 11 patients survived to hospital discharge (mortality 0 %) compared with first-day APACHE II predicted mortality of 30.6 % (p = 0.15). Outcome at 6 months was: good recovery 8/11 (72.7 %), moderate disability 2/11 (18.2 %), vegetative survival 1/11 (9.1 %). Ten of 11 (90.9 %) had a good neurological outcome compared with 50.6 % of historical controls with delayed ischaemic deficit from vasospasm (odds ratio 9.78, 95 % confidence interval 1.24–77.0, p = 0.02), and 0 % of previously reported patients treated with barbiturate coma for vasospasm (p 〈 0.01). Conclusion: Our results are better than previously published outcomes and suggest formal evaluation of barbiturate coma in the treatment of severe resistant symptomatic vasospasm following SAH is warranted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050866
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Intensive care management of paediatric organ donors and its effect on post- transplant organ function (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1424-1432 
    Details
    ISSN: 1432-1238
    Keywords: Key words Organ donor ; Trans-plantation ; Diabetes insipidus ; Cardiac arrest
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: 1. To document the clinical course of paediatric beating heart organ donors. 2. To evaluate the effect of the ICU management of pediatric donors on the immediate function of transplanted organs. 3. To examine the validity of current donor selection criteria. Design: Retrospective chart review and case series study. Setting: Multidisciplinary ICU of tertiary referral paediatric hospital. Patients: All patients who became solid organ donors between January 1980 and July 1990. Outcome Measures: 1. Incidence of major physiological abnormalities of the cardiovascular, pulmonary, renal and metabolic systems. 2. Number of organs retrieved and transplanted, reasons for non-translantation of donated organs. 3. Immediate post-transplant function of transplanted organs. Results: Seventy-seven organ donors were identified from whom 134 kidneys, 31 livers and 12 hearts were transplanted. Sixty (78%) patients developed diabetes insipidus. Sustained hypotension occurred in 41 (53.2%) and was commoner in patients treated with inotropic agents in the presence of a low central venous pressure and in patients with diabetes insipidus who did not receive anti-diuretic hormone replacement. Twenty-seven patients suffered at least one cardiac arrest. The data on post-transplant function were obtained 28.8nfor 129 kidneys (from 70 donors) 30 livers and 9 hearts. Fifty-two kidneys, 10 livers and 2 hearts were transplanted from donors who had suffered at least one cardiac arrest without apparent adverse effect on post-transplant organ function. Thirty-six kidneys from 31 donors suffered either acute tubular necrosis (ATN) or primary non-function. The donors of these organs spent longer in ICU (60.6±45.7 h versus 41.8±30.1 h p=0.045) and had a higher mean maximum serum sodium concentration (163.4±10.9 versus 158.5±9.5 mmol/l p=0.05) than those without these complications. The serum creatinine concentration and degree of inotropic support did not predict post-transplant function. Standard biochemical tests for hepatic function, the dose of inotropic agent received, time in ICU and incidence of hypotension did not predict post-transplant liver function. Conclusions: Aggressive fluid resuscitation and management of diabetes insipidus may promote stability in paediatric organ donors. Donor cardiac arrest does not alter the ICU course or compromise post-transplant organ function. The current criteria used for donor selection failed to predict post-transplant organ function and their use may increase organ wastage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709564
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Intensive care management of paediatric organ donors and its effect on post-transplant organ function (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1424-1432 
    Details
    ISSN: 1432-1238
    Keywords: Organ donor ; Trans-plantation ; Diabetes insipidus ; Cardiac arrest
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives 1. To document the clinical course of paediatric beating heart organ donors. 2. To evaluate the effect of the ICU management of pediatric donors on the immediate function of transplanted organs. 3. To examine the validity of current donor selection criteria. Design Retrospective chart review and case series study. Setting Multidisciplinary ICU of tertiary referral paediatric hospital. Patients All patients who became solid organ donors between January 1980 and July 1990. Outcome Measures 1. Incidence of major physiological abnormalities of the cardiovascular, pulmonary, renal and metabolic systems. 2. Number of organs retrieved and transplanted, reasons for non-translantation of donated organs. 3. Immediate post-transplant function of transplanted organs. Results Seventy-seven organ donors were identified from whom 134 kidneys, 31 livers and 12 hearts were transplanted. Sixty (78%) patients developed diabetes insipidus. Sustained hypotension occurred in 41 (53.2%) and was commoner in patients treated with inotropic agents in the presence of a low central venous pressure and in patients with diabetes insipidus who did not receive anti-diuretic hormone replacement. Twenty-seven patients suffered at least one cardiac arrest. The data on post-transplant function were obtained for 129 kidneys (from 70 donors) 30 livers and 9 hearts. Fifty-two kidneys, 10 livers and 2 hearts were transplanted from donors who had suffered at least one cardiac arrest without apparent adverse effect on post-transplant organ function. Thirty-six kidneys from 31 donors suffered either acute tubular necrosis (ATN) or primary non-function. The donors of these organs spent longer in ICU (60.6±45.7 h versus 41.8±30.1 hp=0.045) and had a higher mean maximum serum sodium concentration (163.4±10.9 versus 158.5±9.5 mmol/lp=0.05) than those without these complications. The serum creatinine concentration and degree of inotropic support did not predict post-transplant function. Standard biochemical tests for hepatic function, the dose of inotropic agent received, time in ICU and incidence of hypotension did not predict post-transplant liver function. Conclusions Aggressive fluid resuscitation and management of diabetes insipidus may promote stability in paediatric organ donors. Donor cardiac arrest does not alter the ICU course or compromise post-transplant organ function. The current criteria used for donor selection failed to predict post-transplant organ function and their use may increase organ wastage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709564
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...