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  • 1
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    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
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  • 3
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Multifokale atriale Tachykardie (MAT) ; Chaotische Vorhoftachykardie ; Antiarrhythmische Therapie ; Säugling ; Angeborene Herzfehler ; Key words Multifocal atrial tachycardia (MAT) ; Chaotic atrial rhythm ; Antiarrhythmic therapy ; Infancy ; Congenital heart defects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Definition: Multifocal atrial tachycardia (MAT) (also called chaotic atrial rhythm or mechanism) is a rare rhythm disturbance in infancy and childhood. It usually occurs as a sequela of chronic obstructive lung disease in adults with an incidence of about 0,5% and a high mortality rate. In infancy, the incidence has been estimated to be about 0,2%, mainly found in young infants. Diagnosis: It is characterized by an atrial frequency greater than 100 per minute, 3 or more different p-wave contours, variable PP, RR and PR-intervals, and a discrete isoelectric baseline. The origin of the arrhythmia remains unclear but atrial distension may play a significant role. Discussion: We report on the clinical course and management of two patients and also review the relevant literature.
    Notes: Zusammenfassung Definition: Die multifokale atriale Tachykardie (MAT) bzw. chaotische atriale Tachykardie oder chaotische Vorhoftachykardie ist im Kindesalter selten. Im Erwachsenenalter ist sie vorwiegend bei Patienten mit akuten oder chronischen Lungenerkrankungen beschrieben und mit einer hohen Letalität behaftet. Im Gegensatz zum Auftreten im Erwachsenenalter besitzt die MAT im Kindesalter durchweg eine gute Prognose. Diagnose: Elektrokardiographisch ist die MAT durch mindestens 3 unterschiedlich konfigurierte P-Wellen charakterisiert, die nicht der elektrischen Sinusachse entsprechen. Es besteht eine isoelektrische Linie zwischen den P-Wellen, die Vorhoffrequenz beträgt normalerweise mehr als 100 Schläge/min mit variablen P-P-, P-R- und R-R-Intervallen. Die Genese dieser Tachyarrhythmie ist unklar, eine Vorhofbelastung als Auslöser ist jedoch wahrscheinlich. Diskussion: Die möglichen Ursachen und Therapiestrategien bei chaotischer Vorhoftachykardie werden anhand zweier Kasuistiken diskutiert und eine Übersicht über die vorliegende Literatur gegeben.
    Type of Medium: Electronic Resource
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