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  • 1
    ISSN: 1432-1238
    Keywords: Lipopolysaccharide ; Liver ; Small intestinal serosa and mucosa ; Tissue oxygen tension ; Acid-base balance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Study on simultaneous O2 supply/uptake relationships in liver and gut during endotoxaemia, to determine whether signs of dysoxia develop uniformly in the splanchnic region. Design Animal study to assess the early effects of endotoxaemia on oxygenation of both liver and small intestine. Interventions Eight anaesthetized pigs received a continuous portal venous infusion of lipopolysaccharide (0.5 μg·kg−1·h−1) for 6 h. Systemic, pulmonary and splanchnic haemodynamics as well as systemic and splanchnic O2 supply/uptake relationships were determined. Results There was a multiphasic haemodynamic response pattern characterized by an early (within the 1st h) and a subsequent more prolonged phase (between the 2nd and 6th h) of decreases and recovery of hepatic arterial, portal venous and superior mesenteric arterial blood flows (electromagnetic flow probes) and splanchnic O2 deliveries. Unrelated to perfusion pressure and O2 delivery, there were early and sustained decreases in ileal mucosal surface partial pressure of oxygen (PO2) (multiwire PO2 electrode) and pH (tonometry). This was not reflected by ileal serosal surface PO2, O2 uptake and arteriomesenteric venous pH and partial pressure of carbon dioxide (PCO2) gradients. There was little evidence of concomitant hepatic dysoxia as evaluated by surface PO2. Conclusions The study demonstrates early and sustained regional (mucosa) intestinal hypoxia with little evidence of simultaneous hepatic dysoxia during initial endotoxaemia.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Lipopolysaccharide ; Liver ; Small intestinal serosa and mucosa ; Tissue oxygen tension ; Acid ; base balance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective:  Study on simultaneous O2 supply/uptake relationships in liver and gut during endotoxaemia, to determine whether signs of dysoxia develop uniformly in the splanchnic region. Design: Animal study to assess the early effects of endotoxaemia on oxygenation of both liver and small intestine. Interventions: Eight anaesthetized pigs received a continuous portal venous infusion of lipopolysaccharide (0.5 μg⋅kg-1⋅h-1) for 6 h. Systemic, pulmonary and splanchnic haemodynamics as well as systemic and splanchnic O2 supply/uptake relationships were determined. Results: There was a multiphasic haemodynamic response pattern characterized by an early (within the 1st h) and a subsequent more prolonged phase (between the 2nd and 6th h) of decreases and recovery of hepatic arterial, portal venous and superior mesenteric arterial blood flows (electromagnetic flow probes) and splanchnic O2 deliveries. Unrelated to perfusion pressure and O2 delivery, there were early and sustained decreases in ileal mucosal surface partial pressure of oxygen (PO2) (multiwire PO2 electrode) and pH (tonometry). This was not reflected by ileal serosal surface PO2, O2 uptake and arteriomesenteric venous pH and partial pressure of carbon dioxide (PCO2) gradients. There was little evidence of concomitant hepatic dysoxia as evaluated by surface PO2. Conclusions: The study demonstrates early and sustained regional (mucosa) intestinal hypoxia with little evidence of simultaneous hepatic dysoxia during initial endotoxaemia.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1076
    Keywords: Key words Inhaled nitric oxide ; Intrapulmonary shunt ; Rabbit ; Surfactant deficiency ; Meconium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Marked hypoxia secondary to intrapulmonary right-to-left shunting is a characteristic of respiratory failure in human neonates and can sometimes be complicated by additional extrapulmonary right-to-left shunting. To investigate the effect of inhaled nitric oxide (iNO) on intrapulmonary shunting, two typical pulmonary diseases of the newborn (respiratory distress syndrome and meconium aspiration) were reproduced in 32 mechanically ventilated rabbits weighing approximately 2 kg each. After tracheotomy, catheters were inserted into a jugular vein, a carotid artery and the right ventricle (to measure systolic right ventricular pressure [SRVP] and mixed venous oxygen content for calculation of shunt by Fick equation). Repeated airway lavages (LAV) with normal saline or repeated instillations of a suspension of human meconium (MEC) were continued until both the a/A-ratio was ≤0.14 and a peak inspiratory pressure ≥22 mbar was needed to keep the tidal volume constant at 10 ml/kg of body weight. Measurements of shunt, SRVP, systolic systemic pressure, physiological dead space, tidal volume and a ventilation index were performed before and after completion of lung damage and at 20 and 60 min after administering iNO at 80 ppm. Four groups of rabbits were studied (n = 8 in each group): LAV control and intervention, Mec control and intervention. 60 min after starting iNO, there was a decrease in shunt (LAV: 67.6% ± [SD] 11.3% vs 56.2 ± 16.4, P = 0.05; MEC: 52.6 ± 6.3 vs 44.3 ± 8.3, P 〈 0.05), in SRVP (LAV: 29.7 mmHg ± 10.1 mmHg vs 20.0 ± 8.2, P 〈 0.01; MEC: 25.1 ± 4.4 vs 22.3 ± 5.0, P = 0.46) and in dead space (% of tidal volume, LAV: 32.7% ± 10.5% vs 25.9 ± 10.1, P 〈 0.01; MEC: 26.1 ± 16.6 vs 18.9 ± 10.1, P = 0.05). These results demonstrate that iNO decreases intrapulmonary shunt (as well as SRVP and dead space). We suggest that iNO may be beneficial in human newborns with severe respiratory failure even if no extrapulmonary shunting via ductus or foramen ovale is apparent.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 883-887 
    ISSN: 1432-2218
    Keywords: Key words: Intestinal ischemia — Emergency laparoscopy — Spectrophotometry — Pulse oximetry — Doppler-ultrasound — Laser-Doppler
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic diagnosis of intestinal ischemia is difficult. Dark-colored bowels are not a reliable indicator for infarction, because there is no correlation between color and oxygenation. The same picture is produced by intraluminal blood or feces. False diagnoses are described. Methods: We analyzed various techniques for assessing intestinal oxygenation and perfusion to support laparoscopic diagnosis. In this study laparoscopy was performed on eight pigs. A 10-cm segment of intestine was fixed to the abdominal wall and rendered ischemic. Measurements of the ischemic segment and normal intestine were taken using laser-Doppler, Doppler ultrasound, spectrophotometer, and pulse oximeter. Doppler ultrasound and pulse oximetry were unsuitable in our model, as was laser-Doppler flowmetry. Results: Only the spectrophotometer proved a highly sensitive means of assessing bowel oxygenation. Conclusions: This method provides the desired additional information about intestinal oxygenation, thus helping to interpret the laparoscopic picture of dark bowels.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 883-887 
    ISSN: 1432-2218
    Keywords: Intestinal ischemia ; Emergency laparoscopy ; Spectrophotometry ; Pulse oximetry ; Doppler-ultrasound ; Laser-Doppler
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic diagnosis of intestinal ischemia is difficult. Dark-colored bowels are not a reliable indicator for infarction, because there is no correlation between color and oxygenation. The same picture is produced by intraluminal blood or feces. False diagnoses are described. Methods: We analyzed various techniques for assessing intestinal oxygenation and perfusion to support laparoscopic diagnosis. In this study laparoscopy was performed on eight pigs. A 10-cm segment of intestine was fixed to the abdominal wall and rendered ischemic. Measurements of the ischemic segment and normal intestine were taken using laser-Doppler, Doppler ultrasound, spectrophotometer, and pulse oximeter. Doppler ultrasound and pulse oximetry were unsuitable in our model, as was laser-Doppler flowmetry. Results: Only the spectrophotometer proved a highly sensitive means of assessing bowel oxygenation. Conclusions: This method provides the desired additional information about intestinal oxygenation, thus helping to interpret the laparoscopic picture of dark bowels.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 263-267 
    ISSN: 1435-2451
    Keywords: Open meniscal resection ; Reduced effusion-rate ; Less necessary equipment ; Less complications ; Offene Meniscusresektion ; Geringere Ergussbildung ; Geringer apparativer Aufwand ; Geringe Komplikationen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Beiträge in Laienpresse, Rundfunk und Fernsehen lassen den Eindruck entstehen, als sei die offene Operationsmethode für die Meniscusresektion obsolet und passé. Mit einer Reihe von Argumenten, wie ambulante Behandlung, geringere Kosten, geringere Morbidität, kürzere Operationszeiten etc. wird versucht Vorteile aufzuzeigen. Zu den einzelnen Punkten wird ausführlich Stellung genommen und Ergebnisse aus der Literatur mit denen einer eigenen Nachuntersuchung über offene Meniscusresektion gegenübergestellt. Dabei kann eindeutig gezeigt werden, dass die postoperative Reizergussrate bei offener Operation wesentlich niedriger liegt als bei arthroskopischer. Es muss betont werden, dass mit der arthroskopischen Operation auch ganz erhebliche Schäden gesetzt werden können, vor allem am Gelenkknorpel. Es wird festgestellt, dass die arthroskopische Operation grosse Erfahrung und technisches Können verlangt. Sind diese und eine ausreichende technische Ausstattung nicht gewährleistet, so wird die offene Methode als weit überlegen angesehen.
    Notes: Summary Articles in the general press, radio and television give the impression that the open operation method for the meniscus is obsolete and passé. With a row of arguments such as ambulant treatment, lower costs, reduced morbidity and shorter operation time etc. attempts are made to demonstrate its advantages. There are comprehensive opinions on each individual point and results from the literature are compared with those of a personal postexamination about open meniscal resection. It can definitely be shown, however, that the postoperative effusion rate by open operation is much lower than with the arthroscopic method. It must be stressed that the arthroscopic operation may cause considerable damage particularly in the cartilage of the joints. It has been determined that for the arthroscopic operation great experience and technical ability is necessary. If these and adequate technical equipment are not guaranteed, then the open method is regarded as the far superior.
    Type of Medium: Electronic Resource
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