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  • 1
    Electronic Resource
    Electronic Resource
    Continuous measurement of cardiac output by the Fick principle in infants and children: comparison with the thermodilution method (1996)
    Springer
    Intensive care medicine 22 (1996), S. 467-471 
    Details
    ISSN: 1432-1238
    Keywords: Key words Fick principle ; Thermodilution ; Cardiac output ; Infants ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective:To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. Design: Prospective direct comparison of the above two techniques. Setting: Pediatric intensive care unit of a university hospital. Patients: 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. Methods: The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20 s. Interventions: In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. Results: Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found: r 2=0.98; P〈0.001; SEE=0.14 l/min. The bias is absolute values and in percent of average cardiac output was −0.05 l/min or −4.4% with a precision of 0.32 l/min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. Conclusion: Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712169
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  • 2
    Electronic Resource
    Electronic Resource
    Successful treatment of a patient with ARDS after pneumonectomy using high-frequency oscillatory ventilation (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1173-1176 
    Details
    ISSN: 1432-1238
    Keywords: Key words High-frequency oscillatory ventilation ; HFOV ; Mechanical ventilation ; Adults ; Pneumonectomy ; Postoperative period ; Pneumonia ; ARDS ; Oxygenation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract High frequency oscillatory ventilation (HFOV) was used in a patient who developed the acute respiratory distress syndrome 5 days following a right pneumonectomy for bronchogenic carcinoma. When conventional pressure-controlled ventilation failed to maintain adequate oxygenation, HFOV dramatically improved oxygenation within the first few hours of therapy. Pulmonary function and gas exchange recovered during a 10-day period of HFOV. No negative side effects were observed. Early use of HFOV may be a beneficial ventilation strategy for adults with acute pulmonary failure, even in the postoperative period after lung resection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051032
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  • 3
    Electronic Resource
    Electronic Resource
    Continuous measurement of cardiac output by the Fick principle in infants and children: Comparison with the thermodilution method (1996)
    Springer
    Intensive care medicine 22 (1996), S. 467-471 
    Details
    ISSN: 1432-1238
    Keywords: Fick principle ; Thermodilution ; Cardiac output ; Infants ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. Design Prospective direct comparison of the above two techniques. Setting Pediatric intensive care unit of a university hospital. Patients 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. Methods The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20 s. Interventions In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. Results Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found:r 2=0.98;P〈0.001; SEE=0.14 l/min. The bias is absolute values and in percent of average cardiac output was −0.05 l/min or −4.4% with a precision of 0.32 l/ min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. Conclusion Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712169
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  • 4
    Electronic Resource
    Electronic Resource
    Effects of dobutamine on left ventricular performance in newborns as determined by systolic time intervals (1987)
    Springer
    European journal of pediatrics 146 (1987), S. 135-139 
    Details
    ISSN: 1432-1076
    Keywords: Newborns ; Dobutamine ; Systolic time intervals ; Echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the effects of dobutamine on myocardial function in newborns, left ventricular systolic time intervals (STI) — normalized pre-ejection period (PEPI), normalized left ventricular ejection time (LVETI) and pre-ejection period to left ventricular ejection time ratio (PEP/LVET) — were assessed by echocardiography in 18 newborns treated with dobutamine for clinically diagnosed heart failure. Examinations were performed prior to and 30 min after starting dobutamine infusion (7.5 or 10 μg/kg per min). Patients were assigned to two groups according to their PEP/LVET prior to dobutamine administration: group I (n=9) with pre-treatment PEP/LVET ≤ 0.35 and group II (n=9) with pre-treatment PEP/LVET 〉 0.35. While there was no change of STI in group I, dobutamine infusion resulted in a significant decrease in PEPI (from 102±4.8 to 87.8±4.2; mean ± SEM;P〈0.01) and of PEP/LVET (from 0.56±0.05 to 0.45±0.05; mean ±SEM;P〈0.01) and in a significant increase of LVETI (from 237.6±5.6 to 253.3±5.2; mean ±SEM;P〈0.01) in group II. Heart rate increased significantly in both groups. Left ventricular end-diastolic dimension, also assessed by echocardiography, did not change in the eight studies performed. An increase in mean arterial pressure was found in three out of five newborns of group II and in one out of four patients in group I. It is concluded that dobutamine can improve cardiac performance in newborns with impaired left venfricular function. This effect is probably due to an improvement in myocardial contractility.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02343218
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  • 5
    Electronic Resource
    Electronic Resource
    Nitric oxide and prostacyclin lower suprasystemic pulmonary hypertension after cardiopulmonary bypass (1993)
    Springer
    European journal of pediatrics 152 (1993), S. 793-796 
    Details
    ISSN: 1432-1076
    Keywords: Newborn ; Cardiac surgery ; Pulmonary hypertension ; Prostacyclin ; Nitric oxide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a 3-week-old male newborn persistent suprasystemic pulmonary hypertension developed after surgical valvulotomy for a critical aortic valve stenosis. Because of a residual transvalvular pressure gradient of 35 mm Hg and postoperative left as well as right ventricular dysfunction, treatment with inhaled nitric oxide (NO) and intravenously infused prostacyclin (PGI2) was attempted. Low-dose inhaled NO and low dose PGI2 corrected severe pulmonary hypertension and led to an increase in cardiac output. Treatment with NO but not PGI2 was accompanied by a rise in PaO2 and systemic blood pressure. Interruption of NO administration led to a rapid increase in pulmonary arterial pressure to suprasystemic levels. With continued i.v. PGI2 and decreasing concentrations of NO, severe pulmonary hypertension resolved after a few days suggesting that a transient endothelial dysfunction was partially responsible for pulmonary vasoconstriction. NO inhalation appears to be an effective new tool in the treatment of severe pulmonary hypertension following cardiac surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02073372
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  • 6
    Electronic Resource
    Electronic Resource
    Sudden pneumoscrotum in a ventilated infant (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 689-690 
    Details
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050912
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  • 7
    Electronic Resource
    Electronic Resource
    Mitral and aortic regurgitation in 84 patients with mucopolysaccharidoses (1995)
    Springer
    European journal of pediatrics 154 (1995), S. 98-101 
    Details
    ISSN: 1432-1076
    Keywords: Mucopolysaccharidoses ; Mitral regurgitation ; Aortic regurgitation ; Doppler echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In echocardiographic and necropsy studies nodular thickening of the mitral valve and, less frequently, of the aortic valve has been found in 60%–90% of patients with mucopolysaccharidoses (MPS). Little is known about the haemodynamic consequences of these morphological changes. In this study 84 unselected patients with different enzymatically proven MPS and 84 age and sex matched, healthy persons were studied prospectively by colour Doppler flow mapping. The patients' age ranged from 1 to 47 years (median 8.1 years). Mitral and aortic regurgitation were defined as a holosystolic or holodiastolic jet originating from the valve into the left atrium or the left ventricular outflow tract, respectively, with peak velocities exceeding 2.5 m/s. Of the 84 patients with satisfactory studies, mitral regurgitation was detected in 64.3% and aortic regurgitation in 40.5%, respectively. Regurgitation was severe in 4.8% of mitral valves and 8.3% of aortic valves. The frequency of aortic and/or mitral regurgitation was 75% in all patients, 89% in MPS I, 94% in MPS II, 66% in MPS III, 33% in MPS IV, and 100% in MPS VI. Combined mitral and aortic regurgitation was present in 29% of our patients. None of the control persons showed mitral or aortic regurgitation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01991908
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  • 8
    Electronic Resource
    Electronic Resource
    Independent right lung high frequency and left lung conventional ventilation in the management of severe air leak during ARDS (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric anesthesia 5 (1995), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Pulmonary air leaks are one of the most common problems in patients with the adult respiratory distress syndrome, ARDS. We report what we believe to be the first case in which unilateral high-frequency ventilation combined with contralateral conventional positive pressure ventilation has been used successfully to manage severe air leak in an infant with ARDS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1460-9592.1995.tb00276.x
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  • 9
    Electronic Resource
    Electronic Resource
    Properties of the circulation classification scheme based on the rotated principal component analysis (1996)
    Springer
    Meteorology and atmospheric physics 59 (1996), S. 217-233 
    Details
    ISSN: 1436-5065
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geography , Physics
    Notes: Summary The study addresses some methodological issues of application of principal component analysis (PCA) to the classification of circulation patterns. The obliquely rotated PCA in T-mode (i.e. with time observations corresponding to variables and grid points to realizations) is applied to 500 hPa geopotential heights over Europe and adjacent parts of Atlantic Ocean. The solutions are examined for various numbers of principal components rotated, and for both raw and anomaly data, with the aim to find the way of determining the optimum number of circulation types. This is done, among others, by examining temporal and spatial stability of solutions, their compliance with simple structure requirements, and temporal behaviour of classifications. Some of the solutions that are pre-selected according to the rule based upon the separation between successive eigenvalues prove to perform considerably better than unselected ones; some of them do not. Which pre-selected solutions should be given preference is impossible to decide in advance, without a detailed scrutiny. Nevertheless, even after such a scrutiny is done, more than a single classification are acceptable. The final choice of the optimum solution depends on the aims of the intended study: It should balance the demands on statistical stability of types and on resemblance between types and daily patterns classified with them.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01030145
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  • 10
    Electronic Resource
    Electronic Resource
    The effect of nifedipine alone or combined with low dose acetylsalicylic acid on endotoxin-induced pulmonary hypertension in the piglet (1988)
    Springer
    Intensive care medicine 14 (1988), S. 595-601 
    Details
    ISSN: 1432-1238
    Keywords: Endotoxin ; Pulmonary hypertension ; Nifedipine ; ASA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cardiovascular responses to the calcium antagonist nifedipine, alone and combined with low dose acetylsalicylic acid (ASA), were evaluated in a piglet model of endotoxin-induced pulmonary hypertension. All animals were anesthetized, paralyzed and mechanically ventilated. Cardiac output (CO), pulmonary artery pressure (PAP), aortic blood pressure (SAP), pulmonary capillary wedge pressure (PCWP), right strial pressure (RAPM) and arterial blood gases were measured before and after induction of pulmonary hypertension by E. coli endotoxin and after treatment. Results of treated groups were compared to a control group of piglets subjected to the same dose (0.15 μg/kg i.v.) of endotoxin. Control animals responded to a bolus injection of endotoxin within 15 min with an increase in mean PAP by 110%. Pulmonary vascular resistance (PVR) increased by 144%. Mean arterial pressure did not change significantly from baseline values. In animals treated with a single dose of 1 mg/kg ASA prior to endotoxin, the initial pulmonary response was not quantitatively different from control values, whereas ASA 20 mg/kg abolished the pulmonary vascular reaction. The increase of systemic vascular resistance (SVR) produced by endotoxin was aggravated by high dose ASA. In piglets treated with nifedipine (4 μg/kg/min) over 30 min after the application of endotoxin with and without additional infusion of nifedipine 60 min prior to endotoxin the PVR could be attenuated. The combination of nifedipine and low dose ASA showed synergistic effects compared to control. The increase of mean PAP was significantly reduced, the PVR remained in base-line range due to a marked elevation of cardiac output.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00256762
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