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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
    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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  • 3
    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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  • 4
    Electronic Resource
    Electronic Resource
    Simultaneous epiglottitis in siblings (1991)
    Springer
    European journal of pediatrics 150 (1991), S. 859-859 
    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/BF01955011
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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
    Purpura fulminans in severe congenital protein C deficiency: Monitoring of treatment with protein C concentrate (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 20-25 
    Details
    ISSN: 1432-1076
    Keywords: Purpura fulminans ; Severe congenital protein C deficiency ; Protein C concentrate ; Coagulation marker
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This report describes the successful use of protein C concentrate to treat severe purpura fulminans in a homozygous protein C-deficient infant for 8 months until oral anticoagulation was initiated. While fresh frozen plasma was previously used in such cases to replace protein C in the acute phase, the availability of a monoclonal antibody purified protein C concentrate now allows specific replacement of protein C, avoiding problems of fluid overload. An occlusive-hydrocolloid bandage proved to be effective in local treatment of skin lesions. D-dimer, fibrin monomer, thrombin-antithrombin complex and prothrombin fragment 1+2 were useful markers in monitoring and optimizing protein C replacement therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02115621
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  • 7
    Electronic Resource
    Electronic Resource
    Colour-flow-mapping in patients with ventricular septal defect (1991)
    Springer
    European journal of pediatrics 150 (1991), S. 527-527 
    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/BF01958439
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  • 8
    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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  • 9
    Electronic Resource
    Electronic Resource
    Hemodynamic effects of dobutamine in children with cardiovascular failure (1982)
    Springer
    European journal of pediatrics 139 (1982), S. 4-7 
    Details
    ISSN: 1432-1076
    Keywords: Children ; Dobutamine ; Hemodynamics ; Improvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of dobutamine, a synthetic catecholamine, was studied in 12 patients aged one day to 14 years with low cardiac output syndromes. After initial stabilization of the patients dobutamine was administered by continuous infusion in a dosage of 7.5 or 10 μg/kg/min. Heart rate, cardiac output (using thermodilution technique and/or pulse contour method), mean systemic and mean pulmonary artery pressures were determined before and after the dobutamine infusion. Systemic and pulmonary vascular resistances, cardiac index and stroke volume index were calculated. Cardiac output and cardiac index increased significantly in every patient, whereas the heart rate changed only slightly, suggesting that the increase in cardiac output was mainly due to the alteration of stroke volume. The mean arterial pressure increased significantly, but the mean pulmonary artery pressure was unchanged. No side effects were observed during the dobutamine infusion. Dobutamine is a potent inotropic drug with limited chronotropic and peripheral vascular effects in newborns, infants and chidren.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442069
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  • 10
    Electronic Resource
    Electronic Resource
    Three cases of neonatal herpes simplex virus infection presenting as fulminant hepatitis (1990)
    Springer
    European journal of pediatrics 149 (1990), S. 555-559 
    Details
    ISSN: 1432-1076
    Keywords: Neonate ; Hepatitis ; Herpes simplex ; Acyclovir
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report three cases of neonatal herpes simplex virus (HSV) infection presenting as fulminant hepatitis. None of the patients had clear risk factors for HSV infection and they all died. Antiviral treatment for HSV is currently available but must be administered early in the course of the disease before irreversible liver tissue damage is present. Since the diagnosis may be difficult to establish, we wish to draw the attention of clinicians to the presentation of neonatal HSV infection and suggest that in such cases viral cultures, including culture of liver tissue, should be obtained early and antiviral treatment administered while awaiting the culture results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01957691
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