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  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Swan-Ganz-Katheter ; Komplikation ; Nahtfixation ; Pulmonalarterie ; Key words Swan-Ganz catheter ; Complication ; Suture fixation ; Pulmonary artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract We report a patient undergoing redo cardiac surgery for combined replacement of the aortic and mitral valves. During the course of the operation, a Swan-Ganz catheter – positioned preoperatively – was accidentally fixed to the wall of the pulmonary artery. As this did not interfere with cardiac output measurement or the pulmonary artery pressure wave form, the fixation was not noticed until an attempt was made to remove the catheter. Fluoroscopy revealed both the catheter's immobility and the location of the suture fixation. The patient required a sternotomy to remove the catheter. In order to avoid this complication, the indications for pulmonary artery catheters during cardiac surgery should be carefully considered. If catheters are inserted, their mobility should by all means be ensured before the chest is closed.
    Notes: Zusammenfassung Der vorliegende Fallbericht beschreibt die Nahtfixation eines Swan-Ganz-Katheters in der A. pulmonalis während eines kombinierten Aorten- und Mitralklappenersatzes. Da die Funktionen des Katheters nicht eingeschränkt waren, blieb die Fixation bis zur beabsichtigten Katheterentfernung unbemerkt. Konventionelle Röntgenaufnahmen legten die Diagnose nahe. Die Katheterentfernung erfolgte operativ über eine Resternotomie des Patienten. Zur Vermeidung dieser Komplikation bei kardiochirurgischen Eingriffen sollte, neben einer strengen Indikationsstellung, vor Thoraxverschluß in jedem Fall die freie Beweglichkeit sämtlicher Katheter im Operationsgebiet geprüft werden.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    International Library Review 6 (1974), S. 275-280 
    ISSN: 0020-7837
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Information Science and Librarianship
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0014-5793
    Keywords: 434 represser-derived HIV enhancer-binding polypeptide ; Bacteriophage 434 operator ; DNase I footprint ; HIV-1 core enhancer ; Inhibition of HIV LTR-controlled in vitro transcription ; Recognition helix of 434 repressor
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1238
    Keywords: Septicemia ; Pulmonary gas exchange ; Pulmonary vascular resistance ; Pulmonary veins ; Pulmonary capillary pressure ; ARDS ; E. coli
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 9 Goettingen minipigs we studied the effect of E. coli bacteremia on effective pulmonary capillary pressure and the longitudinal distribution of pulmonary vascular resistance. Precapillary pressure gradient (dPa) was calculated as the difference between mean pulmonary artery pressure (MPP) and effective pulmonary capillary pressure (Pc) (dPa=MPP-Pc), postcapillary pressure gradient (dPv) as the difference between Pc and left atrial pressure (dPv=Pc-LAP). The disturbance of pulmonary gas exchange was quantified by the AaDO2 quotient 1-PaO2/PAO2. Live E. coli infusion resulted in hypodynamic circulatory failure. Cardiac index fell from 3.7±0.8l·min−1·m−2 to 2.2±0.7l·min−1·m−2 after bacteremia lasting for 3.5 h. Simultaneously venous pulmonary vascular resistance rose from 25% of total pulmonary vascular resistance before to 32% after 3.5 h bacteremia, thus raising Pc from 11 mmHg to 16 mmHg. The degree of respiratory insufficiency was correlated with changes of MPP, dPa and dPv: 1-PaO2/PAO2=0.2+0.035·dPv (r=0.829). Our results show, that the longitudinal distribution of pulmonary vascular resistance changes during septicemia, thus raising Pc. This may be an important factor in the genesis of septic pulmonary failure.
    Type of Medium: Electronic Resource
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