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  • 1
    Electronic Resource
    Electronic Resource
    Plasmapheresis as a rescue therapy to resolve cardiac rejection with vasculitis and severe heart failure. A report of five cases (1995)
    Springer
    Transplant international 8 (1995), S. 382-387 
    Details
    ISSN: 1432-2277
    Keywords: Heart transplantation, plasmapheresis, rejection ; Rejection, heart transplantation, plasmapheresis ; Plasmapheresis, rejection, heart transplantation ; vasculitis, heart transplantation, plasmapheresis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The predominant causes of late graft loss and death after cardiac transplantation are graft rejection and infection. The histopathological classification of acute rejection is based on cellular phenomena such as lymphocytic infiltration and myocyte damage. The adverse prognostic importance of vascular or humoral rejection has been reported, but there is no well-documented treatment available. In our experience, comprising 151 orthotopic transplants, five patients presented with graft rejection characterized by a lymphocytic vasculitis that did not respond to conventional therapy. Because of a deteriorating condition, in spite of vigorous antirejection treatment that included inotropic drugs and circulatory support, plasmapheresis was tried as a last, desperate means to stop the process from developing further. The clinical symptoms rapidly subsided in all five patients after the first couple of plasma exchanges. All of the patients are alive and well after 2–3.5 years of follow-up. Although the mechanism of action is unclear, plasmapheresis was beneficial in these critically ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00337170
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  • 2
    Electronic Resource
    Electronic Resource
    Intraoperative fluid therapy (1983)
    Springer
    World journal of surgery 7 (1983), S. 581-589 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les principes qui règlent l'injection intraveineuse d'eau, d'hydrates de carbone et d'électrolytes chez les adultes (en état d'équilibre normal) au cours des interventions sont décrits. Le problème de la compensation sanguine est également pris en considération. La coordination entre ces deux éléments de la réanimation est envisagée et un protocole de traitement est présenté.
    Abstract: Resumen Se detallan los principios para la administración intravenosa de agua, carbohidratos y electrolitos durante operaciones realizadas en adultos considerados como “en equilibrio” antes de la cirugía. Así mismo, se revisa el problema del reemplazo de sangre con el propósito de coordinar estas 2 áreas clínicas. Se presenta un programa práctico de terapia de líquidos.
    Notes: Abstract The principles for intravenous administration of water, carbohydrates, and electrolytes during operations in adults, who were considered to be “in balance” prior to surgery, are detailed. The problem of blood replacement is likewise surveyed, with a view to coordinating these 2 clinical areas. A practical fluid therapy program is presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01655333
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Hepatic clearance of local anesthetics in man (1977)
    Springer
    Journal of pharmacokinetics and pharmacodynamics 5 (1977), S. 111-122 
    Details
    ISSN: 1573-8744
    Keywords: hepatic clearance ; extraction ratio ; local anesthetics ; pharmacokinetics ; lidocaine ; bupivacaine ; etidocaine ; cardiovascular effects of local anesthetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Two independent methods of calculating hepatic drug clearance were applied to data from studies of the human pharmacokinetics of lidocaine, bupivacaine, and etidocaine. Within experimental limitations, agreement was good between estimates obtained by measurement of areas under blood drug concentration-time curves after rapid intravenous injection and by direct measurement of arterial and hepatic venous drug concentrations. Apparent hepatic extraction ratios of the agents followed the order etidocaine (∼0.73)/s〉lidocaine (∼0.68〉bupivacaine (∼0.37).Pharmacokinetic implications of increases in hepatic blood flow induced by the agents are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01066215
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    A new respiratory rate monitor: development and initial clinical experience (1993)
    Springer
    Journal of clinical monitoring and computing 10 (1993), S. 101-107 
    Details
    ISSN: 1573-2614
    Keywords: noninvasive sensor ; respiratory rate ; patient monitoring ; acoustic air flow sensor ; patient recovery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract The need for continous, noninvasive, and reliable respiratory rate monitoring during recovery from general anesthesia has long been recognized. Alternative principles can be grouped into those detecting the respiratory effort, and those detecting the actual result, i.e. the respiratory gas flow. The second category is of greatest interest for patient monitoring. In this paper, we report the development and initial clinical experience with a new acoustic air-flow sensor. By differential, multipoint detection of the air-flow in the mouth and nose region, the sensor can easily discriminate against different kinds of interference, including motion arterfacts. The sensor is nonexpensive, rugged, simple to apply, and inherently safe. An instrument with continous display of respiratory rate, and an audiovisual apnea alarm has been designed and built. The complete system has been tested on patients during recovery after general anesthesia. In 16 patients, the respiratory rate displayed by the instrument has been correlated against that visually observed. A good correlation was obtained. Minor discrepancies can be explained from the fact that visual observation corresponds to the respiratory effort, whereas the sensor detects the actual air flow. In 12 patients, 24 hour simultaneous recordings were made of respiratory rate with the new sensor, with simultaneous recording of the oxygen saturation and the heart rate with a pulse oximeter. It was found that the new sensor reliabley recorded respiratory depression and apnea. Such events may in some patients be as frequent as one incident per hour. One case of ‘Ondine's curse’ provided clear evidence that pulse oximetry has a low sensitivity to respiratory disorders.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01142280
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    Paper (German National Licenses)
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