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  • 1
    Electronic Resource
    Electronic Resource
    Evaluation of mechanism of increased intracranial pressure with insufflation (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 266-269 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopy — Intracranial pressure — Physiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Previous studies have documented an increase in intracranial pressure with abdominal insufflation, but the mechanism has not been explained. Methods: Nine 30–35-kg domestic pigs underwent carbon dioxide insufflation at 1.5 l/min. Intracranial pressure (ICP), lumbar spinal pressure (LP), central venous pressure (CVP), inferior vena cava pressure (IVCP), heart rate, systemic arterial blood pressure, pulmonary arterial pressure, cardiac output, heart rate, respiratory rate, temperature, and end-tidal CO2 were continuously measured. Mechanical ventilation was used to maintain a constant pCO2. Measurements were recorded at 0, 5, 10, and 15 mmHg of abdominal pressure with animals in supine, Trendelenburg (T), and reverse Trendelenburg (RT) positions. Prior to recording measurements, the animals were allowed to stabilize for 40 min after each increase in abdominal pressure and for 20 min after each position change. Results: The animals showed a significant increase in ICP (mmHg) with each 5-mmHg increase in abdominal pressure (0 mmHg: 14 ± 1.7; 5 mmHg: 19.8 ± 2.3, p 〈 0.001; 10 mmHg: 24.8 ± 2.5, p 〈 0.001; 15 mmHg: 29.8 ± 4.7, p 〈 0.01). The ICP at 15 mmHg abdominal pressure increased further in the T position (39 ± 4, p 〈 0.01). Insufflating in the RT position did not significantly reduce the increase in ICP. The IVCP (mmHg) increased with increased abdominal pressure (0 mmHg: 11.5 ± 6.2, 15 mmHg: 22.1 ± 3.5, p 〈 0.01). This increase correlated with the increase in ICP and LP (r of mean pressures ≥0.95). There was no significant change in CVP. Conclusions: This study suggests that care may be needed with laparoscopy in patients at risk for increased ICP due to head injury or a space occupying lesion. The mechanism of increased ICP associated with insufflation is most likely impaired venous drainage of the lumbar venous plexus at increased intraabdominal pressure. Further studies of cerebral spinal fluid movement during insufflation are currently underway to confirm this hypothesis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900648
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Common bile duct T-tubes (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 60-62 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Bile leak — T-tube — Biliary tree
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Operations on the common bile duct can result in severe long-term consequences. To prevent some of these complications, it is common practice to drain the biliary tree with a T-tube. The T-tube is usually removed 2 weeks after it was placed. There have been numerous reports of bile leak following T-tube removal in the literature. These leaks can result in bile ascites, biloma, or bile peritonitis. Control of bile leaks can be accomplished in a number of ways, including endoscopically or radiologically placed stents or drains and radiologic techniques to drain the fluid collections. We describe a novel technique that can be utilized at the time of T-tube removal that will allow immediate control of the bile leak and prevent the complications of bile accumulation within the peritoneal cavity. We have performed fluoroscopic removal of T-tubes on two patients and found no complications with the technique. We have successfully visualized the T-tube tract in both patients. The T-tube tract can be visualized at the time of T-tube removal in an effort to prevent the complications of tract disruption and subsequent bile leak.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900595
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The chemical control of biofouling in industrial water systems (1998)
    Springer
    Biodegradation 9 (1998), S. 23-37 
    Details
    ISSN: 1572-9729
    Keywords: bacterial resistance ; biocides ; biocorrosion ; biofouling monitoring dispersants
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Energy, Environment Protection, Nuclear Power Engineering , Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Notes: Abstract Oxidising and non-oxidising biocides are commonly used in an attempt to control biofouling in industrial water systems. Many of these programmes, however, fail due to the incorrect selection and application of these chemical compounds. Knowledge of the organisms to be eliminated and system hydraulics are important operational parameters in ensuring the successful application of chemical control programmes. A further complicating factor is the build up of bacterial resistance to many of these compounds. One way of limiting resistance is the alteration of oxidising and non-oxidising biocides at the correct miminum inhibitory concentration and using these in combination with surface active compounds to dislodge any biofilm. A variety of surface monitoring techniques are in use in order to monitor the success of biofouling control programmes. Unfortunately none of these techniques are ideal and results have to be considered very carefully.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008216209206
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    Paper (German National Licenses)
    Fulltext
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