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  • 1
    ISSN: 1432-1238
    Schlagwort(e): Key words Nitric oxide ; Rebound ; Pulmonary hypertension ; Dynamic respiratory system compliance ; Interaction ; Congenital heart disease compliance ; Interaction ; Congenital heart disease
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: To assess the interaction between pulmonary hemodynamics and respiratory mechanics during acute pulmonary hypertension. Patients: Ventilated and paralysed children treated with inhaled nitric oxide because of post-operative pulmonary hypertension. Interventions: Weaning of inhaled nitric oxide. Measurements: Air flow and airway pressure, calculation of dynamic respiratory system compliance and respiratory system resistance for each breath by multiple linear regression. Results: In four patients, increases in pulmonary arterial pressure from 26.1 to 56.7 mmg (p 〈 0.001) during weaning off nitric oxide were associated with decreases in tidal volume (from 9.7 → 8.2 ml/kg, p 〈 0.01) and reductions in dynamic respiratory system compliance (from 0.52 → 0.34 cmH20/ml/kg, p 〈 0.001), while respiratory system resistance was unchanged. Conclusions: Impaired ventilation during acute pulmonary hypertension is predominantly related to a reduction in respiratory system compliance.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1432-1238
    Schlagwort(e): Key words Peritoneal dialysis ; Acute renal failure ; Congenital heart disease ; Cardiac output measurements ; Open chest
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: Evaluation of the acute hemodynamic changes during peritoneal dialysis in patients with low cardiac output syndrome and acute renal failure after open heart surgery.¶Patients: Three newborns and three infants after corrective surgery of congenital heart disease with post cardiotomy dialysis. Five of these had an open thorax during dialysis.¶Methods: Cardiac output measurements using the thermodilution technique on two consecutive days at four different times during the peritoneal dialysis cycle.¶Results: We did not find a deterioration of the cardiac index or systemic vascular resistance measured over two cycles in each of the six patients. Pulmonary artery pressure rose slightly after instillation of the dialysate solution in all patients. Changes in central venous pressure and left atrial pressure were not clinically meaningful. In all patients fluid removal by peritoneal dialysis was effective. All five surviving patients recovered renal function.¶Conclusions: Peritoneal dialysis can be performed in newborns and infants following cardiac surgery without causing acute hemodynamic imbalances. An open chest may have a significant impact on hemodynamic stability during peritoneal dialysis by blunting any possible negative alterations of increased intraabdominal pressure.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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