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  • 1
    Electronic Resource
    Electronic Resource
    Late outcome of percutaneous dilatational tracheostomy in intensive care patients (1995)
    Springer
    Intensive care medicine 21 (1995), S. 475-481 
    Details
    ISSN: 1432-1238
    Keywords: Tracheostomy ; Methods ; ICU ; Postoperative complications ; Follow-up studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Percutaneous dilatational tracheostomy is increasingly practiced in intensive care units and has a low incidence of early complications. The late effects of this procedure are still poorly known and were the focus of this study. Design Prospective descriptive clinical study. Setting Interdisciplinary intensive care unit in a 300-bed teaching hospital. Patients A consecutive group of critically ill patients who underwent percutaneous tracheostomy between Nov. 90 and March 93, surviving at least 2 months after decannulation. Measurements and results There were 17 patients fulfilling the inclusion criteria and 16 of them were seen and examined. The follow-up protocol required a formal standar dized patient interview, a physical examination of the stoma site and a fiberoptic laryngotracheoscopy. Results of these sub-tests and overall outcome rating were standardized and expressed as good, moderate or poor. Subjective rating was good in all patients. All denied suffering from any side effects of their tracheostomy. Clinical examination revealed neither stridor nor hoarseness in any of the patients. Most of the scars were whitish and less than 1 cm in length, a few were sunken in, none had adhesions. In 15 patients the clinical result was good and in one, moderate (whitish, sunken-in scar, longer than 2 cm). Ten patients underwent tracheoscopy, while 6 did not. There were no signs of significant stenosis or tracheomalacia. In 8 patients with minor findings results were scored as good, while 2 were classified as moderate (combination of swelling and scar formation of a string-like membrane). The overall rating was good in 13 patients (81%) and moderate in 3 patients (19%). There were no poor outcomes. Conclusions Late outcome of percutaneous dilatational tracheostomy in critically ill patients is mostly good. Pending further studies, the use of this technique in intensive care units appears justified.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01706200
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Klinische und elektromyographische Verlaufsuntersuchungen bei Patienten mit homologen lyophilisierten Nerveninterponaten (1974)
    Springer
    European archives of psychiatry and clinical neuroscience 219 (1974), S. 223-229 
    Details
    ISSN: 1433-8491
    Keywords: Homologeous Nerve Grafts ; EMG-Control ; Homologe Nerveninterponate ; EMG-Kontrollen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei acht Patienten mit peripheren Nervenverletzungen (5 N. ulnaris, 2 N. medianus, 1 N. peronaeus communis), die klinisch und elektrophysiologisch mehrfach kontrolliert worden waren, wurden durchschnittlich 2–16 Monate nach der Verletzung interfasciculäre homologe lyophilisierte Interponate operativ eingesetzt. Die Mindestlänge der Interponate betrug 30, die maximale Länge 100 mm. Die maximale Entfernung des Interponats vom Muskel betrug 40–50 cm, die minimale 6–8 cm. Nur in einem der Fälle war auch nach Über-schreiten des zu erwartenden minimalen Zeitraums Reinnervation durch den verletzten Nerven selbst zustande gekommen. Diese Reinnervation wurde durch Reizung des betroffenen Nerven und des benachbarten bewiesen, sie war jedoch klinisch bedeutungslos. In den anderen Fällen war es z. T. ebenfalls zu Reinnervation gekommen, jedoch nicht vom verletzten Nerven her, sondern durch kollaterale Sprossung vom Nachbarnerven.
    Notes: Summary A clinical and electrophysiological study was made of 8 patients in whom lyophilized homologeous nerve grafts were implanted. Five patients had experienced ulnar nerve injury, 2 had injury of the median nerve and 1 peroneal nerve dissection. The operation was performed between 2 and 16 months after the injury. Graft length varied from 3–10 cm. Maximum distance from proximal end of graft to endplate zone was 40–50 cm, minimum distance was 6–8 cm. In only one instance (ulnar nerve injury) was reinnervation of the muscle via the graft accomplished, as was demonstrated by stimulating the ulnar and median nerves. The amount of reinnervation was, however, without any functional significance. Reinnervation also occurred in other instances, but was achieved through collateral nerve fiber growth.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00342048
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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