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  • Key words Inhaled nitric oxide  (2)
  • 32.80 Fb  (1)
  • 33.60.Cv  (1)
  • 1
    Digitale Medien
    Digitale Medien
    Synergismus von inhalativem Stickstoffmonoxid und Hochfrequenzbeatmung bei der Therapie des Mekoniumaspirationssyndroms (1998)
    Springer
    Monatsschrift Kinderheilkunde 146 (1998), S. 1050-1053 
    Details
    ISSN: 1433-0474
    Schlagwort(e): Schlüsselwörter Inhaliertes Stickstoffmonoxid ; Hochfrequenzbeatmung ; Lungenexpansion ; Alveoläre Rekrutierung ; Mekoniumaspirationssyndrom ; Key words Inhaled nitric oxide ; High-frequency ventilation ; Lung expansion ; Alveolar recruitment ; Meconium aspiration syndrome
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary High-frequency ventilation and inhaled nitric oxide represent – among others – two treatment options in hypoxemic respiratory failure of neonates. We report the case of a term infant with meconium aspiration syndrome, who only responded favorably to inhaled nitric oxide following the initiation of high-frequency ventilation. At an oxygenation index of 17 we started treatment with nitric oxide in order to reverse right-to-left shunting and improve oxygenation. How- ever the respiratory situation did not improve, the oxygenation index increased to 25. After discontinuation of nitric oxide the mode of ventilation was switched to HFV with mean airway pressures of 15 mbar. Again oxyena-tion was unaffected with an oxygenation index of meanwhile 31. At that stage of a second trial of inhaled nitric oxide was started at a concentration of 10 ppm while continuing high-frequency ventilation. Immediately oxygenation improved significantly, the oxygenation index decreased to 9 within several minutes after restarting nitric oxide. This effect on oxygenation was sustained for the duration of several days during high-frequency ventilation until gradual weaning from iNO could be performed. Discussion: Adequate lung expansion is required in order to achieve the maximum benefit of nitric oxide therapy. Inadequate alveolar ventilation secondary to parenchymal lung disease may lead to a non-response to treatment with nitric oxide. Adequate alveolar ventilation appears to be more readily achieved by the use of high-frequency ven- tilation as compared to conventional ven- tilation. In cases of respiratory failure due to meconium aspiration syndrome this therapeutic regimen should be considered, even if these therapies (high-frequency ventilation, inhaled nitric oxide) have previously been proven inefficient when used as single treatment modalities.
    Notizen: Zusammenfassung Inhalatives Stickstoffmonoxid und Hochfrequenzbeatmung gehören neben einer Reihe weiterer Behandlungsoptionen zu den Therapiemodalitäten bei der Behandlung des neonatalen Lungenversagens. Wir berichten über den Fall eines reifen Neugeborenen mit Mekoniumaspirationssyndrom, das nicht unter konventioneller Beatmung, wohl aber unter Hochfrequenzbeatmung mit einer Verbesserung der Oxygenierung auf die Gabe von inhalativem NO reagierte. Bei einem Oxygenierungsindex von 17 begannen wir eine Therapie mit inhalativem Stickstoffmonoxid, die zu keiner Verbesserung der respiratorischen Situation führte. Auch die nach Beendigung der Stickstoffmonoxidtherapie begonnene Hochfrequenzbeatmung hatte keinen Anstieg des arteriellen Sauerstoffpartialdrucks zur Folge, der Oxygenierungsindex lag zu diesem Zeitpunkt bei 31. Erst eine kombinierte Therapie von Hochfrequenzbeatmung und inhalativem Stickstoffmonoxid führte zu einem deutlichen Anstieg des arteriellen Sauerstoffpartialdrucks und zu einem Abfall des Oxygenierungsindex auf einen Wert von 9. Diskussion: Eine ausreichende Lungenexpansion ist Voraussetzung für ein optimales Ansprechen auf Stickstoffmonoxid. Eine inadäquate alveoläre Ventilation erscheint auf dem Boden einer parenchymatösen Lungenerkrankung ein ausreichender Grund für ein klinisches Nichtansprechen auf eine Stickstoffmonoxidtherapie zu sein. Eine suffiziente Rekrutierung von Alveolen ist unter einer Hochfrequenzbeatmung einfacher zu erreichen als unter konventioneller Beatmung. Diese Kombinationstherapie sollte in Fällen eines hypoxämischen Lungenversagens bei Mekoniumaspirationssyndrom auch dann in Betracht gezogen werden, wenn beide Therapiemodalitäten für sich genommen nicht zu einer Verbesserung der Oxygenierung geführt haben.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001120050362
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  • 2
    Digitale Medien
    Digitale Medien
    Effect of inhaled nitric oxide on intrapulmonary right-to-left-shunting in two rabbit models of saline lavage induced surfactant deficiency and meconium instillation (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 410-415 
    Details
    ISSN: 1432-1076
    Schlagwort(e): Key words Inhaled nitric oxide ; Intrapulmonary shunt ; Rabbit ; Surfactant deficiency ; Meconium
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Marked hypoxia secondary to intrapulmonary right-to-left shunting is a characteristic of respiratory failure in human neonates and can sometimes be complicated by additional extrapulmonary right-to-left shunting. To investigate the effect of inhaled nitric oxide (iNO) on intrapulmonary shunting, two typical pulmonary diseases of the newborn (respiratory distress syndrome and meconium aspiration) were reproduced in 32 mechanically ventilated rabbits weighing approximately 2 kg each. After tracheotomy, catheters were inserted into a jugular vein, a carotid artery and the right ventricle (to measure systolic right ventricular pressure [SRVP] and mixed venous oxygen content for calculation of shunt by Fick equation). Repeated airway lavages (LAV) with normal saline or repeated instillations of a suspension of human meconium (MEC) were continued until both the a/A-ratio was ≤0.14 and a peak inspiratory pressure ≥22 mbar was needed to keep the tidal volume constant at 10 ml/kg of body weight. Measurements of shunt, SRVP, systolic systemic pressure, physiological dead space, tidal volume and a ventilation index were performed before and after completion of lung damage and at 20 and 60 min after administering iNO at 80 ppm. Four groups of rabbits were studied (n = 8 in each group): LAV control and intervention, Mec control and intervention. 60 min after starting iNO, there was a decrease in shunt (LAV: 67.6% ± [SD] 11.3% vs 56.2 ± 16.4, P = 0.05; MEC: 52.6 ± 6.3 vs 44.3 ± 8.3, P 〈 0.05), in SRVP (LAV: 29.7 mmHg ± 10.1 mmHg vs 20.0 ± 8.2, P 〈 0.01; MEC: 25.1 ± 4.4 vs 22.3 ± 5.0, P = 0.46) and in dead space (% of tidal volume, LAV: 32.7% ± 10.5% vs 25.9 ± 10.1, P 〈 0.01; MEC: 26.1 ± 16.6 vs 18.9 ± 10.1, P = 0.05). These results demonstrate that iNO decreases intrapulmonary shunt (as well as SRVP and dead space). We suggest that iNO may be beneficial in human newborns with severe respiratory failure even if no extrapulmonary shunting via ductus or foramen ovale is apparent.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s004310050841
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  • 3
    Digitale Medien
    Digitale Medien
    Photoelectron dynamics of the cooper minimum in free molecules (1986)
    Springer
    The European physical journal 2 (1986), S. 309-318 
    Details
    ISSN: 1434-6079
    Schlagwort(e): 33.60.Cv ; 33.80.Eh
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Physik
    Notizen: Abstract The general properties of the Cooper minimum in molecules are reviewed. Experimental results from synchrotron radiation together with theoretical calculations are presented on both the partial cross sections and angular distribution parameters, β. A detailed examination of HCl is used as an example. Previously unpublished results on CCl n H4−n , CCl n F4−n , ethylene dichloride, I2 and ICl are included. The Cooper minimum is largely discussed as a perturbation from atomic behavior, and is examined as a function of atomic number. The Cooper minimum is also examined as a function of chemical environment. Finally, needs for future research are briefly described.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01426235
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  • 4
    Digitale Medien
    Digitale Medien
    Autoionization resonances in atomic Ga, In, and Pb (1986)
    Springer
    The European physical journal 2 (1986), S. 327-335 
    Details
    ISSN: 1434-6079
    Schlagwort(e): 32.80 Dz ; 32.80 Fb
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Physik
    Notizen: Abstract Autoionization resonances of the type (n−1)d→np, wheren pertains to the outermost shell of Ga, In and Pb, were studied with the use of electron spectrometry in combination with synchrotron radiation. The relative strengths of the exit channels for the various resonance states were measured. In the case of Ga and In, a complete partitioning of the total absorption cross section into thes 2 1 S,sp 1 P, andsp 3 P components (exit channels) was achieved, and in the case of Pb the decay of the resonance states into the major exit channels 6s 2 6p 2 P 1/2, 6s 2 6p 2 P 3/2, 6s 6p 2 4 P 1/2, 6s 6p 2 2 D 3/2 and 6s 6p 2 2 P 1/2 was determined. In Ga, strong coupling was observed for those states of the 4p 2 manifold that have the same symmetries as the final ionic states, e.g. 4p 2 3 P→4s 4p 3 P and 4p 2 1 S→4s 2 1 S. In In, there is a similar, but weaker correlation, which also includes two-electron excitation channels. Comparison between Ga and In shows that thesp 3 P channel is much stronger in In (52% vs 40% in Ga) while thesp 1 P channel is correspondingly weaker (28% vs 37%), with thes 2 1 S channel remaining practically unchanged (20 vs 23%). In Pb, the 6s 2 6P 2 P 1/2 channel displays interference patterns due to a strong, competing direct transition, whereas the other channels do not, indicating population predominantly via the resonance states.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01426237
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