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  • 1
    Electronic Resource
    Electronic Resource
    Patchplasty with expanded polytetrafluoroethylene and skinplasty for the closure of large congenital abdominal wall defects (1994)
    Springer
    Pediatric surgery international 9 (1994), S. 227-230 
    Details
    ISSN: 1437-9813
    Keywords: Congenital abdominal wall defect ; Patchplasty ; Skinplasty ; Expanded ; Polytetrafluoroethylene (PTFE)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A combined technique of patchplasty with expanded polytetrafluoroethylene (PTFE) and a special skinplasty is described for congenital abdominal wall defects where the abdominal cavity needs enlargement but skin closure is primarily possible. The patchplasty consists of suturing two half-moon-shaped, expanded PTFE leaves to the sides of the muscular abdominal wall, then approximating them under observation of intra-abdominal pressure by monitoring five parameters (urinary bladder pressure, central venous pressure, transcutaneous oxygen saturation, ventilation pressure, and mean arterial pressure). The skin is incised in a horizontal manner according to the tension lines. However, after closure, regional necrosis of the skin in the mid-portion above the incision is often observed due to lack of sufficient subcutaneous tissue at this site. Therefore, a skinplasty is done as a preventive measure, resecting this potential site of necrosis. The final appearance of the skin is an inverted T-shape. The surgical and monitoring techniques are described and illustrated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00179623
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  • 2
    Electronic Resource
    Electronic Resource
    Orthostasemanöver während Halothannarkose Eine Modellsituation zur Untersuchung der zerebrovaskulären Autoregulation bei Säuglingen (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 511-515 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Kipptisch ; Autoregulation ; Doppler–Sonographie ; Säuglinge ; Halothannarkose ; Keywords Tilting test ; Autoregulation ; Infants ; Doppler sonography ; Halothane anesthesia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Halothane causes impairment of cerebrovascular reactivity and autoregulation. We used transcranial Doppler sonography (TCD) to investigate the reaction patterns of cerebral blood flow velocities (CBFV) during a standardized orthostatic maneuver after premedication and during halothane anesthesia in infants. After premedication orthostasis led to no significant changes in CBFV. During halothane anesthesia CBFV was significantly higher than after premedication, and orthostasis induced a significant decrease in CBFV compared to values obtained in horizontal position. Heart rate and mean blood pressure were significantly lower than before medication during halothane anesthesia. The observed changes in CBFV during halothane anesthesia represent a characteristic pattern of impaired cerebral autoregulation. The changes in CBFV and heart rate demonstrate that neither systemic nor cerebral hemodynamics compensate for hydrostatic inducement during halothane anesthesia. The tilting test is a useful tool for determining cerebral autoregulation capacity in infants.
    Notes: Zusammenfassung Halothan führt zu einer Hemmung der Vasomotorenreaktivität und verursacht so eine Einschränkung der zerebralen Autoregulation. Wir untersuchten bei Säuglingen mittels transkranieller Dopplersonogaphie (TCD) die Reaktionsmuster der zerebralen Blutflussgeschwindigkeiten (zBFG) im Rahmen eines standardisierten Orthostasetests (Kipptischtest) unter Prämedikation und in Halothannarkose. Unter der alleinigen Prämedikation kam es in vertikaler Körperposition (Orthostase) zu keinen signifikanten Veränderungen der zBFG. Unter Halothannarkose kam es bereits in horizontaler Körperposition im Vergleich zur Prämedikation zu einem signifikanten Anstieg der zBFG. In Orthostase kam es im Vergleich zu den Ausgangswerten in horizontaler Lage zu einem signifikanten Abfall der zBFG. Im Vergleich zur Prämedikation waren unter Haloththannarkose das Niveau der Herzfrequenz und der mittleren Blutdruckwerte signifikant niedriger. Die Veränderungen der zBFG und der Herzfrequenz zeigen, dass unter Halothannarkose sowohl systemische als auch zerebrale Kreislaufparameter nicht kompensatorisch auf die Orthostase als hydrostatischen Provokationsreiz reagieren. Die beschriebenen Veränderungen der zBFG im Orthostasetest während der Halothannarkose stellen ein typisches Muster dar, das bei eingeschränkter Autoregulation zu erwarten ist. Der Orthostasetest ist ein brauchbarer Test zur Beurteilung der zerebralen Autoregulation bei Säuglingen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070091
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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