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  • 1
    Electronic Resource
    Electronic Resource
    Interaction between haematocrit and pulmonary blood volume on pulmonary vascular flow resistance and pressure-flow relationships (1997)
    Springer
    Intensive care medicine 23 (1997), S. 1082-1088 
    Details
    ISSN: 1432-1238
    Keywords: Key words Haemoconcentration ; Haemodilution ; Pressure-flow relationship ; Pulmonary circulation ; Pulmonary vascular flow resistance ; Pulmonary vascular hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Pulmonary vascular flow resistance depends on blood viscosity, mainly due to haematocrit, and on vessel dimensions determining blood volume in this highly compliant vascular bed. We, therefore, evaluated the interaction between haematocrit, blood flow, and transpulmonary vascular pressure gradient under conditions of controlled pulmonary blood volume. Design: Experimental study in isolated zone-III rabbit lungs perfused with autologous blood. Setting: Laboratory for experimental studies. Interventions: Stepwise and independent variation of flow (50, 100, and 200 ml/min), pulmonary blood volume (increments of 2.5 ml and 5 ml imposed by changes of left atrial pressure), and haematocrit (0–50 %) varied by haemodilution (Krebs-Henseleit/albumin) or haemoconcentration (centrifugation). Measurements: Pulmonary arterial, left atrial, and airway pressures as well as reservoir volume (reflecting reciprocal changes of lung blood volume) and lung weight. Results: Haemodilution from the normal haematocrit (32 %) to 10 % at constant pulmonary blood volume and flow decreased flow resistance only slightly, whereas haemoconcentration (50 %) increased flow resistance up to 130 %. At the same time increments of in pulmonary blood volume of 2.5 and 5 ml (approx. 15 and 30 % of normal pulmonary blood volume) at constant haematocrit significantly shifted downwards pressure-flow relationships for all investigated haematocrits (0–50 %). Conclusions: Because of the multiple interrelationships between haematocrit, blood flow and pulmonary blood volume, haematocrit effects on pulmonary flow resistance and pressure-flow relationships in the pulmonary vasculature should be studied at controlled blood volume. While haemodilution only has minor effects, haemoconcentration changes pressure-flow relationships markedly. Pulmonary blood volume has a major impact on slope and position of pressure-flow relationships for all haematocrits investigated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050460
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  • 2
    Electronic Resource
    Electronic Resource
    Laparoscopic cholecystectomy (1993)
    Springer
    Surgical endoscopy and other interventional techniques 7 (1993), S. 537-538 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Cholecystectomy ; Laparoscopic cholecystectomy ; Abscess ; Surgery ; Gallstones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Stones are sometimes spilled at the time of cholecystectomy. Retrieval may be difficult, especially during laparoscopic cholecystectomy. Little is known about the natural history of missed stones which are left behind in the peritoneal cavity. We present a case in which a patient developed an intraabdominal abscess around such a stone. The abscess recurred after drainage and removal of the stone was needed for resolution. This case suggests that care should be taken to avoid stone spillage, and that stones which are spilled into the abdomen should be retrieved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00316699
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Effects of haemoconcentration and haemodilution on acute hypoxia-induced pulmonary hypertension and changes in vascular compliance of isolated rabbit lungs (2000)
    Springer
    Intensive care medicine 26 (2000), S. 1124-1130 
    Details
    ISSN: 1432-1238
    Keywords: Key words Isolated rabbit lung ; Haematocrit ; Haemoconcentration ; Haemodilution ; Hypoxic pulmonary vasoconstriction ; Pulmonary blood volume ; Pulmonary circulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Erythrocytes influence the magnitude of hypoxia-induced pulmonary artery pressure increase. It is, however, unknown to what extent haemoconcentration and haemodilution affect this response and whether intrapulmonary blood volume (and thus vessel dimensions) alters the magnitude of pressure increase. Furthermore, it is unclear whether the haemodilution/haemoconcentration-dependent pressure increase is flow-related, via flow-dependent changes in vasomotor tone or rheologic effects, or can also be observed under no-flow conditions. Design: Experimental study in isolated rabbit lungs (n = 12) perfused with autologous blood at constant flow (100 ml/min) and ventilated with 5 % carbon dioxide in air. Setting: Laboratory for experimental studies. Interventions: Haemoconcentration (centrifugation) and haemodilution (Krebs-Henseleit/albumin) were carried out, resulting in haematocrits between 50 % and 0 %. During hypoxic ventilation, inspiratory oxygen fraction was reduced from 0.20 to 0.03. Measurements and results: Under constant flow conditions, haemodilution (from a Hct of 34–36 % to 0–1 %) decreased hypoxic pulmonary artery pressure response to one-third (from 10.8 ± 2.3 cmH2O to 3.1 ± 1.0 cmH2O, P 〈 0.05), while haemoconcentration did not affect the magnitude of hypoxic response (10.5 ± 2.0 cmH2O). For all haematocrit values an increase in pulmonary blood volume (by 5 ml) decreased the magnitude of pressure response. Hypoxia-induced changes in static vascular filling pressure (double occlusion pressure) and vascular compliance were used to assess the strength of hypoxic vasoconstriction under static conditions. Neither haemoconcentration nor haemodilution altered hypoxia-induced changes in either variable. Conclusions: The magnitude of the acute hypoxic pressure response is not altered by haemoconcentration, but significantly reduced by haemodilution. In contrast, neither haemoconcentration nor haemodilution influenced hypoxia-induced changes in static vascular filling pressure and compliance. This suggests that the degree of hypoxic pulmonary vasoconstriction is not affected under static conditions and that the red blood cell-dependence of the magnitude of hypoxic pressure response is based on flow-related mechanisms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051327
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Laparoscopic fundoplication 1 month prior to lung transplantation (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 668-670 
    Details
    ISSN: 1432-2218
    Keywords: Lung transplantation ; Laparoscopic fundoplication ; Laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Upper midline laparotomy in the presence of pulmonary failure is often complicated by a prolonged period of mechanical ventilation postoperatively. We report the successfull performance of laparoscopic fundoplication, without ventilatory suport, in a woman with end stage pulmonary disease and resting hypercarbia, one month prior to lung transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00188526
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  • 5
    Electronic Resource
    Electronic Resource
    Incidence of complications following laparoscopic hernioplasty (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 16-21 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Hernioplasty ; Technique ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Smaller individual series on the outcome of laparoscopic hernioplasty techniques have been reported. This study reports on the complications of 3,229 laparoscopic hernia repairs performed by the authors in 2,559 patients. The TAPP (transabdominal preperitoneal) technique was the most frequently performed: 1,944 (60%). The totally preperitoneal technique was performed 578 (18%) times. The IPOM (intraperitoneal onlay mesh) repair was performed 345 (11%) times. The plug-and-patch technique was used 286 (9%) times and simple closure of the hernia defect without mesh was used in 76 (2%) repairs. Overall, there were 336 (10%) complications: 17 (0.5%) major and 265 (8%) minor. There were 54 (1.6%) recurrences, with a mean follow-up of 22 months. The TAPP technique had 19 (1%) recurrences and 141 (7%) complications. There were four bowel obstructions in this subgroup from herniation of small bowel through the peritoneal closure and trocar sites. The totally preperitoneal technique had no recurrence and 60 (10%) complications. The IPOM group had 7 (2%) recurrences and 47 (14%) complications. The plug-and-patch technique had 26 (9%) recurrences and 24 (8%) complications. The simple closure of the internal ring had 2 (3%) recurrences and 10 (13%) complications. Laparoscopic hernioplasty is not without complications. Training, experience, and attention to technique will prevent some of these complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187878
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    Paper (German National Licenses)
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