Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 1995
[Hyperbaric surgery and oxygen therapy in clostridial myonecrosis].
116 patients with verified clostridial myonecrosis were treated by means of a regimen of combined cyclic hyperbaric oxygenation at 3 ata and repeated necrectomy. With proximal localization of gas gangrene in the elbow or knee (n = 55) 34.5% of patients survived, whilst with peripheral localization at the limbs (n = 44) the survival rate was 88.6% amputation being avoided in 21 of these cases. Abdominal localization (n = 17) was associated with the lowest survival rate (23.5%). In spite of severe clostridial toxicity in 80.1% of patients at the time of admission, the overall mortality was 50.8%.
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Wien. Klin. Wochenschr. · Jan 1994
Review[Bronchial cancer--development, diagnosis, therapy, prognosis].
Lung cancer is the most frequent cause of death from cancer in men. In addition its prevalence among women is currently rapidly increasing. Main risk factors are smoking, exposure to asbestos and genetic factors. ⋯ In small cell lung cancer the probability of 5-year survival is about 10% for patients with limited disease and less than 1% for patients with extended disease. Although surgery plays a role in stage I to stage IIIA, chemotherapy remains the most important mode of therapy in small cell lung cancer. In stages I to IIIA, however, combined treatment modalities might improve outcome of the patients with small cell lung cancer.
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Wien. Klin. Wochenschr. · Jan 1994
Review["Small volume resuscitation"--does it open new possibilities in the treatment of hypovolemic shock?].
Hypertonic-hyperoncotic solutions are a supplementation to conventional fluid regimens in the management of hypovolemia due to trauma, hemorrhage and shock. In this review the possible modes of action of these solutions are discussed and their efficacy both in experimental and clinical settings is presented. Possible side effects, such as hypernatremia and possible problems in the presence of increased intracranial pressure, following administration of hypertonic-hyperoncotic solutions are discussed, as well as the reaction of normovolemic patients to such infusions.
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Wien. Klin. Wochenschr. · Jan 1994
Comparative Study Clinical Trial Controlled Clinical Trial[Degree of substitution and volume expanding effect of various medium molecular weight hydroxyethyl starch solutions].
Hydroxyethylstarch (HES) is today one of the most frequently used artificial plasma substitutes in prehospital, as well as in clinical settings. However, there are no studies comparing the volume effect of different HES solutions. The goals of the present study therefore were to compare the volume effect of three HES solutions, which are similar with regard to mean molecular weight but different in concentration and degree of substitution. ⋯ The volume expanding effect of 6% HES 200/0.6-0.66 amounted to 700 ml. The volume expanding effect of all starches decreased only slightly during the following two hours; an interesting detail observed was a second volume effect of HES (about 20% of the volume infused). We conclude that for the correlation of fluid deficits due to trauma, hemorrhage and shock HES solutions seem to be most effective artificial plasma substitutes.(ABSTRACT TRUNCATED AT 250 WORDS)
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Wien. Klin. Wochenschr. · Jan 1994
Comparative Study Clinical Trial Controlled Clinical Trial[Comparison of the Combitube with the endotracheal tube in cardiopulmonary resuscitation in the prehospital phase].
A prospective controlled study was undertaken to evaluate the efficacy of the Combitube, a combined endotracheal and esophageal obturator airway adjunct, in prehospital cardiac arrest patients. The Combitube and a standard endotracheal tube were utilized on alternate days as the initial airway of choice by paramedics. Of altogether 86 patients treated during the study period, intubation was possible in 80 cases, 38 receiving a Combitube as initial choice of airway. 11 out of 14 patients who could not be intubated with a standard endotracheal tube were then successfully managed with a Combitube. ⋯ Of the 6 patients who survived 2 had received a Combitube, 2 a standard endotracheal tube and 2 an oropharyngeal tube. While visualized endotracheal intubation remains the preferred method of airway control, the Combitube is an effective airway as backup to the endotracheal tube, as well as a primary airway, especially outside hospital. Contraindications are listed.