Anästhesie, Intensivtherapie, Notfallmedizin
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Anasth Intensivther Notfallmed · Dec 1988
Case Reports[Deep accidental hypothermia (24 degrees C). A case report].
A 65 year old female patient was submitted to the ICU in deep accidental hypothermia, due to lying in cold water after intoxication with Melperon. Body temperature after submission was 24 degrees C; therefore rewarming was done by an extracorporal bypass. After successful rewarming, the further posttraumatic course was free of complications and the patient could be discharged 14 days after the event.
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Anasth Intensivther Notfallmed · Dec 1988
[The equilibrium of nitrogen, potassium and phosphate and renal excretion of creatinine and creatinine over the course of 3 weeks following severe trauma].
In 19 patients after accidental trauma and with intact renal function during an observation time of 21 days we found a cumulated negative balance of nitrogen (N), phosphate (P) and potassium (K) amounting to a mean of 214g, 357 and 447 mmol, respectively. Median daily potassium balance was positive on day 2 to 5 and this was interpreted as an increased extrarenal potassium deposition due to increased levels of circulating catecholamines. Median renal creatinine excretion was about 120% of predicted normal till day 10 and continuously decreased thereafter to values lower than predicted normal. ⋯ During the phase of creatinuria, however, the negative balance of N, K and P seems to be mainly due to muscle wasting. Hypophosphatemia was prominent during the first 5 days after trauma and obviously was caused by a decrease in renal phosphate threshold (TmPO4/GFR). The underlying mechanism of this primary change in renal function after severe trauma could not yet be identified.