Anästhesie, Intensivtherapie, Notfallmedizin
-
This investigation is based on 140 autopsy protocols of unsuccessful resuscitation procedures (Resuscitation Center of the Army Hospital, Hamburg); injections and closed-chest cardiac massage had been performed in every case. - Most of the patients had collapsed because of cardiac shock; patients with thoracic or abdominal injury were excluded from this study. In individual cases only, the following severe complications originated from the resuscitation procedures: fracture of a chest vertebra, serial fractures of ribs resulting in an unstable thorax, bilateral haemothorax, tension pneumothorax, rupture of kidney and of spleen (but not of liver). In one case the lesions caused by the resuscitation measures must be considered as responsible for the lethal outcome. ⋯ The number of fractured ribs ranged up to 16, mainly 3-8 ribs were fractured. Fractures of rib No. 1 and 8-12 were very rare. The fractures were located between the parasternal and axillary lines.--In a comparative study the site of rib fractures after heavy blunt thoracic injuries was preferably found in the dorsal region.
-
Anasth Intensivther Notfallmed · Apr 1983
[Parenteral feeding with a new combination solution containing glucose and amino acids before and after abdominal interventions].
16 patients with major abdominal surgery were treated 3 days preoperatively and 5 days postoperatively with a new parenteral nutrition solution containing amino acids, dextrose, sugar substitutes and electrolytes. The efficacy of the solution was tested with respect to various clinical data including amino acid homoeostasis and nitrogen balance. Even in the postoperative period free serum amino acids remained generally within the normal range. ⋯ The renal losses were about 1% for glucose and 7% for the sugar substitutes. Serum electrolyte concentrations were normal during the investigation period. Because of the high substrate concentration in the solution it was possible to administer 70 g of amino acids and 420 g of non-protein energy sources in an infusion volume of only 2000 ml.
-
Anasth Intensivther Notfallmed · Dec 1982
Clinical Trial Controlled Clinical Trial[Effect of arm splinting on the duration and possibility of monitoring invasive long-term pressure determination of the radial artery].
A special splint technique, which can improve continuous intraarterial blood pressure monitoring via the a. radialis is reported. This method could be applied successfully in 41 patients of the ICU up to 27 days. ⋯ These observations could be seen in contrast to our results, using a conventional splint system, applied in 12 patients for comparison (maximal duration of catheter's placement: 9 days). Our experiences, using this special splint method of arm fixation, lead to the recommendation to use our method routinely in long-term monitored patients, with respect to a longer duration of catheter's intravasal placement, the possibility of undisturbed monitoring and a simple clinical handling.
-
Anasth Intensivther Notfallmed · Dec 1982
Case Reports[Respiratory depression after epidural opiate analgesia with buprenorphine hydrochloride? A clinical case report].
In a case of epidural application of buprenorphinehydrochloride a reduction of arterial pO2 was seen 4-6 hours after the injection. This cannot be explained as a respiratory depression due to buprenorphine, because immediately after a repeat epidural application of the drug the pO2 rose again. Reduced pO2 a long time after buprenorphine is a a result of hypoventilation caused by increased pain.