[Therapeutic modification of contractility under clinical conditions].
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Biomedical subjects
Publications and source records attributed to B Grabensee.
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Seventy-six patients with clinical and ECG evidence of digitalis toxicity and serum-digoxin concentrations over 2.5 ng/ml were investigated for possible correlation between certain ECG changes and the level of serum digoxin, but no correlation was found. However, radioimmunological determination of digoxin level proved to be a reliable means of deciding whether abnormalities of impulse formation or conduction were due to digitalis. In only one case (during haemodialysis) was there a fall in potassium level below normal, with signs of digitalis toxicity electrocardiographically. In five other patients with serum digoxin levels above 6 ng/ml high potassium values were found. Caution in the administration of potassium is advised: it should be given only if it is demonstrated to be below normal. Fifty-one of the patients had impaired renal function.
After 9021 cardiovascular operations 210 patients developed acute renal failure. 140 (67%) out of this group died. The mortality rate of acute renal failure could be reduced from 80% (1958-1966) to 50% (1973-1974). Dialysis treatment should begin early and also in special cases, in which the cause of acute renal failure is not under control. Beyond optimal dialysis therapy common intensive care is important for the prognosis of acute renal failure, especially adaption of drugs to renal function (antibiotics and digitalis), high-caloric alimentation, consequent treatment of infections, strict balance of fluid and electrolytes.
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