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Biomedical subjects

B Lindblad

Publications and source records attributed to B Lindblad.

At least 163 records · Page 9Linked to original sources
PubMed1986

Attenuation of hemodynamic and hematologic effects of heparin-protamine sulfate interaction after aortic reconstruction in a canine model.

This investigation documented the effect of protamine sulfate pretreatment on the adverse hemodynamic and hematologic sequela of rapid intravenous protamine administration in heparinized dogs having undergone prior implantation of aortic prostheses. Fourteen dogs underwent infrarenal aortic replacement with 6 mm inner diameter by 7 cm knitted Dacron double-velour grafts. Carotid arterial, central venous, and pulmonary arterial catheters were placed for continuous hemodynamic monitoring. All dogs were adequately anticoagulated with heparin (150 IU/kg) and reversed with protamine (1.5 mg/kg/10 sec) after graft insertion. Pretreatment regimens studied included normal saline (n4), protamine 0.75 mg/kg (n5), and protamine 2.25 mg/kg in three divided doses of 0.75 mg/kg each (n5). All pretreatment agents were administered 3 minutes before heparinization. Blood pressure (BP), heart rate (HR), pulmonary artery pressure (PAP) and cardiac output (CO) were measured. Hematologic assessments included platelet count (PC), leukocyte count, thrombin clotting time, and total hemolytic complement. Significant salutory effects were associated with protamine pretreatment regarding BP, HR, PAP, CO, and PC. It is concluded that adverse hemodynamic effects of protamine reversal are blocked and certain hematologic effects are reduced with protamine pretreatment before heparinization and its reversal in this canine experimental model.

Animals↗
PubMed1985

A 30-year survey of pulmonary embolism verified at autopsy: an analysis of 1274 surgical patients.

A retrospective study was undertaken of all surgical patients in Malmö, Sweden, during the period 1951-1980, in whom pulmonary emboli were found at autopsy. The autopsy rate was high throughout the period, ranging from 73 to 100 per cent. Of 5477 patients who died during the period, 1274 had pulmonary emboli (23.6 per cent), 349 of which were considered fatal, 353 contributory to death and 572 incidental. Fifty-one per cent of the patients were not operated upon. The number of contributory and incidental emboli increased over the period, to some extent probably reflecting greater thoroughness in postmortems. The frequency of fatal pulmonary emboli decreased in the last 5 year period. Pulmonary embolism was more rare in patients under 50 years of age. The proportion of females increased. In 24 cases major embolism emanated from thrombi around central venous catheters. This retrospective analysis of a large number of patients shows that pulmonary embolism continues to be a major cause of death in surgical patients, and in Malmö as common a cause of death in operated as in nonoperated patients.

Adult↗
PubMed1985

The effect of infrarenal aortic clamping and declamping on central haemodynamics and tissue blood flow in pigs--a comparison of fluid replacement between a colloid and a cristalloid.

A study has been undertaken to compare the effect of fluid administration of a cristalloid (Ringer glucose) with that of a colloid (dextran 40) on central haemodynamics and organ blood flow distribution during clamping and after declamping of infrarenal aorta in pigs. The declamping hypotension was significantly greater in the cristalloid group where a decrease in cardiac output was also seen. Tissue blood flow to the kidneys decreased in the cristalloid group during clamping but was maintained in the dextran group. At declamping there was a reactive kidney hyperaemia in the dextran group, while the medullar flow was still significantly decreased in the cristalloid group. The reactive hyperaemia seen in pancreas and small intestines was also greater in the dextran group.

Animals↗
PubMed1985

Abdominal injuries in children: an analysis of 348 cases.

Three hundred and forty-eight children from Skaraborg County, Sweden, admitted to hospital with abdominal injuries over a 30-year period (1951-1980), have been analysed and compared with all patients with abdominal injury (1407) admitted to hospital from the same area during the same period. The number of children admitted in the second half of the period was greater than during the first but the proportion of children compared with adults was considerably reduced. During the period abdominal injuries due to car accidents increased in adults but not in children. The most frequent cause of abdominal injury in children was a bicycle accident. Abdominal injury due to sport also increased over the period. Mortality decreased, with no deaths in the past 10 years, compared with 8.6 per cent mortality in the first 10 years of the period.

Abdominal Injuries↗
PubMed1985

Infectious complications of percutaneously inserted central venous catheters.

The frequency of early and late complications of percutaneously inserted central venous catheters (CVC) was prospectively assessed. One hundred and fifty-one periods of catheterization (siliconized and heparinized polyethylene and teflon catheters), inserted mainly infraclavicularly and on the right side, were evaluated. Strict aseptic technique was used during insertion and daily care of the CVC. The only early complications noted were three cases of pneumothorax. No nerve injuries or arterial punctures were observed. Of 124 evaluated cases (96 arm-phlebography, 28 post-mortem) 16% developed thrombosis, and in one patient this probably resulted in fatal pulmonary embolism. Septicaemia was seldom seen: two cases were considered as proved and another two cases as probable. This study and other studies indicate that an aseptic technique is essential and perhaps even more important than using tunnelled versus percutaneously inserted catheters in respect of reducing infectious complications of central venous catheters.

Adult↗
PubMed1985

Prenatal diagnosis of hereditary tyrosinemia by determination of fumarylacetoacetase in cultured amniotic fluid cells.

Fumarylacetoacetase was assayed in cultured amniotic fluid cells from four pregnancies at risk for hereditary tyrosinemia and in 11 controls. The enzyme activity was normal in three of the pregnancies at risk for tyrosinemia and healthy children were born. In the fourth case the enzyme activity was deficient, indicating an affected fetus. As the pregnancy was very advanced it was continued, and the child has tyrosinemia. One parent in one of the four families is a compound heterozygote for the tyrosinemia gene and the recently reported "pseudodeficiency" gene for fumarylacetoacetase. This has important consequences for prenatal diagnosis in this family.

Adult↗
PubMed1985

Prevention of thrombosis after hip fracture surgery. Comparison of dextran 70 with and without dihydroergotamine.

The efficacy of dextran 70 with or without dihydroergotamine as prophylaxis against deep venous thrombosis (DVT) was tested prospectively in a randomized series of 65 patients with fracture of the hip. Diagnostic evaluation was made with bilateral ascending phlebography on postoperative day 7. In the dextran 70 group, 5 of the 27 phlebographically studied patients had DVT, an incidence not significantly different from the 10 DVT among 28 patients given dextran 70 + dihydroergotamine. Bleeding complications showed no intergroup difference. The study did not confirm a beneficial effect of dextran 70 in combination with dihydroergotamine as compared with dextran alone in regard to thrombotic complications after surgery for hip fracture.

Aged↗
PubMed1984

The thromboprophylactic effect of graded elastic compression stockings in combination with dextran 70.

We studied 80 patients who were older than 50 years of age to determine if graded elastic compression stockings reduced the frequency of postoperative thrombosis in patients undergoing dextran 70 prophylaxis. All of the patients received a total of 2,000 mL of dextran 70 during three days; according to a random table, each of the patients had one leg encased in a graded compression stocking for one week. Thrombosis development was screened with the fibrinogen I 125 test. Eight patients manifested thrombosis-one in the thigh and seven in the calf--localized to the unstockinged leg, a frequency significantly greater than the zero frequency in the stockinged leg. No untoward effects of this combination prophylaxis were noted.

Aged↗
PubMed1984

Does dihydroergotamine potentiate the thromboprophylactic effect of dextran 70? A controlled prospective study in general and hip surgery.

In a prospective randomized controlled study on postoperative thromboembolism, 259 patients undergoing elective general surgery, emergency general surgery, total hip replacement or hip fracture surgery were given thromboembolic prophylaxis with either a combination of dextran 70 and dihydroergotamine (DHE) or with dextran 70 alone. 500 ml dextran 70 was infused twice on the day of operation, once on postoperative days 1 and 3, and also on day 5 if the patient was still confined to bed. 0.5 mg DHE was given s.c. twice daily starting before operation and continued for 3 or 5 postoperative days. In hip fracture patients prophylaxis was started as soon as the diagnosis was made. 500 ml dextran 70 was given every other day before operation. DHE was given twice daily if so indicated from randomization. The patients were screened for deep-vein thrombosis (DVT) with the 125I-labelled fibrinogen test for 8 days and followed for one month postoperatively. In hip fracture surgery the incidence of DVT was significantly reduced by the combination of dextran 70 and DHE compared to dextran 70 alone (1/32 vs. 11/36, P = 0.003). However, this synergistic effect of DHE could not be detected in the other patient groups. Fatal pulmonary embolism did not occur. No severe side effects attributable to prophylaxis were noted in either group.

Aged↗
PubMed1984

Effects of dihydroergotamine on the feline cardiovascular response to intravenous infusion of live Escherichia coli bacteria.

A septic shock state was induced in cats by intravenous infusion of live Escherichia coli bacteria. Cats pretreated with an unspecific 5-HT blocker, dihydroergotamine (DHE), or with a specific 5-HT blocker, ketanserin, were compared with a series receiving bacteria without pretreatment. DHE pretreatment prevented the reduction in systemic arterial blood pressure found in the other series during the 2-hour period of septic shock. Pretreatment could not influence the increased vascular resistance in the pulmonary vascular bed or the early increase in pulmonary arterial blood pressure. Peripheral blood flow distribution was studied using radioactive labelled microspheres. Compared to bacteremia without pretreatment, the 5-HT blockers increased CNS blood flow and ketanserin also prevented the reduction in pancreatic blood flow. Gastric blood flow and gastric mucosal blood flow remained unchanged in all series as did the small intestinal total blood flow. Small intestinal mucosal blood flow, however, was reduced after 2 h of bacteremia. Microscopy revealed no gastric epithelial damage while the jejunal mucosa was characteristically damaged. There was no correlation between the changes in the small intestinal blood flow and the degree of mucosal damage, however, supporting the countercurrent theory for the pathogenesis of these lesions.

Animals↗
PubMed1984

The role of the prostanoid system in mediating the haemodynamic effects of dihydroergotamine.

Dihydroergotamine (DHE) increases tonus in veins, especially in capacitance vessels, thereby reducing blood pooling and increasing venous blood flow velocity and it has been suggested that DHE achieves its effect partially through its influence on prostanoids synthesis and release. Pretreatment with indomethacin did not affect DHE response in central haemodynamic variables or in tissue blood flow in dogs; nor did it affect the reduced venous vessel area, increased blood flow in dogs; nor did it affect the reduced venous vessel area, increased venous blood flow velocity (measured ultrasonically), or reduced resting calf volume blood flow (measured by plethysmography), caused by DHE in humans. Although the number of animals and of humans in this study were small, nontheless it seems unlikely that the effect of clinically relevant doses of DHE is appreciably mediated by the prostanoid system.

Animals↗
PubMed1984

Postoperative haemostatic changes in patients given thromboembolic prophylaxis with dextran 70--alone, or in combination with dihydroergotamine.

Haemostatic changes were studied in 107 patients undergoing elective general and urologic surgery or hip replacement. All patients received dextran 70 and half of them, randomly chosen, were also given dihydroergotamine. Blood samples were taken before operation and on the fourth postoperative day. In all patients increases in factor VIII:C, VIII:R Ag and fibrinogen were noted, and decreases in thrombin time, antithrombin III and alpha 2-macroglobulin. In patients undergoing hip replacement, alpha 2-antiplasmin (measured amidolytically) also increased. No major intergroup differences were noted. Comparison between elective hip patients given general anaesthesia and those given epidural analgesia revealed no major differences in haemostatic response. From our findings it would appear that the coagulation and fibrinolytic systems remain unaffected by dihydroergotamine.

Aged↗
PubMed1984

Prophylaxis against pulmonary complications in patients undergoing gall-bladder surgery. A comparison between early mobilization, physiotherapy with and without bronchodilatation.

A random comparison of early mobilization and chest physiotherapy (mainly breathing exercises) with or without bronchodilatating inhalations for prophylaxis against pulmonary complications in patients undergoing elective gall-bladder surgery is presented. The operation was performed with a subcostal incision and peroperatively, intercostal nerve block was administered. Preoperative pulmonary status (dynamic volume spirometry, peak expiratory flow rate, arterial blood gas analysis) showed no differences between the groups, and postoperative blood gas analysis and pulmonary X-ray or evident clinical findings did also not show any differences between the groups. Thus early mobilization was as effective in our study as the other prophylactic treatments. In patients without pulmonary disease perhaps early mobilization and efficient analgesia after surgery is as effective as more resource demanding physiotherapy for prophylaxis against postoperative pulmonary complications.

Aged↗
PubMed1983

The effect of dihydroergotamine on platelets, coagulation and fibrinolysis, studied in healthy humans and in dogs.

The effect of dihydroergotamine (DHE) on platelets, coagulation and fibrinolysis was studied in healthy volunteers ex vivo before and after intravenous administration (0.5 mg). In addition, the effect of DHE in different concentrations on platelet aggregation was evaluated in vitro. Haematocrit was found to increase, as did factor VIII:C and antithrombin III - though the latter increases were not significant when correction was made for the altered haematocrit. Though platelet function ex vivo was unchanged, inhibition of adrenaline induced platelet aggregation was noted in vitro when the plasma concentrations of added DHE were higher than those obtained with clinically relevant doses. No effect on fibrinolysis was noted.

Adult↗