Biomedical subjects

B Rosberg

Publications and source records attributed to B Rosberg.

31 records · Page 2Linked to original sources

PubMed1983

Tolerance of two ampicillin esters: a comparison of pivampicillin and bacampicillin.

The tolerability of tablets containing the ampicillin esters, pivampicillin and bacampicillin were compared clinically in 138 patients and by gastroscopy in 2 healthy volunteers. The clinical study showed no difference in tolerability, 26% of patients taking pivampicillin and 23% of those taking bacampicillin reported side-effects. Both preparations were equally effective clinically: 94% of patients taking pivampicillin and 91% of those taking bacampicillin were cured or improved. Gastroscopy showed that the pivampicillin tablets disintegrated more rapidly (10 minutes) than bacampicillin tablets (36 minutes). After disintegration, the pivampicillin tablets covered a larger area of the gastric mucosa than did tablets of bacampicillin.

Adolescent↗

PubMed1982

Anesthetic techniques and surgical blood loss in total hip arthroplasty.

Blood loss during total hip arthroplasty and the relation of different anesthetic techniques to surgical bleeding was explored in a consecutive, prospective study involving 157 patients with no previous history of hip surgery. Intraoperative blood loss was significantly reduced in patients operated under sodium nitroprusside induced hypotensive anesthesia as compared to halothane, NLA or epidural block. It might be suspected that postoperative blood loss is increased when the lowered blood pressure is raised towards normotension, but this was not the case. However, regression analysis between mean arterial pressure and intraoperative blood loss in patients anesthetized with hypotensive as well as "normotensive" techniques showed a poor correlation. Blood loss was greater with NLA and halothane anesthesia than with epidural block. The authors consider controlled hypotension a useful adjuvant in anesthesia for total hip arthroplasty in selected patients. Epidural block, on the other hand, is a suitable anesthetic technique for most patients and has the additional advantage of reduced surgical bleeding as compared to general anesthesia.

Adult↗

PubMed1982

Recurrence of respiratory depression following neurolept analgesia.

Fentanyl, though generally regarded as a short-acting narcotic analgesic, can give unexpected respiratory depression several hours after the last dose. This potentially very dangerous effect is explained in pharmacokinetic studies by a mobilisation of fentanyl from tissue stores. In this report we describe a patient who, following a Harrington correction for scoliosis done with neurolept analgesia, developed a severe respiratory depression 5 h after the last dose of fentanyl.

Adult↗

PubMed1982

Myocardial blood flow, oxygen uptake and carbon dioxide release of the human heart during hemodilution.

Myocardial blood flow, oxygen consumption and carbon dioxide release were studied before and during hemodilution in man. Dextran 70 was used as the dilutional agent to reduce hematocrit values from 37 to 28% (mean). The decrease of oxygen content in arterial blood after hemodilution was compensated by an increase of cardiac output. The myocardial blood flow increased proportionally more than the cardiac output, resulting in a virtually unchanged oxygen tension in coronary sinus blood. The metabolism of the heart was not affected as the respiratory quotient remained unchanged. This investigation suggests that blood losses up to 20% of the total blood volume can be replaced by dextran solutions, without a significant decrease of myocardial oxygen supply.

Adult↗

PubMed1981

Haemodynamic effects of labetalol-induced hypotension in the anaesthetized dog.

Central haemodynamic changes and regional blood flow were studied using the microsphere technique, during labetalol-induced hypotension in dogs anaesthetized with pentobarbitone and fentanyl. Labetalol 15 mg kg-1 decreased mean arterial pressure from an average of 88 mm Hg to 47 mm Hg. Mean pulmonary arterial pressure was unchanged. Cardiac output was reduced by decrease in stroke volume, while heart rate remained unchanged. Myocardial blood flow decreased approximately in parallel with left ventricular work. Perfusion of the brain and kidneys was unchanged.

Animals↗

PubMed1981

Blood coagulation during and after normovolemic hemodilution in elective surgery.

Hemodilution might extend the process of coagulation depending on three possible factors, namely 1) decreased concentration of clotting factors, 2) increased capillary flow and 3) specific actions of the dilutional agent on the clotting mechanism. In two randomized groups of patients undergoing hip arthroplasty preoperative normovolemic hemodilution with dextran 70 was compared to conventional bank blood transfusion. Coagulation parameters, blood loss and incidence of postoperative thromboembolism were studied. Minor reductions of the individual coagulation factors in the immediate postoperative course as well as a protracted APT-time were demonstrated in the hemodiluted group, but total surgical blood loss was not influenced by the hemodilution technique. The frequency of postoperative deep venous thrombosis did not differ between the groups, but there was a significant reduction in the number of silent pulmonary emboli in the hemodilution group.

Blood Coagulation↗

PubMed1979

Preoperative normovolaemic haemodilution with dextran 70 as a thromboembolic prophylaxis in total in hip replacement.

The effect of preoperative normovolaemic haemodilution with dextran 70 in 57 patients undergoing total hip replacement for osteoarthritis, was evaluated with respect to the production of thrombosis and pulmonary embolism. The patients were randomly allocated to one group undergoing preoperative haemodilution and one control group receiving 500 ml dextran 70 during operation and again on the second postoperative day. Before operation blood was replaced by dextran 70 to lower the hematocrit to between 25 and 30. The blood drained from the patients was used to replace blood lost at operation. Between 10 and 14 days after operation the patients were examined by perfusion lung scan, chest radiography and bilateral phlebography. Twelve patients also had 133Xe ventilation scans. The incidence of deep vein thrombosis in the two groups did not differ significantly. Pulmonary embolism was significantly decreased in the preoperative haemodilution group. One patient in the control group had clinical symptoms of, and died from, pulmonary embolism.

Aged↗

PubMed1979

Regional blood flow in normovolaemic and hypovolaemic haemodilution. An experimental study.

The effects on the circulation of limited normovolaemic haemodilution with dextran 70 and subsequent haemorrhage to a mean arterial pressure of 60 mm Hg were studied with isotope-labelled microspheres in the dog. Following haemodilution, cardiac output, stroke volume and systemic oxygen transport increased. The distribution of oxygen to the heart, liver (hepatic artery), spleen and carcass (mainly muscle, skeleton and skin) was increased, while a decrease in oxygen supply to the brain was found. Following haemodilution and haemorrhage, cardiac output, systemic oxygen transport and mixed venous oxygen tension decreased. Blood flow was redistributed to maintain the cerebral, renal, hepatic arterial and coronary circulations, mainly at the expense of blood flow to the carcass and through systemic arterio-venous shunts. Thus, limited normovolaemic haemodilution does not affect the normal circulatory response to moderate haemorrhagic hypotension.

Animals↗

PubMed1979

Regional lung function and central hemodynamics following normovolemic hemodilution in the dog.

Regional lung function, using xenon 133-radiospirometry, and central hemodynamics were studied following normovolemic hemodilution with dextran 70. Normovolemic hemodilution to hermatocrit values of 25% increased cardiac output and pulmonary blood volume significantly. The systemic oxygen transport and mixed venous oxygen tension were unchanged. The acute hemodilution did not significantly change the distribution of ventilation or prefusion within the lungs. It is hypothesised that a tendency to an increase in arterial oxygenation is due to a reduced interstitial pressure in the basal region of the lungs, resulting from water absorption by the hyperoncotic dextran used for hemodilution.

Animals↗

PubMed1979

Regional lung function following hip arthroplasty and preoperative normovolemic hemodilution.

The effect of preoperative normovolemic hemodilution with dextran 70 as dilutional agent on postoperative regional lung function was evaluated in patients undergoing hip arthroplasty in the lateral decubitus position. The major part of the surgical blood loss of these patients was replaced with the received autologous blood. The results obtained were compared to changes in a group of patients in whom the operative bleeding was replaced with bank blood. Regional lung function, as studied with Xe133 radiospirometry, is not negatively influenced by the hemodilution technique. In both groups a reduction in perfusion, ventilation and volume of ventilated alveoli was revealed postoperatively in the lung that was dependent during surgery, probably caused by impaired ventilation of this lung and peroperatively induced microembolism. A more rapid normalization was found in the preoperatively hemodiluted patients. The reduced volume of bank blood transfused to these patients and/or a protective effect of the preoperatively infused dextran on the microembolism evoked by the surgical trauma might explain this difference between the groups studied.

Aged↗

PubMed1977

Preoperative normovolemic hemodilution in total hip arthroplasty. A clinical study.

Pre-operative normovolemic hemodilution was used in 20 patients undergoing total hip replacement. The hematocrit was lowered to 25-30% immediately before operation. 23 patients, in whom operative blood loss was replaced with bank blood, served as a control group. In the hemodilution group the amount of homologous blood transfusions was reduced with 50% compared to the control group. There was no significant difference in clinical complications between the two groups. The technique is simple and the increase in anaesthesia and operation time only about 20 min.

Adult↗

PubMed1975

Regional lung function following prosthetic hip replacement surgery.

With a Xenon133 radiospirometric technique the regional lung function was evaluated before and after prosthetic hip arthroplasty performed in the lateral decubitus position with either respirator-controlled neuroleptic anesthesia or epidural anesthesia with spontaneous breathing. Regional lung function measured in a supine position 1, 20 and 72-96 hours postoperatively revealed a reduction of the perfusion, ventilation and volume of ventilated alveoli on the dependant lung. The reduction was most pronounced immediately postoperatively, especially following respirator-controlled anesthesia. There was also an increase of pulmonary blood volume and a decrease of total lung volume in this group. The changes of lung function are probably caused by congestive atelectasis, secondary to impaired ventilation of the dependent lung. Peroperatively induced microembolism might have potentiated the effect.

Aged↗

PubMedDate not supplied

Comparison of preparation and narcotic-sedative premedication in children undergoing surgery.

A psychological preparation program was developed for use prior to emergency surgery in children. The purpose of this study was to test the hypothesis that provision of specific information prior to an emergency operation would reduce the need for premedication to control anxiety and stress. Children were randomly assigned to either a verbally prepared group given narcotic-sedative premedication (control) or to a psychologically prepared group given only atropine as premedication. The child and parent rated their own anxiety on a Visual Analogue Scale (VAS). The children and parents were also assessed by a nurse preoperatively and postoperatively using a similar scale. The children's pulse, blood pressure, and cortisol were also measured. The results showed no significant difference between the psychologically prepared group and the premedicated group, suggesting that psychological preparation compares favorably with narcotic-sedative premedication.

Adolescent↗