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Biomedical subjects

B Weidler

Publications and source records attributed to B Weidler.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Studies of heart function using apex cardiography in pregnancy-induced hypertension before and following therapy with dihydralazine sulfate].

The apex cardiogram and its 1st differential quotient were simultaneously registered with the phonocardiogram, the electrocardiogram and the curve of the carotid pulse in 10 female patients with pregnancy-induced hypertension before and after the therapy with dihydralazine sulphate. 10 healthy pregnant women of the same trimenon served as comparative group. Altogether 20 parameters were investigated which are regarded as acknowledged indices of the compliance, the contractility and the ability of relaxation. The changes which we found point to an increase of the preload in H-gestosis, which seems to be regressive after the therapy with dihydralazine sulphate. The parameters of contractility and relaxation, including the systolic time intervals, remained uninfluenced.

Blood Pressure↗
PubMed1986

[Acute normovolemic hemodilution in extensive surgical interventions].

In order to ascertain the effect of acute isovolaemic haemodilution on haemodynamics and various laboratory parameters as well as homologous blood consumption 44 patients undergoing major liver surgery were investigated in two groups: group I (n = 22) underwent acute normovolaemic haemodilution after induction of anaesthesia; group II (n = 22) had no blood withdrawn and served as control. Haemodilution led to typical haemodynamic effects such as increase in cardiac index and decrease in systemic as well as pulmonary vascular resistance; no detrimental effect of the procedure could be observed. Haemodilution led to a marked reduction in the consumption of banked blood which was on the average 1.8 units/patient against control intraoperatively and 3.1 units/patient postoperatively summing up to a total of 4.9 units/patient.

Adult↗
PubMed1985

Influence of nimodipine on cardiovascular parameters during coronary surgery.

A total of 78 patients about to undergo open-heart surgery (ACVB) were given nimodipine, a new calcium antagonist, in different doses (0.5 or 1.0 microgram/kg body weight min or 0.03/0.06 mg/kg h) before and during extracorporeal circulation. During infusion (10 to 40 min), the hemodynamic parameters were recorded, including intrapulmonary pressures, the cardiac output and the left ventricular contractility parameters LVP and dp/dtmax. The administration of nimodipine resulted in a dose-dependent reduction of the pulmonary and peripheral vascular resistance with a subsequent decrease of the mean arterial pressure or perfusion pressure (during extracorporeal circulation). The left ventricular pressure (LVP) was reduced, whereas sometimes the cardiac output increased considerably. The contractility (dp/dtmax) was not impaired even by the high nimodipine dose. The heart rate, too, remained unaffected. The nimodipine dose of 0.5 microgram/kg min used in neurosurgery for therapy did not cause any clinically relevant decrease in blood pressure; at higher doses (greater than or equal to 1.0 microgram/kg min) an excessive fall of the diastolic pressure must be avoided in patients with severe (coronary) sclerosis, because a reduced perfusion of poorly vascularized myocardial regions can occur despite improved global perfusion.

Blood Pressure↗
PubMed1985

[Calcium antagonists in anesthesia. Additive analgesia using nimodipine in heart surgery].

Stress and pain induced by surgical trauma seem to be attenuated when calcium antagonists have been applied. In order to ascertain the effect of nimodipine, a new strong acting calcium channel blocker on plasma levels of various stress hormones twenty patients undergoing cardiovascular surgery where investigated in two groups. Ten patients received high-dose fentanyl anaesthesia (mean: 2,45 mg fentanyl/patient), whereas another ten patients were treated with 0,1 mg fentanyl/patient in addition to nimodipine 1,0 micrograms/kgbw X min (from onset of anaesthesia until start of extracorporeal circulation). Between the two groups were no significant differences with respect to perioperative course and postoperative demand for analgetics. Plasma levels of ACTH, somatotropin, glucose and free glycerol were markedly elevated in all patients (n = 20) intra- and postoperatively, whereas cortisol and prolactin remained unchanged. The present data suggest an additive analgesic effect of nimodipine during surgery. This phenomenon is possibly due to a blocking effect of calcium channel blockers on nociceptive nerves. The present model assumes that calcium is essential in pain perception and that decreased calcium would result in analgesia.

Analgesia↗
PubMed1984

[Effect of postoperative parenteral feeding on protein metabolism in heart surgery patients. A comparative study].

To investigate the importance of amino acid infusions in immediate postoperative parenteral nutrition, cardiac patients were randomly allocated into two groups. Applicating identical carbohydrate calories (2000 kcal/day) group 1 received only essential amino acids while in group 2 a combined pattern of essential and non essential amino acids was infused. In addition to routine laboratory data several parameters of protein metabolism including nitrogen balance were evaluated. Although nitrogen balance was positive only in group 2 the differences between the two groups concerning other parameters measured were minimal. The different infusion regimes are discussed revealing the significance of additional parenteral nutrition in these patients.

Amino Acids↗
PubMed1983

[Effect of aspartate compounds on the biochemical characteristics of myocardial energy metabolism in man].

Twenty-five patients undergoing aortic valve replacement were administered two different electrolyte solutions pre- and intraoperatively: patients in group A (n = 9) received a balanced solution of electrolytes and trace metals with aspartate as anion (Inzolen), patients in group B (n = 16) received Ringer's solution with potassium chloride referenced to frequently-measured serum potassium levels. From the left ventricular apex region, needle biopsies were obtained at three points in time: 1. beginning of CPB, 2. end of ischemia, 3. after ten minutes of reperfusion. The tissue samples were enzymatically analyzed for the content of ATP, CP, ADP and lactate. In group A (patients with aspartate) ATP (moderately) and CP (markedly) decreased after ischemia with a marked increase after reperfusion. ADP and lactate in this group (A) increased at the end of ischemia and decreased after reperfusion. ATP and CP in group B (KCl) showed a similar course during the investigation. Lactate (markedly) and ADP (moderately) increased after ischemia without changing after reperfusion. Mean values of ATP and CP in group A were significantly higher than those of group B at all times. Mean values of ADP and lactate, however, in group A were below those of group B. The data indicate an improvement in energetic metabolism of myocardium in man. The results point out the possible importance of aspartates in compound with electrolytes and trace metals in preservation of biochemical energy.

Adenosine Diphosphate↗
PubMed1983

[Changes in plasma amino acids during and following isolated liver perfusion in the human. Brief clinical report].

Plasma amino acids have been analysed during isolated perfusion of the liver in dogs. Aromatic amino acids increased, also the branched chain amino acids showed a small rise. Thus no signs of hepatic failure could be detected. To evaluate early signs of hepatic failure in 2 patients scheduled for isolated liver perfusion, the plasma amino acids where analysed. Corresponding to the results obtained in animals, aromatic acids increased, whereas branched chain amino acids remained constant or rose. Even in the postoperative course no signs of deterioration of plasma amino acids could be detected.

Amino Acids↗
PubMed1983

[Effect of neuroleptanalgesia on operation-induced rise in the antidiuretic hormone].

Plasma-levels of antidiuretic hormone were measured in patients undergoing major abdominal surgery pre-, intra- and postoperatively. All patients (n=20) received neuroleptanalgesia as anaesthetic procedure; 10 of them received etomidate additionally. Initial value of vasopressin as well as values after induction of anaesthesia stayed within normal range in all patients. The operation period was accompanied by elevated ADH-levels with a maximum of 500% above initial values. 5 patients having been antagonized postoperatively with naloxone 0.005 mg/kgbw showed marked increase in ADH-level. In comparison to former investigations we conclude that NLA can not block stress-induced rise in vasopressin-concentration effectively as seen under the combination of NLA plus epidural analgesia.

Abdomen↗
PubMed1983

Influence of epidural fentanyl on stress-induced elevation of plasma vasopressin (ADH) after surgery.

The role of techniques used for management of intra- and postoperative pain on plasma levels of antidiuretic hormone (ADH) was evaluated in 107 patients undergoing abdominal or thoracic surgery. Fifty-one patients had neurolept-anesthesia (NLA) intraoperatively followed by intramuscular piritramide, a long-lasting synthetic narcotic, for relief of postoperative pain. Fifty-six patients had a combination of epidural bupivacaine and NLA intraoperatively followed by epidural fentanyl for relief of postoperative pain. All patients had daily measurements of serum levels of potassium and sodium, plasma levels of ADH, and plasma osmolality for the first 5 postoperative days. In 67 patients arterial blood-gas tensions also were measured at similar times. There were no significant changes in serum electrolyte levels, plasma osmolality, or blood-gas tensions intra- or postoperatively. Plasma ADH levels increased postoperatively in all patients, but in patients given NLA followed by postoperative intramuscular narcotics, plasma levels of ADH were more than twice as great as in patients given epidural anesthesia followed by epidural fentanyl.

Adult↗
PubMed1983

[Anesthesia procedure and postoperative ADH secretion].

44 patients undergoing major abdominal and thoracic surgery received different anaesthetic treatment and different pain therapy during the postoperative period (4 groups). Analysis of plasma vasopressin was performed in all patients pre-, intra- and five days postoperatively. In two groups of patients under neuroleptanalgesia (group A and B) ADH-levels increased markedly during the operation procedure, whereas those of patients under NLA plus epidural analgesia with bupivacaine 0.5% (group C and D) showed only a slight increase intraoperatively. During the postoperative period pain relief was provided by giving fentanyl epidurally (group B and D) or with systemic administration of piritramide (group A and C). During the investigation period vasopressin secretion in patients under epidural opiate therapy was significantly less pronounced as in patients under systemic opiate therapy.

Analgesia↗
PubMed1982

[Antidiuretic hormone in peridural anesthesia with 0.5% bupivacaine. The effect of severe blood loss on ADH release].

14 patients scheduled for peripheral vascular surgery received epidural anaesthesia with bupivacaine 0.5%. Blood samples were obtained preoperatively (twice), intraoperatively (9 times) and postoperatively (3 times) for analysing the following parameters: 1. antidiuretic hormone (ADH, arginine-vasopressin) 2. serum electrolytes (potassium, sodium) 3. plasma osmolality In three patients unexpected sudden blood loss occurred, accompanied by typical haemodynamic changes. Pre- and intraoperative ADH-levels were normal with a slight increase at the end of the operative procedure. Electrolytes and osmolality in serum/plasma stayed within the normal range during the whole investigation period. In three patients suffering from shock due to unexpected blood loss ADH-levels rose excessively. The data demonstrate the well-known stress-attenuation under EDA as well as an increase of ADH-secretion in haemodynamic alteration.

Anesthesia, Epidural↗