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Biomedical subjects

C J Schuster

Publications and source records attributed to C J Schuster.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Early PEEP for improvement of prognosis in patients with acute respiratory insufficiency (author's transl)].

One hundred twenty-seven artificially ventilated patients with acute respiratory insufficiency (ARI) were investigated. In 61 patients positive endexpiratory pressure (PEEP) was used when ventilation with ZEEP proved to be insufficient for one or more of the following reasons: increasing I-aDO2m PaO3 below 60 Torr at FiO2 greater than or equal to 0.5, deterioration of clinical status (group = secondary PEEP). The time elapse between beginning of artificial ventilation and institution of PEEP was 46 +/- 47 h (median 33 h). In 66 patients PEEP was used from the beginning of artificial ventilation (group II = primary PEEP). The distribution of underlying diseases (severe poisoning, pancreatitis, polytrauma or major surgery, pneumonia, cardiovascular failure, sepsis) as well as the frequency of additional vital function failure (circulatory shock, acute renal failure) were comparable in both groups (p greater than 0.05). At the beginning of artificial ventilation both groups were comparable in respect to respiratory insufficiency. PaO2 was 75 +/- 26 Torr in group I and 70 +/- 29 Torr in group II at comparable levels of FiO2 (p greater than 0.05). PaCO2 was 34.7 +/- 8.2 Torr in group I and 37.4 +/- 10.5 Torr in group II. Significantly more patients in group II received corticosteroids (greater than 1 gr/die). Mortality was 48/61 (79%) in group I and 37/66 (56%) in group II (p less than 0.01). End-inspiratory pressure exceeding 35 cm H2O was necessary in 42/61 patients in group I and 28/66 patients in group II (p less than 0.01) and FiO2 greater than 0.5 was necessary to keep PaO2 above 60 Torr in 39/61 patients in group I and 27/66 patients in group II (p less than 0.01). It is concluded that early institution of PEEP improves the course and outcome of patients with ARI.

Acute Disease↗
PubMed1980

Transthoracic electrical impedance during extracorporeal hemodialysis in acute respiratory failure ("Shocked Lung syndrome").

The alteration (delta Z0) of transthoracic electrical impedance (TEI) during extracorporeal hemodialysis (EHD) was investigated in two Groups of patients with acute renal and acute respiratory failure, that differed with respect to the severity of respiratory insufficiency. Group I had moderate respiratory failure (FiO2 0.31 +/- 0.10, PaO2 84 +/- 14 mmHg), and Group II had severe respiratory failure (FiO2 0.75 +/- 0.17, PaO2 77 +/- 14 mmHg). There was a significant correlation between increase in TEI (delta Z0) and decrease in body weight (delta BW) in each individual patient, but the slope of regression lines was remarkably flattened in Group II. In Group I, delta TEI was 1.9 +/- 0.9 omega, the calculated TEI for 500 gr decrease in BW (delta Z0-500 gr) was 0.59 +/- 0.21 omega, and a significant correlation existed between pooled data of delta Z0 and delta BW. In Group II TEI increased less significantly, delta TEI was 0.6 +/- 0.3 omega (P less than 0.001), delta Z0-500 gr was 0.26 +/- 0.27 omega (P less than 0.01), and there was no correlation between pooled data of delta Z0 and delta BW. Increase of TEI in Group II could be completely attributed to increase in hematocrit. It is concluded that patients of Group I with acute renal failure and moderate respiratory failure lost intrathoracic fluid during EHD, whereas patients of Group II with severe respiratory failure did not. TEI during EHD may serve as a test for detection of fixed fluid within the pulmonary interstitium indicating a poor prognosis of the acute respiratory failure.

Acute Kidney Injury↗
PubMed1980

Echocardiographic control of Swan-Ganz catheters.

In 68 patients, subxiphoidal, percordial, and suprasternal echocardiography was used to trace the Swan-Ganz catheter during its passage to the pulmonary artery and to localize its position. The localization of the catheter could be exactly identified in 62 out of 68 patients in whom we managed to obtain a suprasternal echocardiogram. In one patient, the catheter was found (by chest x-ray film) in the left pulmonary artery (LPA) and was regarded to be in the right pulmonary artery according to suprasternal echocardiography. In two patients, the catheter could not be localized by suprasternal echocardiography although it was positioned in the LPA. In three patients, the catheters could not be advanced to the pulmonary circulation and were visualized within the right ventricular cavity by precordial and subxihpoid echocardiogarphy. Thus, echocardiography, particularly the suprasternal approach, has proven a safe, reliable, and easy way for position control of Swan-Ganz catheters.

Catheterization↗
PubMed1980

[Control of blood coagulation and complications in long-term streptokinase therapy].

Streptokinase was infused for 103 +/- 25 hrs. in 27 patients (6 with deep vein thrombosis of the leg, 7 with thrombosis of Vv. axillaris and subclavia, 9 with acute massive pulmonary embolism, 3 with chronic artery occlusion, 2 with thrombosis of the retinal vein). Blood coagulation studies were performed repeatedly. Anticoagulation (prolongation of thrombin time to 1 1/2-2 1/2 of normal) could be achieved without additional heparin by reduction of streptokinase to doses as low as 20 000 U/h. Reptilase time correlated significantly with thrombin times. Following 24 hrs. of infusion, PTT was less than 50 sec. and Quick test less than 50% of normal in most instances. No correlation was found between PTT or Quick test and factor II, V, VI, X activities during streptokinase infusion. Bleeding was observed in 18 patients. The infusion was stopped because of bleeding in 3 cases. None of the coagulation tests performed in this study correlated with the incidence of bleeding. Hemoglobin concentration decreased 2,6 +/- 1,6 gr% and this decrease could no be explained by blood lesses.

Female↗
PubMed1979

Two survivors of severe paraquat intoxication by "continuous hemoperfusion".

"Continuous hemoperfusion" (8 h/day for 2--3 weeks) was performed in two patients suffering from severe paraquat intoxication. On account of paraquat plasma concentrations a fatal outcome due to pulmonary fibrosis would have been expected in both cases. However, both patients survived following "continuous hemoperfusion" therapy. Coated activated charcoal seems to have a higher affinity for paraquat than lung tissue.

Acute Disease↗
PubMed1979

[Influence of diphenylhydantoine on delta sharp-waves in coma. A clinical contribution (author's transl)].

A patient with severe drug intoxication developed the well known EEG stages, starting with burst suppression activity until the pattern with delta waves and sharp waves was reached. At this stage it was treated with diphenylhydantoine intravenously. During injection the sharp elements disappeared and the pattern of faster waves was established. Thus it may be concluded that the sharp wave delta pattern indicates activity similar to that seen in epilepsy and that such a pattern needs anticonvulsant therapy.

Coma↗
PubMed1978

Digoxin and digitoxin elimination in man by charcoal hemoperfusion.

Since there is no widely used causal means of reducing the severity of massive digitalis intoxication the capability of hemoperfusion with coated activated charcoal to remove toxicologically relevant amounts of digoxin and digitoxin was evaluated in vitro and in man. At a blood flow rate of 100 ml/min the digoxin clearance by hemoperfusion in vitro was 51 +/- 8 ml/min in comparison to 24.3 +/- 11.3 ml/min by hemodialysis. The average hemoperfusion clearance of digitoxin was 31.7 +/- 13.4 ml/min, whereas almost no digitoxin was removed by hemodialysis. These clearance values point to the ability of hemoperfusion of eliminating digitalis glycosides from the blood. They do not clarify the essential question whether it is possible to lower the toxic concentrations in the tissues.

Charcoal↗
PubMed1975

[The vessel-mechanics of the common carotid artery in arterial hypertension].

The pressure-diameter relationship of the intact common carotid artery was studied in each of 36 normotensive and hypertensive patients of the same age. The diameter and its changes by pulse pressure were measured using an ultrasound echo-ranging device. The arterial blood pressure simultaneously was determined by the auscultatory method...

Adolescent↗
PubMed1975

[Transcutaneous measurements of age conditioned changes in the elasticity of the human common carotid artery].

Measurements of common carotid arterial wall properties were done in a group of 36 test persons who were clinically free of arteriosclerosis obliterans. The patients were divided into three groups according to the age: 18-33, 36-52 and 56-72 years. Diameter and changes in diameter were measured using an ultrasonic echo-tracking system. Arterial pulse pressure simultaneously was determined by the auscultatory method. The deduced parameters of visco-elastic arterial wall property as distensibility, volume-eleastic modulus and pulse wave velocity indicate that arteries become stiffer with the age. The volume-elastic-modulus specially shows a numerical increase of 100% according to the age. An interpretation based on morphological investigations as well as the possibility using non-invasive methods to recognize an early manifestation of arteriosclerosis are discussed.

Adult↗