Biomedical subjects
Publications and source records attributed to C Vieweg.
Care of the child on the IABP continues to be a challenging experience. Further advances in IABP technology will improve the rate of survival for children with complex congenital heart defects and other more complicated diagnoses. Likewise, this technology will enable critical care nurses to increase their expertise resulting in new gains in nursing knowledge.
Report about the results of serologic diagnostics of rubella. In the years 1975 til 1984 we took care for 17,731 pregnant women. 455 of them had rubella contact. In 16.7 per cent (76 women) there was a titer of 1:16 or below. In 18 cases of them we had to guess the patients on artificial abortion, because there were hints at a rubella disease. Nevertheless out of 379 pregnant women with serologic immunity decided on abortion. Reasons have been discussed. We propose a serologic diagnostics in each case of rubella contact of a pregnant women for prevention of rubella embryopathy.
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Heart transplantation has become the standard of care for patients with end-stage heart failure. The efficacy and therapeutic advantages of transplantation in the pediatric population have not been fully determined. Between March 1985 and September 1986, nine pediatric heart transplantations were performed; the ages ranged from 39 days to 19 years; weight ranged from 2.3 to 100 kg. The underlying disease was acquired cardiomyopathy (four patients); cardiomyopathy caused by congenital mitral valve disease (two patients); unresectable fibroma of the left ventricle in a newborn (one patient); hypoplastic left heart syndrome (one patient); and hypertrophic obstructive cardiomyopathy (one patient). Initial immunosuppression therapy consisted of cyclosporine, prednisone, and antithymocyte globulin. Recently, newer protocols have evolved through experience. Seven patients survived the perioperative period and had follow-up from 1 to 19 months, for a total of 41 transplant months. Rejection occurred at a rate of 1.4 episodes per month in children compared with 0.8 episodes per month in our adult patients. There was no statistical difference in the number, severity, or timing of rejection episodes in the pediatric versus adult population. Major complications included cyclosporine-induced seizures in two patients, mild hypertension in two, five infectious episodes (three bacterial and two viral), and three late deaths. All children who survived are in New York Heart Association functional class I with no developmental delays. This series is heavily weighted with children (33% less than age 1 year). Early results demonstrate that pediatric and infant heart transplantation is technically practical. Improved results are to be expected with additional experience and further modification of adult protocols to assure patient growth and minimize the high infection rate.