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Biomedical subjects

E Pfenninger

Publications and source records attributed to E Pfenninger.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Effect of two years of deferoxamine therapy on iron balance, ferritin, liver and heart in patients with thalassemia major].

The iron balance, the urinary excretion of iron between transfusions, the serum ferritin, the liver density, the size of the heart, the ECG and the echocardiogram of 14 children with thalassaemia major were assessed before and during or after 2 years of deferoxamine therapy (DF, 1 or 2 g/kg body weight/day according to age, by subcutaneous infusion on 5 days per week, 11 months per year). The mean iron balance decreased significantly (p less than 0.001) from 15.4 +/- 4 mg/kg body weight/month before DF to -7.1 +/- 9.4 mg/kg body weight/month in the first year of DF and increased to -2.5 +/- 6.5 mg/kg body weight/month during the second year of DF therapy. Despite administration of a constant dose of DF the urinary excretion of iron during the last days before transfusion was twice as high as during the first days after transfusion. The mean serum ferritin level fell from 6380 +/- 2600 ng/ml before DF to 5074 +/- 1600 ng/ml during the first and 4346 +/- 1900 ng/ml during the second year of DF therapy (p less than 0.05). There was no significant change in liver density or cardiac parameters.

Adolescent↗
PubMed1984

Investigation of intrapartum clearance of the upper airway in the presence of meconium contaminated amniotic fluid using an animal model.

In order to define as effective a procedure as possible for the intra- and post-partum clearance of the upper airways of meconium contaminated infants, three methods of suction clearance, nasal, oral and combined nasal and oral, were carried out on each of five kittens aged between 17 to 19 weeks. There was an interval of at least one week between each investigation. The animals were anaesthetized with ketamine intramuscularly. The pressure changes during delivery were simulated using a compressed blood pressure cuff around the kittens thorax. During the first minute of thoracic compression Tc 99 labeled synthetic sputum was introduced into both the oro- and nasopharynx, then during the 2nd minute the instilled fluid was removed using a conventional extractor with mucus trap. Solely oral or solely nasal routes were used, suction was carried out for 60 secs, whereas when the combined technique was applied the oral and nasal cavities were cleared for only 30 secs each. At the end at the 2nd minute thoracic compression was released and a deep inspiration occurred. After five minutes the radioactivity remaining after suction was documented using a gamma-camera. We attempted to answer the following questions: How much mucus could be extracted with each different method, and where the remaining amount was later distributed? Nasal suction alone was found to be inefficient; using this route an average of 13% (only an eight of the amount instilled) could be removed. Oral suction led to the recovery of an average of 52% of the material instilled, the combined technique much as 56%. After re-establishment of spontaneous respiration, it could be clearly seen that, independent of the efficacy of the technique used, the majority of the remaining radioactivity (55 relative percent) is localized in the head and neck area. Absolute values are 45% for nasal suction, 26% for oral, and 24% for the combined oro-nasal route. The other part of the remaining radioactivity was found in the lung or in the stomach. It must be pointed out that the aspirate need not be disturbed in both of the parts, both the stomach and the lungs can be solely involved. Five minutes after spontaneous respiration had been resumed the lungs revealed only a centrally distributed radioactivity. This corresponds anatomically to the trachea and major bronchi. The peripheral area of the lungs was free of aspirate at this point in time.(ABSTRACT TRUNCATED AT 400 WORDS)

Airway Obstruction↗
PubMed1984

[Animal experiment study on the modification of increased intracranial pressure by THAM (tris-hydroxymethylaminomethane) and sodium bicarbonate].

Intracranial pressure was increased by means of an epidural balloon in 21 young pigs anaesthetised with air/O2 and burprenorphine. Sodium bicarbonate (1 mmol/kg BW) was administered intravenously in 10 animals; THAM (tris-hydroxymethylaminomethane) (1 mmol/kg BW), in 11. Intracranial pressure declined significantly under THAM, from 4.35 kPa in the middle of the infusion to 3.92 kPa at the end, and continued to drop for 15 minutes after its termination. No changes in intracranial pressure, however, were observed in the bicarbonate group. Since mean arterial blood pressure was unchanged in both groups, the increase in cerebral perfusion pressure was significant in the THAM group, but not in the bicarbonate group. Our results, therefore, indicate that THAM is preferable to bicarbonate for correcting acidosis in acute craniocerebral trauma. Controlled ventilation, however, remains indispensable.

Animals↗
PubMed1984

[Abdominal compression and PEEP respiration during cardiopulmonary resuscitation].

Three different resuscitation techniques were assessed by monitoring haemodynamic, respiratory, and cerebral parameters in 12 pigs of average body wt. (29 kg) following electrically induced cardiac arrest. All three techniques were carried out in randomised sequence, each for ten minutes, on each of the 12 animals. I = interposed ventilation and thoracic compression; S = simultaneous ventilation and thoracic compression; SA = simultaneous ventilation and thoracic compression plus abdominal binding 100 mm Hg. A compression rate of 60/min and ventilation rate of 12 min were used for each of the three techniques. 6 animals were ventilated with ZEEP for the whole of the 30 min observation period, the remainder with a PEEP of 5 cm H2O. In both ZEEP and PEEP groups the highest blood pressure and carotid artery flow rates were observed with the "SA" technique. PEEP ventilation and abdominal binding was found to be the most effective combination. Despite a rise in intracranial pressure, cerebral perfusion pressure rose when abdominal binding was applied. The CO2-production and arterio-venous oxygen difference of both ventilation groups were not significantly influenced by the different techniques. Even the technique "SA" did not markedly influence gas exchange or acid-base parameters. Despite an increase in the arterial base deficit and lactate levels during the course of resuscitation, the arterial pH did not fall below initial values because of the low paCO2. The positive effect of abdominal binding is a result of increased intrathoracic pressure, an increase in the effective circulating blood volume, and redistribution of blood flow.

Abdomen↗
PubMed1984

[Acute coronary insufficiency during induction of anesthesia following anthracycline chemotherapy].

Cytostatic treatment with anthracyclines lines can lead to acute or chronic myocardial insufficiency. A cumulative dose of less than 500 mg/m2 body surface area can in general be regarded as safe. A case of acute cardio-circulatory insufficiency during induction of anesthesia is described, in which the total cumulative dose did not exceed 250 mg/m2 body surface area. The pathophysiological mechanisms occurring and the diagnostic and therapeutic measures necessary are discussed.

Anesthesia↗
PubMed1984

[Elevation of the upper part of the body in acute craniocerebral traumas. Possibilities and limits of intensive therapy].

13 cases of severe cerebral trauma were subjected to varying degrees of elevation of the upper trunk (0 degrees, 15 degrees, 30 degrees, 45 degrees) and to head-raising only (0 degrees, 15 degrees, 30 degrees). The intracranial pressure and mean arterial pressure were measured in these positions. On raising the upper half of the body by 15 degrees, intracranial pressure fell from a mean of 35.3 mm Hg to 28.7 mm Hg, and to 25.2 mm Hg on raising to 30 degrees. Further elevation to 45 degrees resulted in an increase in pressure. In contrast, the mean arterial pressure fell constantly as elevation increased, resulting in a decrease in cerebral perfusion pressure at levels above 30 degrees. In no cases did raising of the head alone result in a lowering of pressure. Instead, potentially dangerous increases were observed.

Adolescent↗
PubMed1984

[Animal experiment study on intracranial pressure, after ketamine administration].

The action of ketamine on intracranial pressure in the presence of haemorrhagic shock, at both the dosage levels used for emergency cases and for in-patient treatment, was investigated using an animal model. Haemodynamically stable animals with a normal or raised intracranial pressure served as a control group. All animals were normoventilated. No rise in intracranial pressure was observed with either 0.5 or 2.0 mg/kg body weight of ketamine in those animals with normal, or in those with a raised pressure. This applied to both the haemodynamically stable animals, and to those in haemorrhagic shock. This finding is probably due to the fact that PCO2 levels did not rise under the controlled ventilation.

Anesthesia, Intravenous↗
PubMed1983

[Coagulation disorders in acute cranio-cerebral injuries].

Marked coagulation defects which have a very high mortality rate can arise following acute head injury. Damage to brain tissue leads to the release of substances promoting coagulation which can enter the vascular system and activate the enzyme cascade leading to clot formation. The more widespread cerebral damage is, the greater is the likelihood of clinically relevant DIC occurring. By carrying out clotting tests and taking therapeutic measures where necessary, a potentially lethal outcome can be avoided.

Acute Disease↗
PubMed1983

[Management of anesthesia for the multiply-injured patient with associated craniocerebral injuries].

Adequate anaesthesiological care of polytraumatized patients with associated craniocerebral trauma has the primary objective of preventing secondary cerebral damage. To this end, it is absolutely necessary to be aware of the physiology and pathophysiology of intracranial pressure, cerebral perfusion pressure and cerebral blood flow. The effects on these parameters of physiological feedback parameters, as well as anaesthesiological measures and the drugs used, are discussed.

Anesthesia↗
PubMed1981

[Practical-clinical aspects in primary clearing of the upper respiratory tract in newborn (author's transl)].

There are contradictory descriptions in the literature about the methods as well as the sequence of clearing the upper respiratory tract of new-born babies. In order to clarify this problem anatomical, physiological and pathophysiological aspects of the fetal and neonatal respiratory system are described. Intrauterine asphyxia can lead to aspiration of amniotic fluid (containing meconium, squamous epithelium, lanugo hair). During delivery the fetal airway is cleared by compression of the thorax. Through suction of the mouth, throat and nose--in exactly this defined sequence--before birth of the thorax, aspiration of potentially damaging material can be prevented. The particular problem associated with meconium-steined amniotic fluid is described.

Amniotic Fluid↗
PubMed1976

[Bronchial carcinoids (author's transl)].

Of 35 patients with bronchial carcinoids seen at the Kantonsspital Zürich during 16 years, 33 underwent an operative resection. The endoscopic resection is not recommended because of the risk of hemorrhage recurrence, and that this operation results in only partial removal of carcinoids which develop extrabronchially. It is concluded that bronchial carcinoids are potentially malignant tumours and that resection should be most radical if they show recurrence, invasive growth or metastases. Controls are necessary for a long period of time because even in presence of metastases the growth is very slow.

Adolescent↗