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Biomedical subjects

E Schleussner

Publications and source records attributed to E Schleussner.

31 records · Page 2Linked to original sources
PubMed1981

[Cardiac and vascular effects of midazolam during induction of anesthesia prior to and during extracorporeal circulation in coronary-surgical patients (author's transl)].

8-Chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a] [1,4]benzodiazepine (midazolam, Ro 21-3981, Dormicum) is a new benzodiazepine which, when compared with its predecessors diazepam (Valium) and flunitrazepam (Rohypnol), has several outstanding advantages: We conducted hemodynamic investigations with 0.15 mg/kg b.w. midazolam in a total of 28 coronary patients divided into 3 groups. The new water-soluble benzodiazepine is at the dose given useful in the induction of and as an adjuvant to anesthesia because of its hemodynamic effect.

Anesthetics↗
PubMed1981

[Comparative clinical investigations on the cardiovascular effects of piritramide (dipidolor) and fentanyl (author's transl)].

In 36 patients with acquired heart disease effects of 0.15 mg/kg piritramide on hemodynamics, inotropic state and myocardial oxygen consumption were investigated during and after cardiac surgery (basic neuroleptanalgesia). It could be demonstrated, that piritramide is not inducing any negative inotropic effects compared to a control group (n = 36) and a fentanyl group (0.003 mg/kg, n = 31). There were only small changes in HR, SV, PRA and PLA. A slight decrease in Part, PLV, and arterial perfusion pressure during extracorporeal circulation is interpreted as a peripheral vasodilatation. The resulting decrease in heart work caused a significant decrease in myocardial oxygen consumption (-18%), which is of special advantage in patients with coronary heart disease.

Anesthesia, General↗
PubMed1981

[Haemodynamic effects of morphine in man (author's transl)].

In 52 patients with acquired heart disease haemodynamic effects of 0,2 mg/kg and 1,0 mg/kg morphine were investigated during surgical procedures under neuroleptanalgesia. The following parameters were measured or calculated: heart rate (HR), arterial pressure (Part, Psyst, Pdiast), pulmonary artery pressure (PAP), right (PRA) and left atrial pressure (PLA), left ventricular pressure (PLV), left ventricular end-diastolic pressure (PLVED), left ventricular peak dp/dt (dp/dtmax), cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke index (SI), total systemic resistance (TSR), total pulmonary resistance (TPR), work index of the right (RVWI) and left ventricle (LVWI). Myocardial oxygen consumption (EG) was calculated according to the method of Bretschneider. There was almost no change in cardiac index and stroke index. In comparison to a control group (n=36) morphine caused a dose-dependent decrease in arterial pressure and in arterial perfusion pressure during extracorporeal circulation. This, however, was mainly attributable to vasodilatation and not to a negative inotropic effect. In accordance with the changes in haemodynamics there was a remarkable decrease in myocardial oxygen consumption (EG: -21.1%; 1,0 mg/kg morphine).

Adult↗
PubMed1980

[The effects of dihydroergotamine on volume content and compliance of the extrathoracic capacitance vessels of man under anesthesia during extracorporeal circulation in hypothermia (author's transl)].

The influence of dihydroergotamine on volume content and compliance of the extrathoracic capacitance vessels during extracorporeal circulation was investigated. Compared with an untreated control group the compliance decreased (0.44 ml/mm Hg/kg b. wt.) and 490 ml of blood was mobilized and shifted from the circulation into the blood reservoir of the machine. Therefore DHE counteracts the effects of venous pooling.

Anesthesia, General↗
PubMed1980

[The effects of dihydroergotamine on the circulatory system of man during neurolept analgesia (author's transl)].

The effect of 0.015 mg/kg KHE i.v. on the circulatory system was investigated in 10 patients after closure of an atrial septal defect under neuroleptanalgesia. The arterial pressure increased due to an increase of total systemic resistance. The filling pressures of the right and the left ventricle increased while the stroke index remained unchanged. The maximal rate of rise of left ventricular pressure did not change despite the marked changes of pre- and afterload. The data support the drug mechanism of a volume shift from the peripheral to the central circulation. The possible reasons for the missing stroke index increase are discussed.

Adult↗
PubMed1978

[Comparison of cardiac and vascular effects of sulfentanil (R 30730), a new analgetic, and fentanyl (author's transl)].

In 31 patients with congenital or acquired heart disease, functional class III NYHAC, effects of Sulfentanil (R 30730)--a new analgetic--on hemodynamics, inotropic state and myocardial oxygen consumption have been investigated intraoperatively, during extracorporeal circulation and postoperatively. Results are compared to a fentanyl-group and control-group. There was almost no change in cardiac index and stroke index. In comparison to fentanyl (dose relation fentanyl: sulfentanil = 10:1) there was a more pronounced decrease in aterial pressure, left ventricular pressure, peak dp/dt and myocardial oxygen consumption (-20%) in the sulfentanil-group. In contrast to the fentanyl-group there was, however, no increase in total pulmonary resistance with sulfentanil.

Adult↗
PubMed1978

[Cardio-circulatory effects of aminophylline (Euphyllin) (author's transl)].

In 24 patients with congenital or acquired heart disease, functional class II--IV New York Heart Association Classification, effects of aminophylline on hemodynamics have been investigated intraoperatively, during extracorporeal circulation and postoperatively. Aminophylline caused a decrease in arterial pressure, left ventricular pressure, right and left atrial pressure, total systemic resistance and total pulmonary resistance. At the same time there was an increase in heart peak, peak dp/dt, cardiac index and stroke index. Our results demonstrate beneficial cardiac and extracardiac effects of aminophylline in man.

Adult↗
PubMed1978

[Effects of calcium gluconate and calcium chloride on cardiocirculatory parameters in man (author's transl)].

In 44 patients with congenital or acquired heart disease, functional class II--IV NYHAC, the effects of calcium gluconate (10 ml 10%) and calcium chloride (10 ml 5.5%) on hemodynamics, inotropy and myocardial oxygen consumption were investigated during and immediately after cardiosurgical procedures. There was a significant increase in blood pressure, left ventricular pressure, total systemic resistance, cardiac index, stroke index, peak dp/dt and myocardial oxygen consumption as well as in arterial perfusion pressure during extracorporeal circulation due to i.v.-injection of either one of the drugs. The positive inotropic effects were more pronounced after application of calcium chloride. In emergency situations during anaesthesia or resuscitation, therefore, calcium chloride seems to be of more advantage than calcium gluconate.

Calcium Chloride↗
PubMedDate not supplied

[Nitroglycerin patch for tocolysis--a prospective randomized comparison with fenoterol by infusion].

OBJECTIVE: To evaluate tocolytic efficacy of transdermal glyceryl trinitrate (GTN) in comparison to fenoterol per infusionem in a prospective randomized multicenter study. PATIENTS AND METHODS: 50 pregnant women between 27 and 35 weeks of gestation with preterm labour were treated with either GTN patches (0.4-0.8 mg/h) or fenoterol per infusionem (60-120 micrograms/h) up to stop of contractions or 35 weeks in maximum. The primary outcomes were the prolongation of gestation by 48 h, 7 days or up to 37 weeks of gestation as well as the neonatal outcome. The progression of cervical ripening and maternal side effects during tocolysis were assessed as secondary outcome criteria. RESULTS: There was no difference in successful tocolysis for 48 h and 7 days in both groups, whereas significantly more women passed 37 weeks after GTN therapy. So mean duration of pregnancy, birth weight and height were greater, whereas transfer into neonatal care unit was significantly rare after GTN. There were no differences in neonatal outcome and progression of cervical ripening during tocolysis. Maternal side effects during GTN were fewer and weaker compared with fenoterol. Circa 70% of GTN treated women had a headache temporary, whereas more than 90% of the patients with fenoterol suffered from tachycardia and tremor. CONCLUSIONS: Tocolytic efficacy of transdermal GTN was at least equivalent to the established beta-mimetic therapy with fenoterol. Because of the lower preterm delivery rate transfer into neonatal care for control was significantly rarer after GTN with equally good neonatal outcome in both groups. Beside the headache transdermal GTN therapy had lower maternal side effects in comparison to fenoterol.

Administration, Cutaneous↗
PubMedDate not supplied

Doppler measurements in fetoplacental vessels after maternal betamethasone administration.

OBJECTIVE: To observe the influence of maternal betamethasone administration for fetal lung maturation on the arterial, venous and intracardiac blood flow of the fetus and the uterine arteries. METHODS: Twenty-seven women with singleton pregnancies were examined before the first, and 30 min and 8, 24, 48 and 72 h after the second of two single doses of 8 mg of betamethasone. We recorded blood flow velocity waveforms of the umbilical artery (UA), the middle cerebral artery, the uterine arteries, the ductus venosus, the inferior vena cava and the right hepatic vein, the pulmonary trunk, the ductus arteriosus and the right and left intraventricular inflow of the heart. RESULTS: The resistance index of the UA showed a significant transient decrease 30 min (p = 0.024) after the second betamethasone dose. The peak systolic velocity of the ductus arteriosus increased significantly 30 min after the 2nd dose (p = 0.009) and then returned to non-significant values. No significant change was observed in any of the other vessels. CONCLUSION: Betamethasone causes short-term changes in fetal blood flow. However, this effect seems to be mild and reversible and does not appear to contraindicate the use of corticosteroids to promote fetal lung maturation.

Arteries↗
PubMedDate not supplied

Choriocarcinoma-induced suppression of lymphocyte activity.

The aim of the investigation was to study the influence of human choriocarcinoma cell culture supernatants (HCS) on the expression of lymphocyte surface molecules. Lymphocytes were stimulated with phytohemagglutinin in culture medium supplemented with 50% HCS. After 12 h and 60 h, fluorescence-activated cell sorter analysis was performed with specific monoclonal antibodies. After 12 h of incubation, the cell surface expression of the classical activation markers CD25, CD69, CD71, CD134 and CD3/HLA-DR, as well as of the apoptosis marker CD95 were significantly suppressed by HCS. Qualitatively similar results were obtained after 60 h. It was concluded that choriocarcinoma-induced suppression might be related to a nearly complete block in the cell cycle at early activation steps. The clinical and biological relevance of this phenomenon for the maternal-fetal tolerance are briefly discussed.

Adult↗