Search PubMed⌕ Search

Biomedical subjects

E Vandermeersch

Publications and source records attributed to E Vandermeersch.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Safe intra-clinic transport of intensive-care patients. A concept that avoids monitoring and treatment gaps].

We describe a transport concept ensuring unlimited continuation of cardiocirculatory monitoring, drug therapy and artificial ventilation during transfer of critically ill patients within the hospital. The basis of this concept is a mobile transport unit which can be hooked to the patient's bed, containing a power pack for the monitor, respirator or other devices dependent on power supply. The concept probably improves safety of patients not only during postoperative transfer of the ICU but enables also the safe transfer of critically ill patients from the ICU to diagnostic or therapeutic procedures.

Critical Care↗
PubMed1991

The persufflator: an insufflation device for laparoscopy and especially for CO2-laser-endoscopic surgery.

A new insufflation device for laparoscopic surgery has been developed which permits the persufflation of the abdominal cavity with humidified CO2 at 37 degrees C, with flow rates of 4 l/min/mm of mercury (3 l/min/cm of water) insufflation pressure, i.e. 60 l/min for an insufflation pressure of 15 mm of mercury (20 cm of water). The device consists essentially of an operative laparoscope with a large side opening of 7 mm internal diameter, and a pressure valve limiting the insufflation pressure. The device is safe, since the intraabdominal pressure can never exceed the insufflation pressure. The device has been extensively tested in greater than 500 CO2-laser-endoscopic procedures and has proven to be safe and useful. Smoke can be constantly removed and the pneumoperitoneum is unaffected even by the removal or leakage of large volumes of CO2 from the pneumoperitoneum.

Endoscopes↗
PubMed1991

Cardiodynamic effects of propofol in comparison with thiopental: assessment with a transesophageal echocardiographic approach.

In 40 patients, the cardiovascular effects of low- and high-dose propofol anesthesia (single bolus of 1.5 mg/kg in group A, 2.5 mg/kg in group C) were examined and compared with those of low- and high-dose thiopental (4 mg/kg in group B, 6.5 mg/kg in group D) (n = 10 patients per group). After induction of anesthesia with etomidate, all patients were ventilated with 70% nitrous oxide in oxygen. Peripheral arterial systolic blood pressure (SAP) and transesophageal echocardiographic short-axis measurements were used to calculate the end-systolic pressure-volume relationship (E) as an index of global myocardial contractility. In all groups SAP decreased significantly below baseline levels for the duration of the measurements (15 min after drug administration), except for the lower dose of thiopental, where SAP returned to baseline values within 10 min. Propofol at a dose of 1.5 mg/kg significantly decreased cardiac output (CO) (from 5.1 +/- 0.25 [mean +/- SEM] to 4.2 +/- 0.23 L/min), stroke volume (SV) (from 64 +/- 3 to 56 +/- 3.6 mL), and the slope of E (from 71 +/- 3.5 to 65 +/- 4.2 mm Hg/mL) until 4 min after drug administration. The higher dose of propofol significantly decreased CO (from 5.1 +/- 0.29 to 4.1 +/- 0.26 L/min), SV (from 64 +/- 3 to 52 +/- 4.6 mL), and the slope of E (from 71 +/- 3.6 to 62 +/- 3.7 mm Hg/mL) until 10 min after drug administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[CSE--the combination of spinal and epidural anesthesia].

The availability of very fine-bore, long spinal needles (28/10 Ga) has stimulated a new wave of interest in the technique of combined spinal-epidural anesthesia. The original double-puncture technique has progressed due to special combination needles to the current spinal-needle-through-epidural-needle technique. The availability of adapted Tuohy needles, special combination sets, and long spinal needles indicates a lack of standardization. An appropriate introduction technique via Tuohy needle allows identification of the anatomic landmarks and contributes to successful anesthesia. The spinal component allows a rapid onset and intense analgesia with appropriate muscle relaxation. The epidural catheter allows the administration of agents into the epidural space as well as optimization and prolongation of analgesia in the postoperative phase. Confirming the position of the epidural catheter introduced after spinal anesthesia has been established remains a matter of concern.

Anesthesia, Epidural↗
PubMed1990

Postanesthetic care unit (P.A.C.U.). A necessity for every hospital.

It is of primary importance that all patients awaking from anesthesia are followed in a recovery room. A number of recent publications show clearly that approximately 10% of all anesthetic accidents occur in the recovery period. The most recent study from Buck, Devlin and Lunn shows that most postoperative complications occur during "off hours". Because of inadequate staffing in a great number of hospitals the recovery room is closed at noon and it is not possible to bring all the patients who will then be operated upon to the intensive care unit postoperatively. Besides that, during the last years there is an enormous increase in the number of more serious surgery and also in the number of older and sicker patients. This results in an increasing number of patients requiring postoperative ventilation as medication to support their circulation. Furthermore there is also a new trend for postoperative pain control with continuous epidural administration of local anesthetics and narcotics. This very efficient method of pain control demands closer observation since respiratory depression can occur. In most hospitals, the number of intensive care beds is too small to accommodate the increasing number of those patients. Therefore the original recovery room is gaining a new dimension. It must function now as an intensive care unit setting for short stays. The name "recovery room" is changed into "postanesthetic care unit" (P.A.C.U.).

Age Factors↗
PubMed1989

Propofol does not inhibit hypoxic pulmonary vasoconstriction in humans.

The influence of increasing doses of propofol (from 6 to 12 mg/kg/h by continuous infusion) on hypoxic pulmonary vasoconstriction was studied in 10 patients prior to thoracic surgery. All patients were intubated with a left-sided double-lumen endobronchial tube. Initial anesthesia and muscle relaxation were accomplished by administering fentanyl, droperidol, and pancuronium. After 100% oxygen ventilation of both lungs for 20 min in a lateral decubitus position, the nondependent lung was deflated and one-lung ventilation was started. The dependent lung was continuously ventilated with 100% oxygen. Twenty minutes after the start of one-lung ventilation, propofol at an IV infusion rate of 6 mg/kg/h was added to the anesthetic technique. Thirty minutes later it was increased to 10 mg/kg/h and another 15 min later to 12 mg/kg/h. Then the propofol infusion was stopped. Thirty minutes later, two-lung ventilation was restarted to compare initial values. No changes in venous admixture or PaO2 were observed during propofol infusion. There was no change in any respiratory or circulatory variables except systemic vascular resistance, which decreased significantly immediately after the propofol infusion commenced but returned to control values 15 min later for the rest of the observation period. After reestablishing two-lung ventilation, all variables did not differ from control values. In all patients, the hypoxic pulmonary vasoconstriction reflex was present after institution of one-lung ventilation and was not abolished after administration of propofol in doses from 6 to 12 mg/kg/h.

Aged↗
PubMed1989

Accidental epidural administration of a high dose of sufentanil.

Epidural sufentanil infusions are routinely used for post-operative analgesia after high-abdominal and thoracic surgery in our hospital. The erroneous administration of a bolus of 250 micrograms of sufentanil epidurally was followed by a 24 hour episode of deep analgesia and respiratory depression. The recovery from respiratory depression over a 27 hour period is described.

Aged↗
PubMed1989

Does nitrous oxide affect the hemodynamic effects of anesthesia induction with propofol?

Anesthesia was induced in 20 patients, ASA physical status I and II, with either propofol (2.5 mg.kg-1), vecuronium (100 micrograms.kg-1), and 100% oxygen (Group A), or with equal doses of propofol and vecuronium but with 70% nitrous oxide in oxygen (Group B). All patients were premedicated with lorazepam 2 mg orally. In both groups systolic arterial pressure decreased after 3 minutes (P less than 0.05) due to decreases in cardiac output and stroke volume (P less than 0.05). Systemic vascular resistance in both groups did not change immediately after administration of propofol but increased (P less than 0.05) following intubation. Addition of nitrous oxide did not alter hemodynamic parameters associated with propofol induction.

Anesthetics↗
PubMed1989

Peroperative anisocoria after extravasal loss of i.v. fluids in the neck.

A case is presented of a patient who developed unequal pupils peroperatively after extravasal loss of IV fluids in the neck. The reason for this loss was a malpositioned catheter near the internal jugular vein. Causes of peroperative anisocoria are discussed, and a new explanation is proposed for this particular case.

Adult↗
PubMed1989

Pharmacokinetics of propofol during continuous infusion for pediatric anesthesia.

The blood concentrations of propofol have been examined during anesthesia by continuous infusion of 12 mg/hg/hr. A bolus dose of 3 mg/kg body weight propofol was used to induce anesthesia. The mean concentrations at apparent steady state were in the range of 4.3 to 5.6 micrograms/ml during the infusion. The mean total body clearance, derived from the apparent steady state concentrations in the blood, was 0.0394 litres/kg/minute. The mean propofol blood concentration at awakening was found to be 2.3 micrograms/ml.

Anesthesia, Intravenous↗
PubMed1988

No decisive break-through yet for general anesthesia combined with locoregional anesthesia!

Although on theoretical grounds locoregional anesthesia, because of the claimed suppression of stress response and the ease with which prolonged analgesia can be achieved, seems preferable to general anesthesia, the shortcomings and drawbacks are such that its use is restricted to well chosen indications. The hope that combination anesthesia can overcome the limitations of both techniques remain to be proven whereas the problems that can arise during the combined technique could pose a major threat to the patient.

Anesthesia, Conduction↗
PubMed1988

[A new mobile respiration and monitoring system for transporting critically ill patients].

This article introduces a compact versatile system that can be used when transporting high-risk patients. The equipment can be coupled to a standard hospital bed. An instrument carrier device mounted on rollers which is independent of the medical equipment manufacturer can take up every kind of storage-battery driven apparatus required for monitoring, infusion therapy and continuous drug supply, as well as an artificial respiration unit with sufficient O2 for more than 20 hours of artificial respiration. The entire setup occupies a minimum of space.

Beds↗
PubMed1987

Anesthesia for trauma.

Anesthesia of polytraumatized patients represents a considerable risk for them. The proper treatment of a polytraumatized patient comprises the rapid stabilisation of all his vital functions. At the same time, the attempt must be made to achieve a complete picture of all his injuries in order to be able to select a reliable and safe anesthetic procedure. Over and beyond this, a continuation of all intensive care measures, in particular the optimalization of blood volume, the maintenance of gas exchange, the support of the cardiac, and the balancing of the acid-base and electrolytes, is of the greatest importance for an effective treatment of the polytraumatized patient.

Acid-Base Equilibrium↗
PubMed1987

Anesthetic management of aortic trauma.

Most of the increasing number of ruptures of the thoracic aorta are caused by traffic accidents. Only a minority arrive sufficiently in time at the hospital to receive medical attention. The diagnosis is very difficult to make both on clinical and radiologic findings alone. An aortography is necessary when there is the slightest suspicion of aortic lesion. The lesions are mostly found in the isthmic region of the descending aorta. This and other localisations are easily explained when some specific anatomic, mechanical and congenital factors are considered. Surgical repair should be carried out in all cases as fast as possible. During repair attention must be directed toward the prevention of kidney and spinal cord injury and equally to prevent proximal hypertension and overload during clamping of the aorta.

Aorta, Thoracic↗
PubMed1987

A comparative study between midazolam and thiopental alone or with analgesic and neuroleptic as intravenous induction agents in general anesthesia.

We compared midazolam with thiopental both in association with saline, fentanyl and fentanyl with droperidol for induction of anesthesia. Our data show that the administration of fentanyl or fentanyl and droperidol before midazolam improves the induction to reach almost the quality of a thiopental induction. No difference in cardiocirculatory effects between midazolam and thiopental was found.

Adult↗
PubMed1986

Comparison of intramuscular buprenorphine and a buprenorphine/naloxone combination in the treatment of post-operative pain.

The analgesic efficacy and tolerance of a single intramuscular injection of either buprenorphine (0.3 mg) or a buprenorphine (0.3 mg)/naloxone (0.2 mg) combination was compared in 70 patients suffering from moderate to severe pain after abdominal surgery. Patients in both treatment groups experienced good analgesia which was apparent within 10 minutes of administration and lasted for approximately 12 hours. The most frequently reported unwanted effects were drowsiness and/or sleepiness and nausea and/or vomiting which were of mild or moderate severity in most cases. No significant differences were seen between the two treatment groups with regard to the overall assessments of efficacy and tolerance.

Adult↗