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Biomedical subjects

F T Padberg

Publications and source records attributed to F T Padberg.

61 records · Page 4Linked to original sources

Fibrinolytic therapy.

Fibrinolytic therapy is a useful addition to the armamentarium of most clinicians. Patients with fibrin-based intraluminal clots are seen by almost all physicians. With proper patient selection and careful physician adherence to dosage schedule and monitoring, the incidence of significant complications with fibrinolytic agents is about the same as with heparin therapy. Heparin stops the thrombotic process, whereas fibrinolytic therapy not only stops the thrombotic process, but often reestablishes a normal, hemodynamic state. Patients who undergo fibrinolytic therapy are spared long-term problems like amputation and the postphlebitic syndrome.

Arterial Occlusive Diseases↗

Comparison of heated-probe laser Doppler and transcutaneous oxygen measurements for predicting outcome of ischemic wounds.

Transcutaneous oxygen (TcPO2) measurement has proven to be an accurate means of predicting healing of ischemic wounds. This study compares the ability of TcPO2 and laser Doppler, modified by the addition of a heated probe (LDHP), to assess wound outcome. TcPO2 and LDHP measurements were made at the same site for 80 wounds, which consisted of 51 amputations (25 above knee, 6 below knee, 20 forefoot) and 29 ulcerations. Healing was defined as complete wound closure. Failure to heal was defined by the necessity for proximal amputation in 22 wounds (6 amputations, 16 ulcers). Outcome criteria were chosen to maximize accuracy and either positive or negative predictive values. Criteria with the greatest accuracy and positive predictive value for wound healing were > or = 11 mmHg for TcPO2 and > or = 50 mv for LDHP range. Criteria with the most appropriate accuracy and negative predictive value for wound failure were < 5 mmHg for TcPO2 and < 35 mv LDHP range. All wounds whose LDHP range was < 35 mv failed to heal, whereas some wounds with a TcPO2 of 0-1 mmHg healed successfully. An absolute prediction of wound healing (100% specificity and negative predictive value) was offered when either LDHP range was > or = 125 mv or TcPO2 was > or = 33 mmHg, although accuracy of either measurement at this criteria was unacceptable for more general application. We conclude that TcPO2 or LDHP will assess wound outcome with similar overall accuracy, although each test may be better for predicting a specific outcome.

Aged↗

Acute ischemia-reperfusion injury in the canine hindlimb.

A canine arterial ligation preparation was used to produce whole limb ischemia-reperfusion injury. Alterations in the distribution of arterial blood flow as well as the morphology of skeletal muscle ischemia-reperfusion have not been investigated completely in this setting. Five anesthetized adult mongrel dogs underwent multiple infrarenal aortic branch ligations; one randomly selected hindlimb was subjected to six hours of ischemia and two hours of reperfusion, while the opposite limb served as control. Distribution of arterial blood flow was analyzed by injection of radiolabeled microspheres. Electromagnetically measured femoral arterial blood flow was 92 +/- 10 ml/min during control, and increased significantly (p less than 0.05) to 254 +/- 94 ml/min during reperfusion. Flow distribution to skin, muscle, and bone was 9 +/- 2%, 68 +/- 7%, and 8 +/- 1% during control, and 7 +/- 3%, 65 +/- 8%, and 9 +/- 4% after reperfusion, which did not represent significant changes. Arteriovenous shunting was 11 +/- 4% during control, and was 13 +/- 5% during reperfusion, which was not significantly different. Subcellular injury in the ischemic and reperfused hindlimb was demonstrated by light and electron microscopy. These findings further characterize whole limb ischemia-reperfusion injury in the canine hindlimb.

Acute Disease↗