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Biomedical subjects

G Benad

Publications and source records attributed to G Benad.

At least 37 records · Page 2Linked to original sources
PubMed1994

[LEVEL 1--a new blood warming device].

Hypothermia of less than 35 degrees C, which frequently occurs in connection with massive blood transfusion, is a serious problem in many patients, in particular in those with polytrauma. The restoration of normal body temperature is very important and requires the use of a rapidly-acting, efficient and safe blood warmer, which is able to work effectively at high flow-rates. The LEVEL 1 (Technologies, Rockland, MA) is such a new blood warmer and works as a heat-exchanger via an aluminium column. This system is highly effective. Six hundred ml of sodium chloride 0.9% are warmed from 4 to 35 degrees C within one minute. This device is quickly operational and has a low priming volume. The LEVEL 1 is the only device currently available which is able to warm blood sufficiently during a very rapid blood transfusion.

Blood Component Transfusion↗
PubMed1992

[The treatment of status asthmaticus using ketamine--experimental results and clinical experience].

Intensive therapy of a patient with status asthmaticus must lead to a reduction of vital threat by improving respiratory and cardiac functions. Because of the bronchodilating effect of ketamine, analgesic sedation with ketamine and benzodiazepines is extremely useful for prolonged ventilation. At the beginning of this treatment it can be necessary to supplement the continuous intravenous infusion of ketamine and diazepam or ketamine and midazolam with small bolus doses of up to 3.5 mg/kg/h of ketamine. Experience has shown that the combination of ketamine and midazolam has better controllability. In some of our patients the bronchodilating effect of ketamine was not sufficient and therefore ventilation with halothane was necessary at least intermittently. In contrast to halothane, ketamine can be combined with vasodilators and sympathomimetics as our own experience has shown. The combined application of ketamine with glycerol trinitrate or sodium nitroprusside is indicated in the event of pulmonary or general hypertension. The use of sympathomimetics--mainly beta-sympathomimetics--antagonizes the negative inotropic effect of ketamine, improves the circulatory system and leads to a direct bronchodilating effect. Progress in treatment was mainly achieved by continuous intravenous infusions of terbutaline (Bricanyl). Aminophylline is very compatible with ketamine, but because of its stimulating effect the use of aminophylline seems to be reasonable only during weaning from the ventilator. Control of the usually deep analgesic sedation and an accompanying optimum drug therapy are only possible with complete cardiorespiratory monitoring including invasive blood pressure measurement and catheterization of the pulmonary artery. In our clinic 24 patients with status asthmaticus were treated. Sixteen asthmatic patients were treated with analgesic sedation using ketamine and benzodiazepines, three of them without intubation and ventilation. In spite of the life-threatening situation and reanimation before admission to the intensive care unit, only one patient died. Our experience has shown that intensive therapy including analgesic sedation with ketamine and benzodiazepines, optimized by application of sympathomimetics and vasodilators, is suitable for overcoming the life-threatening situation of patients with status asthmaticus.

Animals↗
PubMed1989

[A successful prolonged resuscitation following mitral valve replacement--a case report].

Based on a case report a successful resuscitation lasting 2 hours and 28 minutes is described and discussed. This case report demonstrates that particularly with cardiosurgical patients the recently fixed "Do not resuscitate order" is hardly to be taken into account. If the absolute criteria for breaking off the resuscitative measures are not present, resuscitation should be continued regardless of its duration.

Heart Arrest↗
PubMed1987

[Catheter problems in the use of ventricular cardiovascular assist systems].

The prerequisite for efficient assist-ventricles and impulses in the pulsatile pumping function are sufficiently dimensioned afflux and flowing off connections. In systematic investigations on the hydraulic circulation model the cannulas from an internal parameter of 12 mm with a total length of the connection distance to the inflow and outflow valve, respectively, at the bypass ventricle of 30 cm proved sufficient for performing a volume of output of 5-6 l/min in clinic-relevant filling pressures in a hypodynamic circulatory situation. Connection cannulas for the heart-lung machine used in routine work are not sufficient in periodic filling and ejection processes in the pulsatile pumping function for an effective decompression and effective increase of the cardiac output. In case of an ECG-triggered mode of action of the ventricular assist-system an increase of frequency up to 130/min in after that incomplete filling of the assist-ventricle does not remarkably restrict the effectiveness of the assist-system.

Assisted Circulation↗
PubMed1987

Comparison of atracurium, pipecuronium, and vecuronium for tracheal intubation.

In order to compare tracheal intubation conditions, 34 adult patients about to undergo elective surgery received at random atracurium 0.5 mg X kg-1, pipecuronium 0.1 mg X kg-1 or vecuronium 0.1 mg X kg-1, intravenously. Intubation was attempted when only the first of the train-of-four finger contractions, arising from ulnar nerve stimulation, remained. The three relaxants provided effective conditions for intubation. The time required to suppress all but the first train-of-four response was shortest in the group given atracurium (P less than 0.05). Compound muscle action potentials (emg) were continuously filmed from just before induction of anesthesia until the trachea was intubated. The degree of neuromuscular blockade was similar in the three study groups.

Action Potentials↗
PubMed1986

[Anesthesiologic problems in endoscopic interventions of the respiratory organs].

In 28 patients--16 normotensive and 12 hypertensive patients--anaesthetized with hexobarbitone, halothane, nitrous oxide/oxygen and intermittent doses of suxamethonium we examined the influence of diagnostic bronchoscopy on arterial blood pressure, heart frequency, rate pressure product as well as acid-base balance and arterial oxygen partial pressure. Both groups of patients showed a remarkable and highly significant increase in these hemodynamic parameters during intubation, extubation and bronchial lavage. Clinically relevant changes of acid-base balance and arterial oxygen partial pressure which could be responsible for these hemodynamic reactions did not occur. Sympathicotonic reflexes caused by the bronchoscopy are considered to be the main causes for the increase in blood pressure, heart frequency and rate pressure product. They can only be prevented by a sufficient narcosis depth.

Acid-Base Equilibrium↗
PubMed1984

[The Rostock artificial heart--current status and perspectives].

The authors report on their experiences gained by animal experiments (calf) and their attempts (human corpses) concerning adaptation of the apparatus to the human thorax. At the present time they do not see a chance for its routine clinical use. The main reason why is the impossibility to install the extrathoracic driving system into the thoracic cage and last not least the wear of the material used for the heart chambers.

Animals↗
PubMed1982

[Experiences with the Rostock artificial heart].

A totally artificial heart--the Rostock totally artificial heart (Rostock TAH) was implanted in calves. We can give the following deductions after 27 examinations: -- The Rostock TAH was tested successfully in endurance test about 7 months; it show no sign of wear. -- The surgical technique of the implantation was standardised and a successful experimentation is possible. -- The longest survival time was 15 days. The hemodynamic early results were very good in 3 other animals. -- Modifications of the Rostock TAH were taken up relating to the dimensions of the artificial ventriculi and by mounting a screw cap for avoiding an air embolism. -- Adaption tests in the corpse show that the present form of the artificial heart is not ideal for a possible application in man. -- The problem is still existing in developing a suitable drive system locates intrathoracically. The present drive and control system on a pneumatic base is qualified only for the animal experiment but not for a possible application in man.

Anesthesia, General↗
PubMed1979

[Concentrations of local anaesthetics and vasoconstrictor drugs (author's transl)].

By checking the list of local anaesthetics produced in the GDR containing vasoconstrictor drugs it could be proved that there exist disproportions concerning maximum concentrations and maximum doses of the local anaesthetic on the one hand and epinephrine as well as norepinnephrine concentration on the other. This dangerous situation could be changed on initiative of the Society of Anaesthesiology and Reanimation of the GDR.

Anesthetics, Local↗