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Biomedical subjects

G Grimm

Publications and source records attributed to G Grimm.

At least 91 records · Page 5Linked to original sources
PubMed1987

[Specific therapy of acute benzodiazepine poisoning using flumazenil (Ro 15-1788)].

In 20 patients with coma (grade 4: n = 7, grade 3: n = 8, grade 2: n = 2, grade 1: n = 3) due to benzodiazepine intoxication, solely or combined with alcohol or other psychoactive drugs, the effect of a specific benzodiazepine antagonist, Flumazenil (Ro 15-1788), was evaluated. In terms of coma depth, 80% of the patients responded to application of 1.96 mg Flumazenil as a mean with immediate awakening or improvement of at least two steps in coma grading. In those 3 patients, who failed to respond to Flumazenil, the history revealed amitriptyline or barbiturates to be responsible for the comatose state. The observed side-effects of Flumazenil included increase (n = 4) or decrease (n = 3) of blood pressure, increase of heart rate (n = 7), cutaneous flush (n = 1) and ventricular extrasystoles (n = 1). Agitation and generalized convulsions, each observed in 1 patient, presumably were due to an acute benzodiazepine-withdrawal rather than an intrinsic side effect of the antagonist. In conclusion, Flumazenil proved to be a potent antagonist of benzodiazepines in patients with severe coma and even may serve as a valuable diagnostic in cases of suspected benzodiazepine intoxication.

Adult↗
PubMed1987

[Effect of high-dose prednisolone on lung fluid in patients with non-cardiogenic lung edema].

The influence of high-dose prednisolone on extravascular lung water (EVLW) was studied in a randomized trial in patients with noncardiac pulmonary edema. The patients were treated every 6 hours for 48 hours with 2 g of prednisolone-hemisuccinate or placebo. In the prednisolone-group (n = 7) EVLW decreased from 16.4 +/- 6.2 before to 11.8 +/- 5.1 ml/kg after treatment (p less than 0.05). Additionally alveolar-arterial oxygen gradient (AaDO2/FiO2), pulmonary vascular resistance and heart rate decreased, while arterial oxygen tension (PaO2/FiO2) and mean arterial pressure increased (p less than 0.05). In the placebo-group (n = 7) EVLW increased slightly from 17.5 +/- 3.1 before to 19.3 +/- 10.3 ml/kg after treatment. Additionally all other parameters did not change significantly in this group. Although no statistical significant difference was found between the two groups of treatment, a decrease in EVLW was observed in all prednisolone-treated patients, whereas a pronounced increase in EVLW was found in 3 placebo-treated patients. Probably, those patients would have benefited from high-dose prednisolone treatment. High-dose prednisolone reduced EVLW and improved hemodynamics and gas exchange in patients with noncardiac pulmonary edema, whereas placebo did not achieve comparable effects. Therefore, high-dose prednisolone appears beneficial in noncardiac pulmonary edema in respect of EVLW, hemodynamics, and gas exchange.

Adult↗
PubMed1987

[Hemofiltration for the reduction of lung fluid in ARDS?].

Hemofiltration has been advocated for reduction of extravascular lung water (EVLW) in both clinical and experimental ARDS. The influence of hemofiltration on EVLW was studied retrospectively in 10 patients with this syndrome. After 2 to 38 hours' hemofiltration net fluid balance was -3640 +/- 3609 ml. EVLW remained almost unchanged (from 17.6 +/- 5.4 before to 15.6 +/- 4.1 ml/kg after hemofiltration). In 4 patients a reduction of over 15% in EVLW was achieved, whereas in the remaining 6 patients EVLW changed within a range of +/- 10%. However, hemofiltration caused a decrease in cardiac output and oxygen delivery, thereby adversely affecting its benefits on EVLW and gas exchange. In ARDS hemofiltration should be performed under careful hemodynamic monitoring and only in some of the patients an immediate reduction in EVLW can be achieved.

Adult↗
PubMed1987

Pharmacokinetics of ceftazidime and netilmicin in patients with sepsis.

The pharmacokinetics of ceftazidime and netilmicin were evaluated under septicemic conditions. In a longitudinal study, both drugs were administered simultaneously (ceftazidime 2.0 g 20 min constant i.v. infusion and netilmicin 150 mg i.v. bolus injection) every 12 hours to patients who had a positive blood culture and hyperdynamic circulatory functions. Twenty-four hours after the first period of this pharmacokinetic study, identical parameters were evaluated under dipyrone induced normothermic conditions. The mean residence time and the volume of distribution was significantly altered during septicemia compared to normal conditions. With respect to the relative distribution properties ceftazidime tended to be distributed to a greater extent to the tissue compartment, whereas netilmicin showed an opposite behaviour. Beside significant correlations of absolute values, i.e. blood volume vs. volume of distribution, and relative values, i.e. total peripheral resistance vs. extraction rate, all other attempts failed to show any meaningful correlation. Owing to the heterogenous alterations of metabolic and hemodynamic functions and pharmacokinetic parameters, respectively, the data gained from this study do not allow any statistically validated conclusion regarding the pathophysiological mechanisms involved, although these findings are in accordance with animal experiments.

Adolescent↗
PubMed1985

Influence of verapamil on gastric acid secretion and gastrin release in dogs.

Gastric secretion is supposed to be calcium-dependent. The effect of verapamil (0.3 mg/kg/h i.v.), a calcium channel-blocking agent, on stimulated gastric acid secretion and gastrin release was investigated in 8 mongrel dogs. Stimulation was either performed by bombesin (1.0 microgram/kg/h i.v.) or by insulin (0.3 U/kg i.v.). Verapamil significantly inhibited both the bombesin- and the insulin-stimulated gastric acid secretion. Mean total gastric acid output over a 120-min period was 9.5 +/- (SEM) 2.2 mmol after bombesin stimulation and 6.3 +/- 2.0 mmol after bombesin and verapamil (p less than 0.01). The respective values were 15.3 +/- 2.0 mmol for insulin stimulation and 7.0 +/- 1.6 mmol for insulin and verapamil (p less than 0.01). There was no significant influence of verapamil on plasma gastrin concentrations. Thus, the impairment of acid secretion by verapamil is not due to an inhibition of gastrin release in intact dogs.

Animals↗
PubMed1984

[Echocardiographic diagnosis of fetal heart insufficiency caused by supraventricular tachycardia].

A fetus with hydrops congenitus universalis and congestive heart failure in the 34th week of gestation caused by supraventricular tachycardia was diagnosed by ultrasound. A reanimation in the infant delivery by cesarean section with a heart rate of 360 beats/min was successful. By a weight at birth of 3140 g, pre- and postnatal 930 g edema was found. The postpartal treatment of the supraventricular tachycardia with verapamil, methyldigoxin and propranolol was successful. The child recovered uneventfully.

Echocardiography↗