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Biomedical subjects

G Redl

Publications and source records attributed to G Redl.

27 records · Page 2Linked to original sources
PubMed1986

[Differences in the neuromuscular blockade of the larynx and thenar muscles following relaxation with vecuronium].

To objectivate the clinical impression of different neuromuscular depression in the larynx- and limb-musculature, an attempt was made in 5 patients to quantify laryngeal muscle relaxation by electromyographic recordings of evoked responses from the vocalis muscle during endolaryngeal microsurgery. Mechanographic and evoked electromyographic recordings of the thenar muscles were obtained simultaneously. Nearly total suppression of evoked responses at the peripheral muscle site was observed after a bolus dose of either 60 micrograms/kg or 100 micrograms/kg of the nondepolarising muscle relaxant Vecuronium. However, the vocalis muscle was not blocked completely. The neuromuscular depression ranged from 61 to 92% depending on the dose. In no case was the recommended intubating dose (ED 95) of 60 micrograms/kg sufficient for complete relaxation of the vocalis muscle. The present results do not support that the extent and/or time course of intrinsic laryngeal muscle relaxation correlates with peripheral neuromuscular depression in a quantitative manner. The different degree of relaxation achieved by Vecuronium in the hand and larynx is probably due to their different content of acetylcholine receptors.

Adult↗
PubMed1986

[The pharmacodynamics of vecuronium on the musculature of the vocal cords and the ball of the thumb. Preliminary report].

During endolaryngeal microsurgery, an attempt was made to quantify laryngeal muscle relaxation by electromyographic recording of evoked responses from the vocal cord musculature in 5 patients. Both mechanographic and electromyographic recordings from the adductor pollicis were obtained simultaneously. Following a bolus dose of vecuronium (60 micrograms/kg, n = 3, and 100 micrograms/kg, n = 2), nearly total (97%-100%) suppression of evoked responses at the peripheral muscle site was observed; the vocal cords, however, did not show complete neuromuscular (nm) blockade, but rather varying degrees of nm depression ranging from 61%-92%. The present results clearly show that quantitative information as to duration and degree of neuromuscular depression in the vocal musculature may be obtained by electromyographic recordings of evoked potentials in the clinical setting; it is impossible however, to quantitatively estimate the extent of intrinsic laryngeal muscle relaxation from peripheral nm depression. The pharmacodynamic differences observed might be due to the varying acetylcholine receptor density of the muscle groups studied.

Adult↗
PubMed1985

[Monitoring kidney function in abdominal infection].

In ICU patients suffering from abdominal sepsis acute renal failure (ARF) is a common (50% incidence) and often lethal (more than 80% mortality) complication. Continuous monitoring of renal function is necessary for both adequate fluid replacement and early detection of ARF. Using a programmable handheld computer the following parameters are calculated at least daily: creatinine, osmolal and free water clearance, fractional excretion of sodium and potassium and non-saline loss. The clearance values are corrected to 1.73 m2 body surface area. Free water clearance proved to be a particularly valuable guide for fluid therapy as well as for early diagnosis of ARF. In all septic patients renal function is impaired to some degree, since despite increased cardiac output creatinine clearance is only normal or even decreased. More than 50% of our patients with abdominal sepsis develop ARF, resulting in a dramatic increase in mortality. Goal of renal monitoring in sepsis is to detect ARF as early as possible and to differentiate between extrarenal and septic origin to enable immediate surgical treatment.

Acute Kidney Injury↗
PubMed1985

[Continuous hemofiltration in peritonitis].

During a period of 3 years 27 patients in acute renal failure (ARF) due to peritonitis underwent pump driven continuous hemofiltration (PDHF). PDHF caused neither hemodynamic nor metabolic disturbances, which in contrary are frequently seen during intermittent hemodialysis treatment in septic patients. BUN and creatinine levels fell significantly (p less than 0.001) and remained at 60 mg% and 2.0 mg%, respectively (mean values). Severe coagulation disorders occurred in 5 patients; in 2 patients PDHF was continued under protamine administration into the venous line, in 3 patients PDHF was stopped for 24 hours and than started again. Bleeding stopped in all cases, therefore surgery was not necessary. Other major complications of PDHF were not observed. Kidney function recovered in 44.4% of patients, and mortality was 70.4%. This is clearly lower than in abdominal septic patients under intermittent hemodialysis. Despite much higher costs (2.5 times the costs of hemodialysis treatment per day) PDHF seems to be a promising alternative in the treatment of ARF complicating septic multiple organ failure.

Acute Kidney Injury↗
PubMedDate not supplied

[The use of a rapid infusion system in orthopedics].

Major orthopedic surgery such as partial resection of the pelvis and subsequent implantation of a prosthesis is highly connected with massive bleeding. Therefore we tested the hypothesis that the use of a rapid infusion device, which was originally designed for liver transplantations, can prevent hypovolemic shock. We studied 20 patients: in one group (n = 10) the iv volume was given in a conventional way (37 degrees C) by use of pressure infusion bags. Patients of the second group (n = 10) received the iv volume via the Rapid Infusion system (Haemonetics Corp., Braintree, MA). We can conclude that with this new device for rapid volume replacement it is possible to keep the patient's vital functions stable even during times of excessive bleeding and to prevent from metabolic consequences following hypovolemic shock.

Adult↗