Continuous transcutaneous monitoring of PO2 and PCO2.
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Biomedical subjects
Publications and source records attributed to G Rooth.
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During the years 1965--1974, 125 cases of posterolateral diaphragmatic hernia have been operated at five departments of pediatric surgery in Sweden. The overall operative mortality was 50%. A follow-up investigation included 19 cases, where in 12 cases spirometry and in 11 cases studies of the mobility of the diaphragm were included. Physical examination revealed excellent results in most cases. Lung function studies, however, show a moderate (20--30%) reduction, which is not surprising with regard to lung hypoplasia and impaired movement of the diaphragm on the operated side. In adolescence and younger age, these patients are mostly in excellent condition; but later, when lung function is also reduced by the age factor, their neonatal condition may be of importance.
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Continuous monitoring of oxygen tension using the transcutaneous electrode developed by Huch and co-workers was studied in severely ill newborn infants. Acceptable results were obtained despite the theoretical possibility that vasoconstriction might interfere with the method when used in the very ill. The reliability and clinical usefulness of the method is illustrated in 4 cases of severely ill newborn infants.
Parturients during normal labour were given glucose. The maternal-fetal difference of glucose increased with increasing maternal glucose level. Glucose load caused a rapid early response of maternal insulin release. A parallel rise in plasma lactate and pyruvate occurred in both fetus and mother. The basal maternal hydroxybutyrate and glycerol concentrations decreased significantly during glucose load. The study demonstrated that at term, components of lipid metabolism in fetal and maternal plasma-in contrast to glucose -vary independently. No major disturbances of the fetal acid-base balance were found.
Attention is called in this brief review article to the development and clinical uses of a new technique for monitoring blood oxygen tensions in newborn infants. This technique uses an electrode recently developed by Huch et al. in Germany to measure arterial oxygen tensions directly through the skin. This device allows for continuous monitoring with a non-invasive technique. The method is now in use in European hospitals. Clinical experiences are cited to document its usefulness.
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Normally the kidneys respond to an acid load by increased ammonia production. In six patients with adult-type diabetes this response was reduced by a mean 50% after a therapeutic dose of phenformin. The reduced ability to compensate for acid loads may be one factor leading to metabolic acidosis and lactoacidosis sometimes associated with phenformin therapy.
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