Search PubMed⌕ Search

Biomedical subjects

H Burchardi

Publications and source records attributed to H Burchardi.

At least 91 records · Page 5Linked to original sources
PubMed1985

Experimental studies on the adult respiratory distress syndrome: effects of induced DIC; granulocytes and elastase in mini pigs.

The potential role of granulocyte proteinases on experimentally induced ARDS was evaluated. In order to investigate the acute effects on lung function, elastase (330 U kg-1h-1) or thrombin (75-150 U kg-1 h-1) was continuously infused into anaesthetized and mechanically ventilated mini pigs. Both elastase as well as thrombin induced a progressive respiratory failure with prompt increase in pulmonary vascular resistance, and decrease of cardiac output, further a pulmonary leukostasis, and a disturbance of blood coagulation leading to hypocoagulability. High proteolytic activity selectively in the lung indicates a possible role of proteinases released from sequestered polymorphonuclear neutrophils. Similar results following elastase infusion were however obtained in leukopenic animals pretreated with a single dose of dimethylmyleran (5 mg kg-1) which depleted the granulocytes totally. These results offer the possibility that elastase itself may cause respiratory failure and lung tissue damage. On the other hand the digestion pattern of phosphorylase kinase by lung tissue homogenates of thrombin- or elastase-infused mini pigs clearly indicates that elastase is only one of several mediators which may cause experimentally induced ARDS even in the absence of granulocytes.

Animals↗
PubMed1982

[Continuous arteriovenous hemofiltration (CAVH)].

The continuous arteriovenous haemofiltration (CAVH) is a simple, safe, inexpensive and personnel-saving method for treatment of uremic patients. Since the introduction of the CAVH in 1977, far more than 200 patients have been treated by this method in our hospital. In the present paper the method and our experiences during the clinical application are presented. The haemofilter is placed in an extracorporal shunt between the A. and V. femoralis. Cannulation of these vessels is performed by means of a modified Seldinger technique using commercially available catheter. During haemofiltration, heparin is infused into the arterial blood line at a rate of 10 IU/kg . h. The filtrate is totally or partially replaced by nutrition solutions, enteral or parenteral, and by a potassium-free Ringer's lactate i.v. solution, according to the required fluid balance. In most cases the filtrate-substitution rate will be high enough to compensate renal failure, and thus conventional dialysis methods will not be necessary. Clinical experience to date allows the following conclusions: optimal control of water and electrolyte balance; unlimited parenteral nutrition, continuous fluid withdrawal better tolerated than intermittent withdrawal by means of dialysis; low risk of local bleeding with skilled puncture technique of the femoral vessels. Low dose continuous heparin administration into arterial blood line is sufficient for extracorporal anticoagulation. Saving of expenses: No investment costs for machines; specially trained dialysis personnel superfluous.

Blood↗
PubMed1981

[A simple method for determination of the functional residual capacity during artificial ventilation (author's transl)].

A simple method for determination of the functional residual capacity (FRC) during artificial ventilation by inert gas dilution using a rebreathing technique is described. The measurements can be made during various techniques of mechanical ventilation (eg. PEEP, IMV etc.). Myorelaxation is not required. This technique was used to assess the volume of a lung model (actual volume: 3670 ml) with the result of repeated measures being 3686 +/- 29 ml. Duplicate measurements in artificially ventilated pigs showed a coefficient of variation of +/- 3.2%. In artificially ventilated patients FRC was determined both with this technique and with a reference method, giving a difference of 111 +/- 55 ml (p less than 0.001). The errors in measurements of FRC by this method are small, and as the measurement requires a minimum of time and the apparatus is simple, the method is accurate and yet simple enough to be used on a routine basis in the intensive care unit. Even high risk patients are not disturbed by this technique. The method has the advantage that it can easily be learned by nurses and paramedical personal.

Animals↗
PubMed1981

[Determination of pulmonary diffusing capacity during artificial ventilation (author's transl)].

Pulmonary diffusing capacity may be determined by rebreathing techniques using various test gases. The errors caused by functional inhomogenities are smaller with the rebreathing method than those found in the single-breath technique. However, until now there have been some disadvantages to the clinical application of the rebreathing technique. In the present paper, a modification of the rebreathing technique suggested by Piiper, Scheid, Meyer and Adaro (1975 and 1976), in which pulmonary diffusing capacity for carbon monoxide, DCO(RB), is measured, has been applied to intubated and anesthetised patients. Measurements were performed in 39 surgical patients with healthy lungs during artificial ventilation and narcosis. Under these conditions all patients had a DCO(RB) greater than or equal to 75 ml/min . kPa (10 ml/min.torr). The coefficient of variation for duplicate measurements was +/- 4.2%. In the same patients DCO-single-breath-measurements, DCO(SB), were also made. There was a significant (p less than 0.0001) correlation between DCO(RB) in artificially ventilated, anaesthetised patients in a supine position and DCO(SB) for spontaneously breathing, awake patients in a sitting position. A linear regression analysis of the data showed the DCO(SB) was related to DCO(RB) in the following manner: DCO(SB) = 1.62DCO(RB) = 4.44 (ml/min.torr) (r = 0.71, n = 39). The mean value of DCO(RB) was 53.4% of the mean value of DCO(SB). This difference may be due to the combination of different techniques used and different conditions during the measurements (reduced FRC, difference in F1O2 etc.). The histogramm of the distribution of DCO(RB) had a similar form to that of DCO(SB). The modified method has a high reproducibility and can easily be performed as a bed-side test without disturbance to patients with an endotracheal tube.

Adolescent↗
PubMed1980

Management of anuric intensive-care patients with arteriovenous hemofiltration.

It may be concluded from our results to date, that arteriovenous hemofiltration is an accurate and reliable method for the management of fluid balance in patients resistant to diuretics. Early use of this method may improve the prognosis of intensive-care patients by decongestion or dehydration of lungs, reduction of cardiac pre-and after-load and unrestricted infusion therapy for prevention of catabolism. In addition, the method has been shown to be useful for compensation of uremia and particularly for hypernatremia. The fact that this method requires no investment costs might be of particular interest to many intensive-care units which cannot afford expensive hemodialysis or hemofiltration machines.

Adolescent↗
PubMed1978

[The effect of tramadol, a new analgesic, on respiration and cardiovascular function (author's transl)].

1. The effect of 1-(m-methoxyphenyl)-2-(dimethylaminomethyl)-cyclohexan-1-ol (tramadol; Tramal), a new i.v. administered analgesic, on respiration and cardiovascular function was investigated in 15 patients in a clinic of general surgery. 2. Blood gas analysis revealed that tramadol, unlike morphine-like analgesics, does not depress respiration. 3. The drug did not affect blood pressure, and the observed slight increase in heart rate was transient and statistically not significant.

Analgesics↗
PubMed1978

[Cardiac tamponade after perforation of ventricle by central venous catheters and transvenous pacemakers (author's transl].

Two cases of cardiac tamponade after perforation of the right ventricle by central venous catheter and transvenous pacemaker are reported. The apex of the right ventricle represents a "locus minoris resistentiae" for a perforation because of its thin wall and frequent infiltration of fat with relaxation of the small muscle bundle. An analysis of 41 heart perforations by central venous catheters and 47 by transvenous pacemakers from the literature demonstrates the particularly high mortality of the perforation by a central venous catheter referring to the possible production of hydropericardium. We think that extreme carefulness in the use of catheters, knowledge of the danger and vigorous treatment could reduce the mortality.

Aged↗