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Biomedical subjects

H Flaatten

Publications and source records attributed to H Flaatten.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Nitrogen oxide (nitrogen monoxide) administered via respirator. A new therapeutic alternative in acute respiratory failure and shock lung].

Adult respiratory distress syndrome (ARDS) still has a high rate of mortality. It is usually necessary to treat these patients with a respirator using a high inspiratory fraction of oxygen. The condition is often associated with pulmonary hypertension and increased pulmonary vascular resistance. Nitric oxide (NO) has been shown to be a potent endogenous vasodilator. It is a gas and can thus be delivered to the lungs of intubated patients by means of a respirator. Because of its very short halflife, the effect of inhaled nitric oxide is limited to the pulmonary vasculature and it has no systemic effects. The local vasodilatation caused by nitric oxide leads to improved oxygenation, primarily because of reduced intrapulmonary shunting of blood. From April 1993 to July 1995 we treated 14 patients with severe ARDS with inhaled nitric oxide. All patients were critically ill, with a mean APACHE II score of 24.5. Oxygenation was increased in all patients after treatment with nitric oxide, but in spite of this eight patients (56%) died. There were no significant differences between survivors and non-survivors as regards age or severity of the disease.

Acute Disease↗
PubMed1996

Surgery during inhalation with nitric oxide in a patient with severe adult respiratory distress syndrome (ARDS).

Nitric oxide (NO) is increasingly used in intensive care units (ICU) in order to treat serious hypoxaemia secondary to ARDS. Since interrupting NO delivery in such patients for more than a few minutes could lead to serious adverse events, moving the patient outside the ICU has been very difficult. Recently developed equipment (Noresc 1503) enabled us to deliver 10 or 20 ppm NO from a ventilatory bag with reservoir. This is used for ventilation under transport from the ICU to the operating theatre (OT) or radiology department. We present a patient with severe ARDS undergoing major surgery while being treated with NO. The patient could be moved to the OT and operated on during five hours without significant changes in vital functions.

Administration, Inhalation↗
PubMed1995

[Use of growth hormone during catabolic state in a patient in postoperative intensive care].

Patients in the intensive care unit often enter a catabolic state with significant protein loss, which may increase postoperative complications. Nutritional support alone usually does not reverse a catabolic state and thereby induce a positive protein balance. Recent studies suggest that recombinant human growth hormone (rhGH) stimulates protein synthesis and improves protein balance in critically ill patients. An increase in the level of growth hormone often fails to occur in critical illness and injury. We describe the case of a man aged 45 years who underwent laparoscopic fundoplasty for hiatus hernia repair. Because of complications, including perforation of the oesophagus, he entered a sustained catabolic state with negative protein balance and a weight loss approaching 20%. Therefore, on the 29th day after operation we started treatment with rhGH, Norditropin 24 IE/day im. The protein balance became positive three days later. This parameter maintained positive, also after the growth hormone therapy was discontinued 12 days later. The further course was uneventful and the patient was transferred to his local hospital 51 days after the fundoplasty. His condition was improving steadily.

Coma↗
PubMed1995

[Light stylet--an alternative when intubation is difficult].

Using a light stylet, it is possible to perform oro- and nasotracheal intubation without the need of visualizing the larynx or extending the patient's neck. This makes the light stylet a valuable alternative when conventional intubation with a laryngoscope is difficult or impossible. Intubation with the light stylet is easy to learn, is relatively atraumatic, has an acceptable success rate and is fast enough to compete with laryngoscopic intubation. The equipment is inexpensive. We describe successful intubation with the light stylet in four patients. Two had unstable neck fractures, one had previously been difficult to intubate, and one had trismus.

Aged↗
PubMed1991

Percutaneous placement of permanent central venous catheters: experience with 200 catheters.

The prospective registration of 200 percutaneous placements of permanent central venous catheters (Hickman catheters and subcutaneous infusion ports) was conducted in 172 patients aged 3 months-95 years. The insertions were reviewed to assess whether certain groups of patients or physicians were associated with more complications than others. Complications occurred in 16 patients (8.0%), of which 12 were arterial punctures. Two attempts (1%) at catheter placement failed. None of the complications required treatment. Of the catheter placements, 70% were performed by one of the three authors, and the rest by seven other experienced anesthesiologists. The complication rates were not different between the two groups. Nor was the complication rate significantly higher in small children. Percutaneous placement of permanent central venous catheters thus proved to be a safe and reliable technique, even in small children. The method is easily learnt by physicians experienced in central venous catheterization. Using this method, permanent venous access may be offered to a large number of patients.

Adolescent↗
PubMed1990

[Parenteral nutrition at home. National and Scandinavian organization and team work].

Long term parenteral nutrition is lifesaving in a few patients with severe gastrointestinal failure. Such therapy is often carried out at home (Home parenteral nutrition, HPN) and based on a high degree of self-care. The risk of complications is high, and it requires a considerable skill and experience from the hospital staff to manage HPN and educate patients. The prevalence of such patients in the Nordic countries is 3-4 per million. In some Nordic countries it is impossible to centralize this treatment only to one or two hospitals. With such a small number of patients scattered all over the country it is therefore important to establish a national co-operation and registration regarding HPN-patients. This will increase experience with HPN and make it possible to standardize the therapy with regards to indications, catheter technique, nutritional supply, management of complications, education etc. Furthermore it is a wish to expand this co-operation and registration to include all Nordic countries. Such multinational co-operation might be of value in cases of rare and difficult patients on HPN and in children and will further increase our experience with HPN. Results from a meeting on Nordic co-operation concerning HPN is presented.

Humans↗
PubMed1989

Postdural puncture headache. A comparison between 26- and 29-gauge needles in young patients.

The incidence of postdural puncture headache after spinal anaesthesia with two types of 26- and 29-gauge needles was investigated in 149 patients less than 30 years old. Ten patients, (6.7%), six men and four women, developed typical symptoms of postdural puncture headache, while six (4.0%) developed headache of other origin. There were no headaches in the 29-gauge group. Spinal anaesthesia in four patients (8%) was impossible to perform with the 29-gauge needle. By using the latter, spinal anaesthesia can be given to young adults with little risk of postdural puncture headache.

Adolescent↗