[Methods and risks of plasmapheresis in severe courses of Guillain-Barré syndrome].
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Adult↗
Biomedical subjects
H Schinzel
Publications and source records attributed to H Schinzel.
[Transesophageal echocardiography in the evaluation of hemodynamics in artificial respiration with positive end expiratory pressure].
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Echocardiography↗
[The effect of cortisone on the course of respiratory and clinical parameters in ventilator patients with imminent ARDS].
24 subjects in an intensive care unit with indication for mechanical ventilation with PEEP and predisposition for ARDS have been investigated. All patients received 2 g prednisolone 8 times over 48 hours. In group A (14 patients) this was administered within the first 24 hours of the beginning of the ventilation, and in group B (10 patients) at a later stage in the therapy. Severity of the disease was assessed by TISS, and, in addition to respiratory parameters, coagulation, thrombocytes, blood sugar, lactate and phosphate were determined. The data were evaluated by exploratory data analysis with box plots and median values. According to TISS, the two groups are comparable (group A 31.5 points, group B 31.3 points, age in group A 50.6 years, in group B 54.0 years). FiO2 rose from 0.44 to 0.82 in group B and in group A declined from 0.83 to 0.3 during receipt of PaO2 of more than 60 torr. EIP (endinspiratory pressure) rose from 28.7 cm H2O to 33.5 cm H2O in group B and fell from 29 to 26 cm H2O in group A. Compliance in group B fell and remained constant at over 48 ml/cm H2O in group A. PTT and TZ were normal in both groups, and Quick time values lower in group A than in group B. Thrombocytes fell to 63,000 in group B and rose to 201,000 in group A. Lactate, phosphate and leukocytes were unchanged in both groups. No cases of pulmonary infection were observed in either group. Mortality was 50% in group A and 80% in group B. Critical evaluation of the data from this retrospective study suggest a more favourable course, especially of the respiratory parameters, if a high dose of corticosteroids is administered at an early stage (group A).
Blood Coagulation↗
[Low molecular heparin for treatment of venous thrombosis in two very low-birth-weight pre-term infants with genetic risk factors].
We describe the use of low molecular weight heparin to treat venous thrombosis in two very low-birth-weight pre-term infants (GA: 30 and 27 weeks) both with genetic and acquired prothrombotic risk factors. Initially both infants were treated with unfractionated heparin. Since in one infant no effect on the thrombus size was observed and in the other infant there was an increase in size, the anticoagulation therapy was switched to subcutaneously injected low molecular heparin (Enoxaparin). During enoxaparin therapy the anti-Xa-level was carefully monitored and dosages were adjusted accordingly. Partial resolution of the thrombosis was achieved in both infants during enoxaparin therapy. No clot extension or recurrence of thrombosis occurred. An accidental overdose of Enoxaparin (100 times the required dosage) was administered to one infant without any consequences. Our data suggest that the use of low molecular weight heparin (Enoxaparin) for treatment of venous thrombosis in our two preterm infants was practical, safe and effective.
Dose-Response Relationship, Drug↗