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Biomedical subjects

J Kilian

Publications and source records attributed to J Kilian.

At least 73 records · Page 4Linked to original sources
PubMed1981

[The recovery room - function and organization (author's transl)].

Postanaesthetic observation and control of the patient, independently of surgery, is an integral part of the anaesthetic course. The anaesthetic procedure is terminated in the recovery room only, where all negative effects of anaesthesia and surgery or their sequels can be properly assessed and eliminated. After restoration of vital functions and protective reflexes only the patient may be transferred to normal wards or intensive care units for further control of his postoperative condition. Following long-term surgery, and in any high-risk case in general, postoperative mechanical ventilation or application of continuous positive airway pressure (CPAP) can reduce the incidence of respiratory complications. The additional and extensive therapeutic and diagnostic tasks to be covered in the recovery room call for special consideratons in equipping and staffing. Adequately trained nurses in sufficient number, respiratory devices covering any mode of ventilation and an emergency laboratory are indispensable prerequisites for proper function. Only then the anaesthesiologist will be able to satisfactorily perform his comprehensive task of providing stable vital functions, preoperatively in establishing the state of operability, intraoperatively by corrective therapy and postoperatively until anaesthetic effects and surgical trauma have subsided.

Humans↗
PubMed1981

[Improvements of the flow dynamics in caval catheters: first clinical experiences (author's transl)].

A hydrodynamic model was designed in order to study, on the evidence of flow patterns, the outlet flow characteristics of various catheters, and further, to estimate the degree of mixing between infusion solutions and blood with varying types of catheter-end openings. It was found that a crosswise arrangement of four openings was the most effective in mixing infusion solutions into the bloodstream.

Biophysical Phenomena↗
PubMed1981

[The influence of heparin and dilution of the results of blood gas analyses (author's transl)].

The results of blood gas analyses are affected by the type and length of storage of the sample and by differences in dilution and heparin concentration. Experiments established that keeping the specimen in iced water for one hour had no effect. Increasing the heparin concentration affected the results less than did dilution of the sample despite the acidity of the solution. If, on the other hand, heparin in powder form was employed (Monovette) the results were influenced by the absence of dilution of the sample and by the different type of heparin used. This particularly affected the acid-base balance and has to be taken into account when evaluating the results. The use of heparin Monovette simplifies the technique of taking blood samples as there is no need to fill the dead space and it provides reproducible results as the problem of differences in dilution does not arise.

Blood Gas Analysis↗
PubMed1980

[Effects of pirenzepin on the course of acute gastric stress lesions (author's transl)].

Twenty-two severely ill patients with multiple injuries and sepsis were treated with IV pirenzepin or placebo 3 x 10 mg per day in the frame of the double-blind study. All the patients were examined three times with endoscopy during the 14-day observation period. In 100% of cases without prophylactic treatment, stress lesions were observed, 60% of these cases had bleeding. A prophylactic IV pirenzepin application had an unmistakable protective effect regarding the stress bleeding, number and degree of stress lesions.

Benzodiazepinones↗
PubMed1980

[Bacterial contamination as a complication of intravenous therapy in intensive care (author's transl)].

Intravenous infusion therapy has become an indispensible part of intensive care. Problems of bacterial contamination during this therapy are well known. To check on the possible routes of contamination we examined the infusion system in its several parts (infusion solution, infusion system, connection between infusion system and catheter and content of syringes). The highest rate of contamination was found at the connection between the infusion system and the catheter after use for 24 h (26.7%, 39 out of 146 probes); just at the beginning of the infusion we found bacterial growth in 7.1% (10 out of 141 probes). After injection of drugs into the system the infusion solution was contaminated in 1.9% (6 of 320 probes). The system for measuring the central venous pressure was contaminated in 2.7% (4 of 148 probes). At the end of infusion the infusion solutions were contaminated in 3.1% (9 of 287 probes). Different drugs in syringes in no case were contaminated. In most cases (59 probes) we found gram-positive bacteria (87.3%), in only seven cases (9.7%) gram-negative bacterias and in two cases Candida tropicalis. Our results show that the extrinsic or in use contamination plays the most important part in bacterial contamination of the infusion system. Infection control of intravenous therapy necessitates care in the hygienic standard adopted during the infusion and injection procedures.

Antisepsis↗
PubMed1979

[Effects of ventilation with defined formaldehyde concentrations on lung function and lung structures. Animal experiments on the noxiousness of formaldehyde residues after disinfection in the aseptor (author's transl)].

Having seen the development of fatal pneumonias in ventilated patients, the cause of which was assumed to be the presence of residual traces of formaldehyde in the air in the respirator Kilian and Haug showed in 1973 initial formaldehyde concentrations up to 0.2 ppm in the ventilatory air of respirators correctly disinfected in the Aseptor. To study the effects of formaldehyde on lung function and lung structures, 23 young pigs were automatically ventilated with defined formaldehyde concentrations during 6 hours. The concentrations used were 0.02 ppm, 0.2 ppm and 2.0 ppm (double of the maximum permissible concentration). We found no differences in lung function, as shown by compliance measurements and arterial blood gas analysis. No radiological differences were in the thorax. Histologically, there were only slight alterations in lung structure in the group ventilated with double the maximum permissible concentration of formaldehyde. We conclude that the disinfection of respirators using formaldehyde in the Aseptor will remain the method of choice.

Animals↗
PubMed1979

[Infusions emergencies following the administration of plasma substitutes -- analysis of case reports to the committee on drugs. The problems of medical statistics, prophylaxis and immediate therapy (author's transl)].

In the period 1967 to 1976 the Adverse Drug Reaction Committee of the Medical Association of the Federal Republic of Germany (AMK) received 323 reports of transfusion emergencies following the administration of colloid plasma expanders (dextran, gelatin, starch). The reports ranged from medium to severe cases. Nine percent of the reported cases had a fatal outcome. The data contained in these case reports could only be statistically analyzed within certain limitations as the reports were incomplete and other parameters necessary for a definite statistical evaluating were missing. Furthermore the results do not cover the following points: 1. What percentage of reactions to plasma expanders in W. Germany was reported? --2. What percentage can be attributed to the individual colloids within the entirety of these undesirable side effects? --3. What percentage of the individual colloids can be allocated to the varying degrees of severity of these reactions? -- Further limitations which complicated the analysis of the case reports are discussed individually. Despite these difficulties an attempt was made to analyse the parameters necessary in the diagnosis of acute transfusion emergencies and to compile a guide for the clinical symptomatology. Grading of reactions into four degrees of severity has proved useful both in terms of diagnosis and immediate therapy. The medical statistical evaluation presented in this paper gives an indication as to the significance of the observed side-effects and confirms the statement and recommendations made elsewhere in the literature. In these emergency cases life-threatening incidents appear to be more common than is generally assumed and the user is aware of. The incidence of product-specific emergencies can only be determined to some degree of accuracy by randomized prospective studies. These would have to be conducted with numerous strict guidelines. On the basis of the results presented here, these studies should be attended to with a sense of urgency. Regardless of the difficulties encountered in the evaluation of the case reports, guidelines as to the recognition of reactions, prophylaxis and immediate remedial therapy could be established. These would appear to suffice as urgently required comprehensive information for the nursing staff as well as all doctors. Recognizing side-effects and instituting immediate remedial therapy along the principles laid down in these guidelines can in most cases of severe reactions remove the acute threat to life.

Adolescent↗