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Biomedical subjects

L Sunder-Plassmann

Publications and source records attributed to L Sunder-Plassmann.

At least 109 records · Page 6Linked to original sources
PubMed1981

Tissue pO2 and transcutaneous pO2 as guidelines in experimental and clinical drug evaluation.

Tissue pO2 measurements on skeletal muscle surface both in patients and in animals in a model of occlusive disease revealed local tissue hypoxia that, until now, had not been detected with any other method. This kind of local tissue hypoxia is interpreted as a disturbance of local microflow distribution in the presence of unchanged regional blood flow rate. In response to buflomedil infusion, tissue pO2 histograms improved without any change in regional blood flow or distal blood pressure. In comparison to healthy volunteers, transcutaneous pO2 measurements in patients allowed establishment of of tcpO2 profiles along the lower extremity which were in agreement with angiographic localization of vessel occlusion. In a preliminary study, buflomedil infusion (3 mg/kg) over 30 minutes caused a significant increase in tcpO2 in 5 patients in the absence of any significant change of segmental blood pressure. It is concluded that both tissue pO2 and tcpO2 measurements are able to provide unique information about local changes of the microcirculation in occlusive vessel disease.

Animals↗
PubMed1978

[Hypothermic circulatory arrest after total blood exchange in dogs (author's transl)].

Total body washout (hct less than 1%) in hypothermia was performed in 31 dogs using either a crystalloidal or a colloidal perfusate. Blood exchange and cooling was achieved by means of partial bypass and heat exchanger. Short lasting blood exchange for crystalloids without cardiac arrest resulted in 66% survival of the animals. When in addition circulatory arrest was established for 30 min at 14 degrees C oesophageal temperature blood exchange for crystalloids was not tolerated. All four animals of this group died within 19 hours presenting massive interstitial edema. Replacement of the crystalloidal perfusate by a colloidal solution (2.5 g% Dextran 60 at Ringer's Lactate) and establishing circulatory for 30 or 60 min resulted in survival rates of 71% and 50% respectively. The use of the colloidal perfusate effectively prevented edema formation. Death could not be correlated with the parameters controlled.

Animals↗
PubMed1977

[Correction of tetralogy of Fallot and its influence to oxygen transport and lung changes. Part I. Oxygen transport (author's transl)].

30 patients with tetralogy of Fallot were examined before and after correction. 10 of whom had previous procedures including 13 Blalock-Taussig shunts, 1 Cooley anastomosis and 6 pulmonary valvulotomies (Brock) with a dilator. Hemoglobin and blood gases were measured in 22 patients pre- and postoperatively on the 7th respectively 14th day and finally after 12 months. In 8 children the concentration of 2,3-DPG was accessed (pre-, postoperatively, immediately in ICU, on the 1st, 7th, 14th day and after 21 months). Hypoxia of various degrees was found at any time of the investigation, verified by a low venous oxygen saturation, high 2,3-DPG concentration and an erythrocytosis. The 2,3-DPG concentration was always elevated (preoperatively 18.2 +/- 1.8 muMol/g Hb; postoperatively 1st till 14th day 19.0 +/- 2.2; after 21 months 16.3 +/- 1.2 muMol/g Hb). Preoperatively hypoxia was correlated to the degree of the heart disease expressed by the hight of the Hb-concentration. In contrary after the correction signs of hypoxia (decreased venous oxygen saturation, increased 2,3 DPG-concentration) appeared with a low Hb as found in patients with anemia. The long term check-ups are indicative for slight cardiac residual disorders as there are hypoxic myocardial damage, residual gradients over the right ventricular outlet, reopened VSD's, and ventriculotomy scar tissue. Though the elevated 2,3-DPG-concentration and the consecutive rightward shift of the oxygen saturation curve obviously compensate these cardiac handi-caps as the excellent physical condition of the children shows.

Adolescent↗
PubMed1976

[Myocardial contractility in dogs in hemorrhagic shock and after volumn replacement (author's transl)].

Myocardial contractility was evaluated in 8 out of 14 anaesthetized mongrel dogs during haemorrhagic shock and after volume replacement with Dextran 60 using the force-velocity relation of the contractile elements at zero load (Vmax). 7 animals received 50,000 or 20,000 KIE respectively of a proteinase inhibitor after bleeding and immediately before and one hour after the infusion of Dextran 60. The release of the lysosomal enzymes acid phosphatase and beta-glucuronidase was inhibited significantly (p less than 0.05) in the animals treated with Trasylol. However, the inhibition of the lysosomal enzymes seems not to have a decisive influence on the dynamic of the macro- and microcirculation and the myocardial contractility.

Acid Phosphatase↗
PubMed1976

[Preoperative haemodilution: basis adaption mechanism and limitation of clinical application (author's transl)].

Basically the adaptational mechanism in acute, normovolaemic dilutional anaemia with dextran-60 is an increased flow rate to organs and tissues due to decreased viscous flow resistance. There is no decrease in systemic oxygen transport and no increase in oxygen extraction ratio unless the hematocrit drops well below 20%. Thus adequate tissue oxygen supply is guaranteed in limited dilution as shown by direct measurements of tissue PO2. The feasibility of a new concept of acute preoperative haemodilution with subsequent autotransfusion of the shed blood is demonstrated in 34 patients. Within the safe limits of clinical dilution in the haematocrit range of 25-20% adequate tissue oxygenation is provided by a rise in cardiac output, whereas heart rate, blood gases and acid base status are essentially unchanged. Autotransfusion during surgery and postoperatively helps to save donor blood, is easy to perform, gives better tissue perfusion at the microcirculatory level and prevents postoperative thromboembolic complications.

Blood Transfusion, Autologous↗
PubMed1975

[Acute left heart failure following repair of atrial septal defects. Its treatment by reopening].

Among 716 patients operated on for an ASD, 15 of them, following closure of the defect, developed acute left heart failure requiring partial re-opening. The most prominent anatomical finding in these cases was hypoplasia of the left ventricle. Also remarkable in some patients was severe pulmonary hypertension, which may have led to right ventricular hypertrophy. Therefore, a marked difference of the stroke work of the left and right ventricle, respectively, appeared to be the essential underlying hemodynamic mechanism. The prognosis has been found to depend mainly on prompt surgical intervention; so in all poor-risk cases continued monitoring of left atrial pressure is indicated for early detection of impending left heart failure.--The high incidence of left heart failure as cause of death after repair of an ASD indicates the importance of this complication.

Adolescent↗
PubMed1975

[The fate of the pulmonary hypertension after ASD-closure in adults (author's transl)].

10 female and 7 male patients, who were operated for secundum type Atrial Septal Defect with Pulmonary Hypertension, got postoperative check-ups including right heart catheterisations. The investigations were performed on the average 6.6 years postoperatively. There was a fall of the systolic pulmonary pressure and of the flow; pulmonary resistance fell in 8 cases and rose in 9. The low left ventricular cardiac index together with an elevated left atrial pressure may be the pathogenetic cause of postoperatively elevated pulmonary resistance.

Adolescent↗
PubMed1975

[Total blood exchange with circulatory arrest in deep hypothermia].

Total body wash out (hct less than 1%) with circulatory arrest of 30 to 60 minutes in deep hypothermia (esoph.temp. at 14 degrees C) was performed in 17 mongrel dogs by exchange against modified Ringer's Lactat-Solution. During rewarming the pump fluid was partly replaced by homologous packed red cells for readjustment of the hematocrit. After perfusion with a colloidfree perfusate all animals died under signs of massive interstitial edema. 8 out of 13 animals were long term survivors after exchange perfusion with colloid containing perfusate (dextran 60, 25 g/1). It has been demonstrated that a sanguineous circulatory arrest in deep hypothermia can be tolerated for 30 to 60 minutes if the formation of interstitial edema is prevented by use of an oncotically active perfusate.

Animals↗
PubMed1975

[Hydroxyethyl starch as plasma substitute: experiments in isovolamic haemodilution (author's transl)].

Isovolaemic haemodilution to a hematocrit of 10% was achieved by stepwise exchange of blood against 6% hydroxyethyl starch (HES) in 11 splenectomized dogs. All animals survived the actuely performed extreme haemodilution; one animal died 5 days later due to massive bilateral pneumonia. Blood volume as determined by 51Cr-tagged red cells was unchanged at hematocrit 10%; 2 and 5 hours after reaching the minimum haematocrit, blood volume was reduced by 7 and 15% of control. At day 3 after dilution, blood volume was normal again. Thus under conditions of extreme isovolaemic haemodilution the volume effect of hydroxyethyl starch was found inferior to that of dextran 60. Haemodilution with HES was associated with a presistent augmentation of the serum concentration alpha-amylase.

Amylases↗
PubMed1974

Hemodilution.

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Anemia↗