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Biomedical subjects

M Pichler

Publications and source records attributed to M Pichler.

At least 91 records · Page 5Linked to original sources
PubMed1976

[Haemodynamic changes in acute myocardial infarction following high doses of furosemide (author's transl)].

Haemodynamic measurements were carried out after administration of furosemide to 10 patients suffering from acute myocardial infarction and congestive heart failure. It was observed that a transient deterioration in cardiac function (decreased cardiac output, increased enddiastolic pulmonary arterial pressure and increased pulmonary and systemic resistance) occured in the pre-diuretic stage in these failing hearts. After the onset of diuresis the haemodynamic parameters showed a reversal of the previous trends (increased cardiac output, decreased enddiastolic pulmonary arterial pressure and pulmonary resistance). The consistently lower enddiastolic pulmonary arterial pressure in the diuretic phase as compared with the pre-diuretic value ensured an improvement in cardiac haemodynamics. An attempt was made to interpret the haemodynamic results in the light of the Frank-Starling's curve.

Acute Disease↗
PubMed1976

[The effect of "standardized forced diuresis" (SFD) on serum and urinary electrolytes(author's transl)].

The effect of standardized forced diuresis (SFD) on the serum and urinary electrolyte levels was investigated in 10 cases of severe self-poisoning with hypnotic drugs. Diuresis was initiated by furosemide and maintained at an hourly urinary ouput of 2 litres. Fluid and electrolyte substitution was carried out with a standardized electrolyte solution. Initiation and termination of the SFD was performed abruptly. The mean values of sodium, potassium, chloride and phosphorus in the urine varied widely at the beginning of the SFD, while the calcium and magnesium values varied only slightly. During SFD, urinary stabilization occured at a particular ionogram, in correlation to the electrolyte concentrations in the infusion fluid and with only minimal individual variation. Owing to this satisfactory correlation, none of the patients developed signs of electrolyte disturbances, so that no correction of the infusion constitution was necessary. The abrupt termination of the SFD prevented electrolyte disturbances in the recovery phase.

Adult↗
PubMed1976

[Angiotensin - a possible cause of acute renal failure (author's transl)].

The hypertensive action of angiotensin is purely brought about by peripheral vasoconstriction and may, thus, lead to reduced perfusion of vital organs, especially the kidneys. The dangers of angiotensin in triggering off acute renal failure are illustrated by a case report in which this drug was administered to a comatose patient with hypovolaemic hypotension following barbiturate self-poisoning.

Acute Kidney Injury↗
PubMed1976

[Severe intoxication with leponex (author's transl)].

The clinical picture and the therapeutic management of a severe case of self-poisoning with Leponex (clozapin) are presented. In particular, the grave complications, their possible aetiology and the value of the administration of cortisone are discussed. Forced diuresis or haemodialysis are ineffective measures on account of the low serum concentrations of Leponex.

Adult↗
PubMed1976

[Clinical results with dopamine in acute renal failure (author's transl)].

Dopamine possesses specific pharmacological actions which distinguish it from the other catecholamines. Apart from its positive inotropic effect, dopamine exerts a favourable influence on renal function with an increase in renal blood flow and alterations in intrarenal haemodynamics. The use of dopamine in the early stages of acute oliguric failure is recommended on the basis of the good therapeutic response achieved in a series of cases.

Acute Kidney Injury↗
PubMed1976

[Parenteral nutrition in hepatic coma (author's transl)].

A special program of parenteral nutrition was established in 16 patients with genuine hepatic coma and in 24 patients with portal encephalopathy; this program involves stepwise addition of various nutritional components. On the day of admission water and electrolyte balance is normalized, on the following morning infusions with 40% glucose solutions are started, and the patient is adapted to glucose as the source of calories within the next 48 hours. After this period total parenteral nutrition is instituted comprising all essential ingredients of nutrition. Application of amino acids was especially adjusted to the situation of hepatic coma taking into account not only the typical derangements of metabolism in hepatic coma, but the essential complications of this disease as well. Serial determinations of plasma amino acids were done in order to assess the program of nutrition. Before the beginning of parenteral nutrition plasma levels of amino acids were altered in a manner typical for liver failure; these alterations could be normalized almost completely by total parenteral nutrition.

Adult↗
PubMed1975

[Partial parenteral nutrition in acute myocardial infarction (author's transl)].

The influence of partial parenteral nutrition (PPN) was compared with the effect of a calorie-free solution in 2 groups of patients (n = 10) with acute myocardial infarction. Both groups received the same daily diet of 800 to 1000 Cal. The control group was given, in addition, a calorie-free electrolyte solution and the PPN group was given a nutritious solution consisting of 1000 Cal carbohydrate and 26.5 g 1-amino acids daily by means of a subclavian catheter. The exact monitoring of the water balance indicated that patients with acute myocardial infarction can safely be given parenteral nutrition. Neither haemodynamic nor metabolic complications occurred in the group with PPN due to the small infusion volume and the continuous administration of the infusion volume and the continuous administration of the infusion. The control group was in negative nitrogen, potassium and phosphorus balance in comparison with the PPN group. This demonstrates that a hypocaloric diet is insufficient in the acute phase of myocardial infarction and causes catabolism, which can be prevented by PPN. Stimulation of healing of the myocardial infarct can be expected through the improvement of protein metabolism by PPN.

Diet↗
PubMed1975

[Fatal self-poisoning with the tetracyclic antidepressive drug, ludiomil (author's transl)].

The clinical and analytical data are presented of a case of severe Ludiomil self-poisoning (assumed total ingested dose: 3000 mg). Ludiomil resembles the tricyclic antidepressive drugs in regard to its toxic effects. Two essential observations made in Ludiomil poisoning are: 1) the limited therapeutic possibilities due to delayed elimination and 2) the severe degree of respiratory distress.

Adult↗
PubMed1975

[Acute pancreatitis with shock and acute renal failure (author's transl)].

Acute pancreatitis is discussed from the viewpoint of a medical intensive care unit, with particular reference to the early and late complications. The measures which must be promptly implemented in order to successfully combat the grave early complications of shock and acute renal failure are stressed. Continuous monitoring ensures that prompt surgical management is undertaken in cases of late complications-abscess formation, sequestration and sepsis. A review of the characteristic clinical and laboratory data of patients with acute pancreatitis treated in our unit is presented in table I.

Acid-Base Equilibrium↗