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Biomedical subjects

N Mutz

Publications and source records attributed to N Mutz.

70 records · Page 4Linked to original sources
PubMed1980

[Forced diffusion ventilation (FDV). Bases and clinical application (author's transl)].

A new concept for an alternative gastransport mechanism in the lungs is introduced. It is based on an enhancement of diffusive processes in the bronchial tree and allows gas exchange under quasi apnoic conditions. This enhancement is achieved by a modified high frequency jet ventilation technique utilizing frequencies up to 3000/min. The technical equipment used for this so called forced diffusion ventilation consists of a solenoid valve that interrupts the flow from a high pressure source with adjustable frequencies and impulse pause ratios. A special tracheal tube with an additional jet line implement in its wall carring a nozzle at its tip had to be developed. Animal experiments demonstrate that a sufficient gas exchange even with frequencies of 3000/min can be achieved with this FDV. Under this conditions the lung can be kept in its expiratory inflation level. This technique using frequencies of 350/min has been successfully applied to a patient suffering from multiple bronchopleural fistulas over 16 days. Also the mechanism of FDV is jet not quite clear, penetration of fresh gas into further generation of the bronchial tree, axial diffusion and convective transport due gas oscillations and the volume displacement of the beating heart seem to be responsible for the gas exchange.

Adult↗
PubMed1980

[Inversed ratio ventilation (IRV). Role of the respiratory time ratio in artificial respiration in ARDS].

Considering the advantages shown by the experiences of Reynolds on prolonged inspiration time it was suggested to study this type of ventilation also in ARDS. We tried the inverse ratio ventilation (IRV) in patients with ARDS and in postoperative cardiac surgical patients. An obvious improvement of gas transfer in the lung is seen and becomes better with increased duration of this type of ventilation. A better filling of various parts of the lung with longer time constants is achieved with prolonged inspiration. An effect similar to PEEP caused by an air trapping mechanism, can be seen with the shortening of expiration time. This air trapping mechanism is followed by autonomous adaption of PEEP for the local situation in various parts of the lung. A higher PEEP in poorly ventilated areas is automatically adjusted with IRV, than in areas with a short time constant (individual PEEP).

Biophysical Phenomena↗
PubMed1980

[Steal-induction with ketamine in childhood: comparison of the postanaesthetic period (author's transl)].

The behaviour of 48 children ranging from weeks to eight years was observed and compared after four different anaesthesia methods. Either ethrane or halothane was used with or without induction with ketamine i.m. (5 mg/kg bodyweight). Restlessness, the depth of postanaesthetic sleep, shivering, muscle rigidity and vomiting were evaluated every 15 min. up to one hour postoperatively using a graduation from 1--4. Ketamine combined with halothane showed significantly less postoperative restlessness than all other methods. No statistically proven differences were seen in the other criteria, which were noticed more than once. The psychic effects as well as the practical clinical application of this method are discussed.

Anesthesia, Inhalation↗
PubMed1979

[Assessment of the cardiac output by impedance cardiography (differential rheography) to give optimum continuous positive pressure ventilation (author's transl)].

It is very important to know the cardiac output in artificial positive pressure ventilation for the determination of the exact dosage of dopamine and the endexpiratory pressure. Invasive monitoring of the cardiac output is not suitable for routine bedside use. In our study we looked into the question of whether the dosage of dopamine in continuous positive pressure ventilation could be controlled by impedance determination. Differential rheography, as described by Kaindl, Polzer, and Schuhfried, was used in the study. Relative changes in cardiac output after dopamine administration are shown with sufficient accuracy using the above-mentioned method.

Cardiac Output↗
PubMed1979

[Experiences using the suction curettage system of Hamann and Pockrand (author's transl)].

All curettages of a 8-week-period were done using the suction system of Hamann and Pockrandt. This test-collective includes 66 patients, their age was between 20 and 78 years; 6 of them had to be excluded: the surgical intervention was begun without general anaesthesia but continued with general anaesthesia is required by the patient. The test-collective was divided into 2 groups: in group A (30 patients) all suction-curettages were done in general anaesthesia, in the first 20 patients a conventional curettage with dilation of the cervix were performed additionally, in order to proof the effectiveness of the suction curettage. The histological findings of the materials of the conventional curettages had shown no more informations than that of the materials of the suction curettages. -- In group B (30 patients) the suction curettage were done in diazepampentazocin-analgesia; a third of them had specified no sensations, the others had stated a feeling of pressure or spasms. -- In each group the histological examinations were possible without any problems. The advantages of the suction curettage system are the rare necessity of cervix dilatation (7 of 60 cases), the possibility of the operation without general anaesthesia and the possibility of a quick performance of the curettage.

Abortion, Incomplete↗
PubMed1979

[The alveolar-arterial oxygen quotient. standard norms, clinical findings (author's transl)].

From the practical standpoint of view the A-aDO2 proved to be a good parameter for evaluation of global gas exchange. The endexspiratory oxygen pressure, recorded by mass spectrometry, is set equal to the alveolar oxygen pressure. Therefore it is possible for clinical use to have an on line monitoring of PETO2--PaO2. It is necessary to specify the pressure difference in dependence of the inspiratory oxygen pressure since the alveolo-arterial oxygen pressure difference increases with increasing inspiratory oxygen pressure concentration. For practical clinical purposes we come out with the relative ratio of the difference adjusted to the alveolar oxygen pressure. The alveolar-arterial oxygen quotient also called "quotient": formula: (see text) has proved to be a clinical suitable figure. For this quotient are no standard norms reported in the literature. This study was set up to evaluate the quotient in 9 healthy volunteers. The standard norms, found in our study, can basically used for practical clinical purposes. This quotient is demonstrated to be practicable in intensive care medicine (obstructive pulmonary disease, acute pulmonary failure, positive pressure ventilation).

Adult↗
PubMed1979

[Loss of resistance in axillary plexus blockade].

The results of the "loss of resistance" method for identification of the perivascular space are demonstrated. The axillary plexus with its accompanying structures is embeded in the perivascular space. 20 pressure readings were performed with a special transducer. A statistically significant pressure loss was demonstrated after passing the vascular and nerve sheath. The distinct pressure differences during the tissue penetration are recognized with the finger guiding the syringe, similar to the technique used for peridural anaesthesia. We thus believe that we can offer an exact method for blocking the axillary plexus with maximum safety which does not rely on the cooperation of the patient.

Axilla↗
PubMed1978

[A rare cumulation of vena cava catheter complications in the same patient (author's transl)].

Two complications that occurred in connection with the use of CVP catheters in the SVC and IVC in one patient are described: 1. Extravascular injection in the superior mediastinum and in the extrapleural space. 2. Massive thrombosis of the IVC. The differential diagnosis of a wedening of superior mediastinum is discussed. Recommendations are made to prevent these complications.

Adult↗
PubMed1978

[The continuous perivascular axillary plexus block in hand replantation surgery (author's transl)].

A modified techniques of axillary plexus block is described which enables prolonged analgesia. The main principle of this techniques is to insert an indwelling canula into the perivascular tissue of the plexus brachialis. A cold local anaesthetic (4 degrees) is injected for controlling the canula site. The indications for this technique are all corrective and reconstructive operations of the upper extremity and the postoperative alleviation of pain. Twenty cases with different indications are discussed in this paper. No allergic, toxic or inflammatory reactions were seen in our patients. They were satisfied with this method of analgesia. The easy application, absence of time limiting factors and suitable intraoperative monitoring are the advantages of the method.

Brachial Plexus↗
PubMed1977

[Pulmonary edema due to unilateral pneumothorax (unilateral shock lung) (author's transl)].

Unilateral pulmonary edema due to chest drainage is reported in the present paper. Drainage was carried out, because of pneumothorax. The disorder could be treated successfully with differenciated mechanical respirator therapy and additionally with methylprednisolon, heparin, spirolactone and dopamin. Based upon clinical symptoms and on present literature we suggest to account this so called "pulmonary edema exvacuo" to the main complex of acute respiratory insufficiency (unilateral shock lung).

Adult↗