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P Sporn

Publications and source records attributed to P Sporn.

71 records · Page 4Linked to original sources
PubMed1982

[Bedside evaluation of hemodynamic and respiratory data with a programmable pocket calculator].

Information obtained from repeated measurements of basic haemodynamic and pulmonary artery catheterization data has become useful for treatment of critically ill patients. In addition, the determination of cardiac output, the systemic, central venous, pulmonary arterial and pulmonary capillary wedge pressures, and blood gas data of arterial and mixed venous sampling allow to calculate derived cardiorespiratory variables. Since manual computation is a time-consuming measure in the daily routine of an intensive care unit and online computer monitoring an expensive one, we developed a program for bedside use in a handheld programmable calculator. This program incorporates the following characteristics: calculation of standard hemodynamic, oxygen transport and perfusion-related variables, temperature correction of blood gas data, and derivation of oxygen saturation and intrapulmonary shunt.

Blood Gas Analysis↗
PubMed1981

[Lipid and lipoprotein metabolism in acute pancreatitis].

In 10 patients with acute pancreatitis the lipid- and lipoprotein-metabolism was studied. In all patients blood samples were drawn for estimation of the fasting concentration of the lipoproteins. In 7 patients the postheparinlipasesystem was testet by an intravenous heparintest. Afterwards, 0.2 g fat/kg bodyweight were injected intravenously in 2 min. Before, 5, 10, 30 and 40 min after injection blood was drawn. Lipids were estimated by means of full encymatic methods, lipoproteins were determined according to the lipid research clinics method, NIH, using a combination of ultracentrifuge and polyanion precipitation. In comparison with healthy people the cholesterol, specially the LDL fraction was low. Additionally the triglycerides were elevated in 3 patients, caused by elevation of the VLDL fraction. After injection of heparin in all patients the triglyceride concentrations fell. That shows a functionating lipoprotein lipase system. Intravenously injected fat was eliminated in all patients with an elimination rate between 1 and 2 %/min. From these results it is concluded that exogenous fat is eliminated sufficiently from serum in acute pancreatitis. There is no sign for disturbed fat metabolism in these patients. Therefore the contraindication for fat emulsions in acute pancreatitis does not seem to be justified. Due to the fact of glucose intolerance in these patients fat emulsions could be used for an adequate supply of energy. Patients with a hyperlipoproteinemia should be excluded from this therapy by daily detection of triglycerides.

Acute Disease↗
PubMed1981

[Hydrothorax after catheterization of the right internal jugular vein (author's transl)].

Two cases of hydrothorax are reported which developed as the result of intrapleural catheter malposition after cannulation of the right internal jugular vein. Predisposing factors for this rare, but frequently misdiagnosed, complication are discussed. In both cases control chest radiography with small doses of contrast medium as well as aspiration of blood failed to indicate malpositioning. To prevent this complication the use of larger doses of contrast medium and/or control aspiration shortly after the start of infusion are recommended.

Aged↗
PubMed1981

[A new adaptor for endotracheal tubes to permit suction without interrupting artificial ventilation (author's transl)].

A new side-hole adapter (C/D SUCTION ADAPTER, Novametrix Medical System) enables tracheobronchial suctioning during uninterrupted mechanical ventilation. Compared to conventional end-hole suctioning techniques a significantly smaller drop of arterial pO2 during suctioning procedures was found. Additional advantages e.g. reduced formation of microatelectasis, improved expulsion of bronchial secretion and lower risk of tracheal mucosa lesions by the catheter tip are discussed.

Humans↗
PubMed1980

[Metabolic studies on intensive care patients during gastric tube feeding with a formulated diet, rich in bulk].

Results of metabolic investigations in 5 intensive care patients fed via gastric tube with a prefabricated formula diet (based on milk protein, rich in bulk material) are reported. Clinical handling proved to be rather simple, due to the homogeneity of the mixture tube, obstruction never occurred. Tolerance of the tested tube feeding was good in 4 of 5 patients (in 1 tetanus patient the study to be interrupted because of acute abdominal symptoms), mean body weight increased. During the 10-day treatment period, a slightly positive nitrogen balance (mean 1.4 +/- 5.9 g/day) resulted in a cumulative nitrogen retention of 15.5 g. Fat losses in faeces, probably due to high intake (more than 50% of calories administered), were moderately elevated compared to normal values; in some patients decreased fat resorption with steatorrhoea was observed on various days. The formula diet under investigation may be qualified as a suitable nutritional regime for intensive care patients with intact gastrointestinal function. In cases with impaired fat utilization, however, relative calorie deficiency interfering with protein synthesis (gluconeogenesis) might occur. Lowering of the fat quota (having been taken into account in the meantime) to the benefit of elevated carbohydrates may be desirable in this context.

Adolescent↗
PubMed1980

[Fatal hyperthermic crisis after premedication. Human stress syndrome or trigger effect of promethacine (author's transl)].

A case report of a fatal hyperthermic crisis after premedication and before introduction of anaesthesia is given. Based on the typical clinical course, CK isoenzyme patterns and preliminary results of familial investigation the diagnosis of malignant hyperthermia could be established. According to literature reports, psychic stress and/or phenothiazine medication may be assumed as triggering factors. Until a potential causality between malignant hyperthermia and phenothiazine medication can definitely be ruled out, their use in suspicious cases of susceptibility to malignant hyperthermia should be avoided.

Adolescent↗
PubMed1980

[Influence of isosorbide dinitrate on haemodynamics and gas exchange in acute respiratory distress syndrome (author's transl)].

The effects of intravenous isosorbide dinitrate (ISDN: 3, 6, 9, and 12 mg/h) on systemic and pulmonary vasculature, gas exchange, and dynamic lung compliance were investigated in 7 controlled ventilated patients suffering from ARDS after trauma or in sepsis. Parameters were recorded before and after 20 min. ISDN infusion with 30 min interruption between the different dosage steps. Systemic circulation, heart rate, cardiac index, and stroke index remained grossly unchanged. MPAP was significantly decreased at 6, 9, and 12 mg/h ISDN to 61,7%, 61%, and 69,3% of initial value, as well as PCWP to 49,6% 45,5% and 41,5% of initial value. The drop of RVSWI at 6 and 9 mg/h ISDN to 59,1% and 63,2% also was statistically significant. There was an increase in Qs/Qt, AaDO2, and dynClung, though the increases were not statistically significant. O2availability remained unchanged. Administration of ISDN in ARDS causes an improvement in right ventricular function due to a reduction of pre- and afterload as well as intrapulmonary blood volume. In a similar manner increasing lung compliance may be explained by volume shif. The slight alterations of ventilation-perfusion-ratio as seen by increases in Qs/Qt and AaDO2 can be tolerated because of the unchanged O2availability.

Hemodynamics↗
PubMed1979

[Effect of a 3.6 o/o dextran Ringer acetate solution on moderately hypovolemic patients in intensive care].

The effects of 1000 ml 3.6% dextran Ringer's acetate solution (Mw 61,800; infusion time 60 min) on circulation, blood and plasma volume, blood viscosity and renal function parameters were investigated, the renal elimination of dextran also being measured. During the entire investigation period no significant alterations of cardiocirculatory parameters, blood and plasma volume and rheological properties of blood could be demonstrated, the same holding true for kidney function values. Dextran excretion was about 33% three hours after the end of infusion, reaching 51% of the whole amount given 21 hours later. It has to be assumed that mainly macromolecular dextran components of less efficiency are retained intravascularly. Taking into consideration the practically absent volume expanding effect - even at the end of infusion period - this dextran solution cannot be recommended as a blood substitute during acute hemorrhage or as an "expander" in other shock states.

Acetates↗
PubMed1977

[Patterns of renal and haemodynamic functions in cadaver kidney donors under dopamine (author's transl)].

Haemodynamics and renal function have been examined before and during i.v. infusion of dopamine (175 microgram/min) in 11 patients admitted as potential kidney donors to an intensive care unit. The findings of the control period revealed an extreme decrease of renal tubular function which points to a cessation of central regulation. The cardiovascular system showed a slight increase of blood pressure and heart rate during dopamine. Urine flow and renal blood flow increased significantly as well as the excretion of sodium while inulin-clearance showed only a minimal rise. The functional renal impairment under conditions of brain death as well as the influence of dopamine on circulation and renal function are discussed. The results indicate that dopamine may exert a favourable effect in preparation of kidney donors for the withdrawal of the organs.

Adolescent↗
PubMed1976

The role of the anaesthesiologist in the intra- and post-operative management of kidney transplant patients.

Based on experiences with 256 kidney transplant operations in 239 patients over a period of ten years (18.6. 1965 to 15.4. 1975) the role of the anaesthesiologist as it had developed in our institution has been described. Some problems with regard to the anaesthetic management of living donors were discussed. The care of patients who, due to their deteriorating cerebral function, are potential donors was also described. An outline of the own anaesthetic management of the recipient has been given and alternative methods were mentioned. Some special points were specifically stressed like the choice of relaxants, fluid replacement, blood transfusion, diuretic treatment starting already intraoperatively. Good intensive care of the potential donor is of great importance for the function of the transplanted organ. Very important is also the postoperative treatment of the recipient, which in our institution is performed in a teamwork between anaesthesiologist, surgeon and nephrologist. Finally, the functional results of our series are briefly demonstrated.

Anesthesia, General↗
PubMed1975

[The effect of propanidid in patients with an increased tendency to cerebral convulsions (author's transl)].

In view of the observation of tonic-clonic convulsions after the use of Propanidid in certan patients, a study was undertaken of the effects of this drug (7 mg/kg) on the EEG of 2 volunteers with a known history of epilepsy. Both subjects developed tonic-clonic convulsions and showed typical alterations of the EEG pattern even before the onset of hyperventilation. These EEG alterations were producible also during complete relaxation. The convulsions were easily stopped by the administration of short-acting barbiturates. Similar observations reported in the literature are briefly discussed. The conclusion is drawn that Propanidid should not be given to patients with a known history of epilepsy or any other convulsive disease.

Electroencephalography↗
PubMed1975

[Ophthalmodynamographic and ophthalmodynamometric findings following irreversible loss of cerebral function (author's transl)].

In 12 patients with irreversible cessation of cerebral function (so-called "brain death") ophthalmodynamographic (ODG) measurements were made. In 8 of these ophthalmodynamometric (ODM) investigations were also made. ODG results were abnormal in all cases, pulsation volumes showing a deep decrease (x:16.8 mm3;x of mean arterial pressure 79,1 mm Hg). ODM measurements revealed highly scattered results, ophthalmic artery pressure being normal in 3, increased in 1, severely reduced in 2 patients.--In 2 other cases mere touching of the eye bulb by the ophthalmodynamometer caused a sudden complete collapse of the central retinal artery. Whereas the ODG results might already be considered as useful auxiliary findings, for definite evaluation of the clinical significance of ODG and ODM in diagnosing an intracranial circulatory, additional comparative investigations may be necessary.

Aneurysm↗