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Biomedical subjects

R Neuhaus

Publications and source records attributed to R Neuhaus.

At least 127 records · Page 7Linked to original sources
PubMed1980

[Pheochromocytoma in pregnancy--pathophysiology and therapy (author's transl)].

In this paper pathophysiology of pheochromocytoma and its modern diagnostic and therapeutic management are discussed with special regard to the combination of pheochromocytoma and pregnancy. The preoperative treatment with phenoxybenzamine is evaluated. As for the anesthetic management barbiturates and neurolept anesthesia are recommended. In the acute treatment of extreme blood pressure values sodium nitroprusside is preferred to phentolamine. Whereas vaginal delivery is contraindicated in a patient with pheochromocytoma there is no definite superiority of tumorresection along with caesarean section against a separate abdominal procedure.

Adrenal Gland Neoplasms↗
PubMed1978

[Risk of general anaesthesia (author's transl)].

95 506 patients who received general anesthesia during the period of 1964--1977 were studied. The account of all actual or possible life threatening complications during the anesthesia is given: oedema of the glottis, air embolism, accidental injection of the wrong drug, respiratory insufficiency, hypoxia, pulmonary oedema, airway occlusion by the cuff, vomiting and aspiration, anaphylactoid reaction, death within 24 hours, death on the table. Deaths not attributable to anaesthesia are listed separately. We have found that in one of every 139 anaesthetics given there was a life threatening complication to the patient. In every 197th anaesthetic there was a clear connection with the anaesthetic technique used. In contrast with the great number of near fatal complications the rate of irreversible damage or mortality connected with general anaesthesia was low.

Adolescent↗
PubMed1976

[Cardiodepressive effects due to ketamine, etomidate, methohexitone and propanidid. A clinical study by means of the systolic-time-intervals (author's transl)].

The cardiodepressive effects of ketamine (1mg/kg), etomidate (0.3mg/kg), methohexitone (1mg/kg) and propanidid (4mg/kg) have been compared by means of the systolic time intervals on patients during a steady-state halothane--N2O:02(1.1)-- anaesthesia. This anaesthesia served as a pharmacological model of reduced myocardial function, and moreover, it should block the centrally-elicited cardiac stimulation by ketamine, thus unmasking the direct negative inotropic action of this anaesthetic. Ketamine and etomidate are of lesser cardiac depressant action than methohexitone or even propanidid. Diazepam (0.2-0.25mg/kg) proved to be able to attenuate or abolish, respectively, the ketamine-induced increases of heart rate and blood pressure in normo- and hypertensive patients, and might therefore be useful for induction anaesthesia in cardiac and coronary risk patients, as proved on two patients with recent myocardial infarction.

Adult↗
PubMed1975

[Intense therapy in two cases of "near-drowning" (author's transl)].

A short review of the pathophysiological mechanisms in case of 'drowning' or 'near drowning' with or without aspiration of hypo- or hypertonic water is given. In our clinical experience on 22 cases, 17 did not need intensive care and improved without further problems. 3 came dead into the clinic, there being more than 30 min latency between cardiac arrest and the beginning of resuscitation, resuscitation, therefore, being without success. The last 2 cases of 'near-drowning' with fresh water aspiration developed, 100 min and 50 min respectively after the drowning accident, fulminant pulmonary oedema, which could be cured after application of PEEP in Engstroöm-IPPB in one case. In our opinion PEEP should be applied in all cases of intraalveolar pulmonary oedema in the same way as was advised for interstitial pulmonary oedema, if the individual case requires mechanical ventilation at all. The possibility of pulmonary oedema developing, even hours after the accident and primary resuscitation, should be born in mind in all cases of 'near-drowning'.

Adolescent↗
PubMed1975

[Ketamine - a cardiovascular stimulating agent with direct cardiodepressant action (author's transl)].

Induction anaesthesia with 2 mg/kg of ketamine causes the well-known increases in heart rate and blood pressure. Simultaneous registration of the systolic-time-intervals (PEPI, LVETTI, PEP/LVET = Q), however, reveals a biphasic effect of ketamine on these contractility-parameters: an initial increase of PEPI and Q, representing a cardiac depressive effect of ketamine, is followed by a decrease of PEPI and Q, indicating a positive inotropic action of ketamine. Injecting the same dose of ketamine during the steady-state of a halothane-N2O:O2-anaesthesia, that causes a depression of the central and peripheral sympathetic activity, however, results in an increase of PEPI and Q, only. Thus, ketamine is a cardiac depressive agent, this effect, however, usually being overlapped by a centrally-induced cardiac stimulation.

Blood Pressure↗
PubMedDate not supplied

Myocardial oxygen consumption and regulation of coronary blood flow during stepped relief of the left ventricle.

In 25 calves an atrio-ventriculo-aortic bypass was performed and the metabolism and the regulation of coronary blood flow during stepped assistance of the left ventricle was studied. With mean aortic blood pressure kept constant stepped decrease in left ventricular pressure from 120 to 0 mmHg diminished myocardial oxygen consumption from 7.7 to 1.9 ml O2/min X 100 g. Increasing right ventricular pressure by banding the pulmonary artery with left ventricular pressure and mean aortic pressure kept constant the oxygen uptake of the left ventricle increased about 20.7 +/- 32.% when measured by Fick's principle but remained unchanged when calculated from hemodynamic parameters of the left ventricle (-1.5 +/- 3.5%). At constant coronary perfusion pressure coronary blood flow decreased when left ventricular pressure was reduced from 120 to 100 mmHg. Further decrease in left ventricular pressure to 0 mmHg showed no effect on coronary blood flow. Increasing heart rate from 152 +/- 9 to 208 +/- 8 b.p.m. enhanced myocardial oxygen uptake of the assisted heart about 59.0 +/- 11.4% while resistance to flow decreased about 40.4 +/- 2.8%. These results show that the metabolic regulation of coronary blood flow is still acting even in the assisted left heart.

Animals↗