Biomedical subjects
Publications and source records attributed to R Schorer.
The key factor in malignant hyperthermia does not seem to be a defect in the calcium-storing membrane of the skeletal and cardiac muscle cells. The primary cause would appear to be deficiency of adenylate kinase.
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A new CO2-Analyzer for continuous measurement of CO2 content during artificial respiration is described. Based on infra red absorption, this device may be used for measuring the carbon dioxide content of expiration in anaesthesia and intensive care. Carbon dioxide infrared absorption is affected by nitrous oxide. This side effect can be compensated by a single switch, if the sample contans N2O.
A computer-assisted system for the calculation of derived blood-gas and acid-base parameters, consisting of an analysator (AVL 937) desk calculator (HP 9825A) and external printer (HP 5150A) is described. For the calculation of the derived parameters corrections were made for patient temperature, plasma protein, reduced haemoglobin and CO2-carbamino haemoglobin. The time needed for calculating and feed back was shortened.
The present case report describes a case of intrapleural infusion by means of a subclavian catheter. The clinical situation together with the signs of posteroinferior infarction in ECG led to a wrong diagnosis. During an emergency oepration the intrapleural infusion caused cardiac arrest which could be mastered by successful reanimation. After drainage of the intrapleural infusion the patient recovers without further complications. Prior to every infusion subclavicular catheters should be tested by blood aspiration.
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Ventilatory disturbances are induced by airway closure associated with an increase of the venous admixture from alveoli with a low ventilation-perfusion-ratio. Closing volume was measured by single breath nitrogen washout curves and correlated with ventilatory disturbances derived from multiple breath nitrogen washout curves and an inspiratory gas distribution index (IDI). There was present a close correlation between the closing volume in relation to the functional residual capacity and the IDI. With rising closing volume in relation to functional residual capacity a deterioration of the inspiratory gas distribution with increasing venous admixture was observed.
Local toxic reactions from adrenaline following nerve block anaesthesia have been observed by many workers. Because of this potential danger we studied the changes of anaesthetic solutions containing adrenaline during a longer storage period. The measurements show a drop in the pH of the solutions caused by decomposition of adrenaline. This effect of storage is not detectable with the naked eye but makes analytical procedures necessary. Molecular oxygen and light decompose the solutions rapidly. After a storage period of some months the acidity of the solutions is comparable to concentrated acetic acid, a fact which could lead to local complications.
Extended perfusion with extracorporal circulation membrane oxygenators of the Lande-Edwards type was performed in 43 patients. Two groups of patients were studied in detail: 1. Patients undergoing aortic valve replacement primarily because of calcified aortic defects (n equals 20; average perfusion time 96 min.1 2. Young children in whom the operation of Mustard was mainly performed (n equals 10; average perfusion time 92 min.) There were no deaths or complications due to the use of the membrane oxygenator. Particular emphasis is laid on the careful preparation of the apparatus. Although venous drainage is only by gravity, high flow perfusion was possible in all age groups. Haemodynamics and metabolism were good even after 1 1/2 hours perfusion. Haemodialysis was slight.
In a group of 21 patients with thoracotomy the lung function was investigated pre-and postoperatively with particular consideration to N2-clearance. From the N2-clearance an Inspiratory Gas Distribution Index (IDI) is derived. This Index allows in combination with blood gas analysis an interpretation of ventilatory disturbances in the lung.
In a group of 12 hypovolemic patients some parameters of circulation and kidney function were measured before and after an infusion of 1000 ml 6% hydroxyethyl starch solution (HES) was given. There were found increases in cardiac output, centralvenous pressure and endogenous creatinine clearance, and decreases of total peripheral resistance and shock index. Under the conditions of this investigation HES solution showed good properties as a plasma substitute.
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