Search PubMed⌕ Search

Biomedical subjects

R Spiel

Publications and source records attributed to R Spiel.

14 recordsLinked to original sources
PubMed1979

[The efficacy of the intra-aortic balloon pump for patients with heart failure complicating acute myocardial infarction (author's transl)].

Assisted circulation was carried out with the help of an intra-aortic balloon pump in 22 patients with acute transmural myocardial infarction and heart failure (despite medication). Two patients died in hospital. The combination of the balloon pump and nitrates proved to be particularly effective. The follow-up examination of the survivors showed a distinct pulmonary arterial pressure during ergometry. All of the examined patients revealed extensive akinetic and diskinetic areas, significant stenosis being detectable either in the proximal area of the Ramus descendens anterior or in two or three blood vessels.

Adult↗
PubMed1979

[Ventricular rupture during acute myocardial infarction (author's transl)].

In a series of 523 consecutive patients with acute myocardial infarction (AMI) 112 died; among these were 18 with rupture of the free wall of the left ventricle (HR) (group RU); two other cohorts were formed: one sample of all patients with acute (transmural) myocardial infarction (group KO) and another cohort of death of AMI in 1976 (EX). 1. patients with HR are significantly older than the KO group; there is no difference in age compared to the patients who died of AMI other than HR (group EX). 2. Women with AMI have a higher chance to die of HR than men. 3. The RU group has significantly more often clinical signs of congestive heart failure than the control group. 4. Cardiogenic shock is significantly more frequent in the RU-group than in the control group. 5. All deaths (EX + RU) have worse hemodynamic data than the control group (KO). 6. Elevated blood pressure (before and after AMI) could not be identified as a risk factor for HR in our patients. 7. In the course of AMI, death in pump failure occurs significantly later than heart rupture.

Acute Disease↗
PubMed1978

Bacterial contamination of pulmonary artery catheters.

The catheter tips of 152 patients, who were haemodynamically supervised by pulmonary artery monitoring or continuous cardiac output determination, were bacteriologically examined. 106 cultures remained sterile, 21 cultures revealed a growth of non pathogenic organisms. Staphylococcus aureus was cultured 15 times, pseudomonas aeruginosa 4 times, Citrobacter as well as Escherichia coli twice, and Klebsiella and Enterobacter once each. There was no statistically significant connection between dwelling period and contamination. Also diabetes mellitus or corticoid medication in high dosage had no significant influence on contamination rate.

Bacteria↗
PubMed1977

[Arrhythmias during catheterization of patients with acute myocardial infarction (author's transl)].

Arrhythmias in forty consecutive patients with acute myocardial infarction during ventricle passage of floating catheters were compared with those in forty patients with chronic heart disease. Lidocaine (1 mg/kg body weight i. v.) as a bolus proved to be effective in reducing the incidence of these arrhythmias, because the number of single ventricular premature beats (VPBs), and the number of VPBs in salves was significantly reduced. Haemodynamic changes due to this bolus are small and short-lasting, so that they are acceptable, especially when continuous monitoring of the patients is attempted. Furthermore dangerous arrhythmias are reported in 1600 cases treated with floating catheters.

Acute Disease↗
PubMed1977

[Continuous monitoring of the pulmonary artery pressure in acute myocardial infarction (author's transl)].

The method of continuous pulmonary artery pressure (PAP) monitoring and its use in 66 patients with acute myocardial infarction is described. Measurement of PAP should be the first diagnostic step in hemodynamic monitoring and early recognition of left ventricular failure. In cases of elevated PAP and critical general state of the patient, monitoring should be extended by measuring pulmonary wedge pressure and cardiac output. Hemodynamic monitoring should be continued for 3 to 5 days, since some cases of acute myocardial infarction with increasing PAP up to the 4th day after the onset were recorded. With the safety precautions mentioned, neither threatening, arrhythmia, nor thromboembolic or septic complications were observed.

Acute Disease↗
PubMed1977

[Behavior of pulmonary artery pressure in the egometric exercise test in chronic coronary disease].

Bicycle exercise stress tests of 39 patients with coronary heart disease are compared to those of 33 healthy persons. The difference in enddiastolic pulmonary artery pressure (PAEDP) of the patients compared to the healthy is low at rest (PAEDPhec healthy = 8.49 +/- 2.80, PAEDPCHD = 10.51 +/- 5.09, p = 0.05). Stress testing (50 Watts) brings significant differences of the average enddiastolic pressures (PAEDP healthy = 12.76 +/- 3.61, PAEDPCHD = 19.38 +/- 7.96, p = 0.001). More important than this (already well known difference) is the wide divergence of results within the group of patients with CHD. For this reason this type of investigation seems to be a good "screening method" regarding selection for coronary arteriography. The reason for the pathological rise of PAEDP can be found in a decrease of compliance due to ischaemia ("coronary factor"), or in exercise induced temporary heart failure ("myocardial factor"), or both.

Adult↗
PubMed1977

[Agranulocytosis after antiarrhythmic therapy with ajmalin (author's transl)].

A case of agranulocytosis (min. leucocyte count 980/mm3) after 4 weeks of treatment with an ajmalin derivate is reported. Recovery could be achieved by taking away the antiarrhythmic drug. It appears that these agranulocytoses only happen after a dosage of more than 300 mg/die, and that they have an intermediate position between allergic and toxic agranulocytosis (phenothiazine type).

Aged↗
PubMed1976

[Pulmonary artery end-diastolic pressure recordings after myocardial infarction (author's transl)].

29 patients with acute myocardial infarction were subdivided into 3 groups using the information gained by continuous measurement of the pulmonary artery end-diastolic pressure (PAEDP) during a stay of 3 to 5 days in the coronary care unit of this hospital. Group I comprised patients with a PAEDP of below 12 mm Hg (without treatment), group II those with a PAEDP of between 12 and 20 mm Hg and group III those patients with a PAEDP of above 20 mm Hg. 3 to 6 months after rehabilitation and ambulant ""coronary training'' a follow-up control PAEDP measurement was performed at rest and during ergometric stress with the bicycle exercise test. 2 out of the 15 patients in group I had a pathological PAEDP at rest, whilst exercise of 50 watts raised the PAEDP to pathological values in 40% of this group of patients. Group II: 58% of the patients with an initially-raised PAEDP showed a normal value at follow-up examination 3 months subsequently. Exercise of 50 watts raised the PAEDP to pathological values in 66% of the patients in this group. Group III. The pathologically high PAEDP recordings at rest made it impossible to subject these patients to stress with the bicycle ergometer. The prognostic value of the classification of patients with myocardial infarction into pressure groups and the importance of PAEDP follow-up measurements on patients after myocardial infarction at rest and after ergometric stress are discussed.

Acute Disease↗
PubMed1976

[The prognostic value of continuously measured pulmonary artery pressure in recent myocardial infarct].

Enddiastolic pulmonary artery pressure (PAEDP) was measured continuously in 100 patients with acute transmural myocardial infarction, beginning on admission to the CCU and lasting till the 3rd, 4th or 5th day. The PAEDPs of the first day were averaged and on this basis the patients were divided into three groups. Mortality in Group I (41 patients with PAEDP below 12 mm Hg) was 4.9%, in Group II (43 patients with PAEDP of 12-20 mm Hg) 16.3%, and in Group III (16 patients with PAEDP above 20 mm Hg) 43.8%. Use of additional hemodynamic parameters such as cardiac output, cardiac index, and cardiac work index increased prognostic precision for patients in the acute stage. However, they did not improve prognostic precision on fatal outcome in the post-acute stage. Bicycle exercise stress tests carried out several months later with simultaneous evaluation of hemodynamics (PAEDP) showed a good suitability for rehabilitation in Group I and in 58% of the patients in Group II. The other 42% had a significant rise in pulmonary artery pressure, could not undergo stress, and, in our view, are suitable for rehabilitation only in exceptional cases.

Aged↗