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Biomedical subjects

Sven Gottschling

Publications and source records attributed to Sven Gottschling.

22 records · Page 2Linked to original sources

Sedation with midazolam and ketamine for invasive procedures in children with malignancies and hematological disorders: a prospective study with reference to the sympathomimetic properties of ketamine.

Different pharmacological agents have been used for sedation in children undergoing invasive procedures. The authors prospectively evaluated the efficacy, the occurrence of adverse side effects, and cardiovascular parameters in midazolam and ketamine sedation for invasive procedures in children with malignancies and hematological disorders. A total of 183 invasive procedures were performed on 63 children (mean age 9.2 +/- 5.2 years). Intravenous sedation consisted of 0.1 mg midazolam/kg and 1.0 mg ketamine/kg. Incremental dosages of ketamine (0.33 mg/kg) were given if necessary to maintain deep sedation. Systolic and diastolic blood pressure, heart rate, and oxygen saturation were recorded. All 183 invasive procedures were successfully completed with satisfactory sedation levels in 170 procedures (92.9%; 95% CI:88.2-96.2%). In 33 procedures (18%; 95% CI: 12.8-24.4%) sedation was associated with side effects, the most common being oxygen desaturation. One patient experienced a transient episode of laryngospasm. There was a significant increase in both systolic and diastolic blood pressure and heart rate after ketamine medication (p <.01). Procedure and recovery time were correlated to ketamine dosage (p <.01). The combination of midazolam and ketamine is efficacious in achieving deep sedation for painful invasive procedures. Considering the possibility of potentially serious respiratory complications it should be performed only by physicians who are trained in advanced airway management and life support. As opposed to many other sedative drugs with cardio-depressant properties, ketamine causes a rise in both systolic and diastolic blood pressure, and heart rate.

Anesthetics, Combined↗

Ganglianeuroma: radiological and metabolic features in 4 children.

Ganglioneuroma constitutes a benign and surgically treatable tumor. The authors studied 4 patients with histopathologically proven ganglioneuroma focusing on radiological and metabolic features. The results confirm previous investigations that have shown metabolic activity in ganglioneuroma and characteristic patterns in imaging studies. Although for definite diagnosis tissue investigation is required, certain clinical and radiological features are suggestive of ganglioneuroma.

3-Iodobenzylguanidine↗

Intraindividual propofol dosage variability in children undergoing repetitive procedural sedations.

The authors prospectively assessed intraindividual variability in propofol dosage for induction of sedation in repetitive procedures in children with malignancies. A total of 80 procedures were performed in 24 children. Primary outcome measure was the intraindividual propofol dose required to achieve adequate sedation. Intraindividual variability in propofol dosage required to achieve adequate sedation was 0.0-2.2 mg.kg-1. Twenty-five percent of the patients had a dose range of 0.0-0.5 mg x kg-1; 37.5%, >0.5-1.0 mg x kg-1; and 37.5% >1.0-2.2 mg x kg-1. Due to remarkable intraindividual differences, propofol dosage should be titrated toward the desired level of sedation.

Adolescent↗

An epidemic airborne disease caused by the oak processionary caterpillar.

The oak processionary caterpillar (Thaumetopoea processionea Lepidoptera) is found in several European countries. It usually lives in oak forests or on single-standing oak trees. The larva of from the 3rd to 6th developmental stage (instar) develops poisonous hair (setae), filled with an urticating toxin that may lead to serious dermatitis, conjunctivitis, and pulmonary affection (summarized as lepidopterism) on contact with the setae. In June 2004 more than 40 people including young children developed symptoms of lepidopterism after resting within 20 m of an infested oak tree. Only a few people had touched the caterpillars. All those with clinical symptoms of lepidopterism could be treated as outpatients, but several needed systemic steroids because of the severity of their complaints. Lepidopterism, an airborne disease caused by the setae of the processionary caterpillar, is a growing public health problem because of the increasing numbers of outbreaks.

Adolescent↗