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Biomedical subjects

U Hedstrand

Publications and source records attributed to U Hedstrand.

At least 37 records · Page 2Linked to original sources
PubMed1981

Albumin treatment following major surgery. I. Effects on plasma oncotic pressure, renal function and peripheral oedema.

The effect of a 20% albumin solution on plasma oncotic pressure, renal function and peripheral oedema was investigated in 30 adult patients undergoing elective major abdominal surgery. Half of them received an average of 173 g of albumin between the end of the operation and the 5th postoperative day, in accordance with a standardized scheme. Otherwise the same schedules for fluid therapy and blood replacement were followed in all patients. Postoperatively, serum albumin and plasma oncotic pressure were fairly normal in the albumin group, but decreased by 28% and 24% in the control group. The difference between the groups was statistically significant during the first week, but disappeared during the second week. Arm and thigh circumferences increased postoperatively to a similar extent in both groups. There were no apparent differences in circulatory variables, alveolo-arterial oxygen tension difference, incidence of wound infection or postoperative restoration of intestinal activity between the groups. Although renal and thromboembolic complications occurred only in the control group, the material is too small to permit any conclusions to be drawn from the possible difference in renal function and morbidity between the groups. The limited availability and high cost of albumin require strict indications for its use. Our results so far have failed to justify routine administration of concentrated albumin postoperatively.

Abdomen↗
PubMed1980

Cerebral computed tomography in methanol intoxication.

In four of six patients with methanol intoxication, computed tomography (CT) showed necrotic changes in the area of the putamina. Hemorrhages were also seen in some cases. There was a clear relationship between the severity of the clinical symptoms and the CT findings, indicating the potential of CT for prognosis and possible therapy guidance.

Adult↗
PubMed1979

Interpretation of the tcPO2 curve in adult patients in an intensive care unit.

From the data collected on 135 adult patients in an intensive care unit the following conclusions of the interpretation of the transcutaneous PO2 curve in this type of patient may be drawn: 1) One to four minutes after the electrode was attached a nadir (= the lowest initial point) was reached and then there was a gradual increase which ended with an initial plateau. This plateau could be predicted from the lowest initial point by adding 30 mm Hg. 2) If the lowest initial point was 35 mm Hg or less, it was expected that the final tcPO2 level would be lower than the actual PaO2. 3) No correlation was seen between the lowest initial point of the tcPO2 curve and the time until the initial plateau was reached. In 75% of the cases the plateau was reached within 20 minutes. 4) A slight positive correlation was found between arterial blood pressure and lowest initial point. The difference between the means of the lowest initial point for a group with blood pressure less than or equal to 90 mm Hg and another group with blood pressure greater than 120 mm Hg was highly significant. 5) Transcutaneous PO2 measurements were more likely to represent the arterial PO2 level if blood pressure was greater than 120 mm Hg than if it was less than or equal to 90 mm Hg. 6) The lower the initial tcPO2 level, the more likely it was that the arterial level was higher than the tcPO2 level (see also point 2). 7) The differences between PaO2 and tcPO2 were independent of the arterial PO2 level. 8) The overall correlation between PaO2 and tcPO2 in this material was 0.91; the slope was 0.90 and the intercept -8 mm Hg. The correlation coefficient within each individual patient was higher. 9) The correlation coefficient between PaO2 and tcPO2 for those patients in whom PaO2 was 60 mm Hg or less was comparatively low. This may be explained by the bad condition of these patients followed by a reduced blood flow. 10) An initial drop in tcPO2 to zero level indicates a reduced peripheral circulation, but this must be suspected when the initial drop is below 35 mm Hg.

Adolescent↗
PubMed1978

The use of physostigmine as an antidote in tricyclic anti-depressant intoxication.

The value of physostigmine treatment of unconsciousness due to self-poisoning by tricyclic antidepressant drugs (TAD) was evaluated in 10 patients, and the following conclusions are drawn: 1. A slow i.v. injection of 2 mg of physostigmine produces a clear-cut increase in consciousness within 15 min if a TAD (or other drugs with central anticholingeric potencies) is mainly responsible for the poisoning. This "test dose" can give valuable diagnostic information. 2. Repeated i.v. injections seem of little practical value, since they may be expected to produce a state with rapid shifts in the level of consciousness. 3. If the test dose has a positive effect, immediate i.v. infusion of 4 mg physostigmine/h will maintain a high level of consciousness. Infusion should be stopped every sixth hour for about 30 min to check whether the level of consciousness still falls upon withdrawal of therapy 4. In cases of massive TAD overdosage, i.v. injection of physostigmine may increase the risk of grand mal seizures. 5. No signs of enhanced peripheral cholinergic activity following physostigmine are seen if 30 mg of propantheline is given i.v. every sixth hour. 6. No evidence has been produced that the morality rate in TAD poisoning is lower following physostigmine treatment whan with conventional supportive care. There must be the usual preparedness for cardiac complications.

Adult↗
PubMed1978

Effect of respiratory physiotherapy on arterial oxygen tension.

The effect of deep breathing on arterial oxygen tension was investigated in 45 postoperative patients. Arterial oxygen tension was estimated by the transcutaneous oxygen tension method, which allows continuous non-invasive measurement of the arterial oxygen tension changes. Three deep breaths in 1 min, assisted by three respiratory therapy devices, were compared to a standard physiotherapy programme. A peak increase in arterial oxygen tension of 3--4.5 mmHg occurred after 1 min, and significantly increased values were seen for 2--4 min following deep breathing with the three respiratory devices. From the various physiotherapeutic procedures, verbally and manually assisted deep breathing gave a 7 mmHg PO2 peak and significantly increased values for 6 min. The sign mechanism is discussed in the light of the present knowledge of airway closure, which gives a satisfactory explanation of the short-lasting increase in oxygen tension.

Closing Volume↗
PubMed1976

The concordance of respiratory fluctuations in oesophageal and central venous pressures.

Respiratory fluctuations in oesophageal and central venous pressures were recorded in 13 healthy subjects and compared with respect to phase and amplitude concordance. An average divergence in phase of nearly 180 degrees was obtained, with large inter-individual variations. Disregarding phase the amplitude of the respiratory central venous pressure was found to be, on the average, a good 1/4 of that of the oesophageal pressure in the supine posture, and a good 2/3 while the subjects were sitting. These figures also varied considerably. It is suggested that the findings might be referred to competition between a central venous pressure raising effect of inspiration enhanced venous return, and a central venous pressure depressing effect of the inspiratory fall in intrathoracic pressure. The partitioning of costal and abdomino-diaphragmatic breathing is considered of great significance to the outcome of this competition. It is concluded that the oesophageal balloon catheter technique for estimation of transpulmonary pressure cannot simply be replaced by the central venous catheter technique in healthy subjects. Its application in patients with certain pulmonary disorders, however, might be more successful.

Adult↗
PubMed1976

The antianabolic effect of tetracyclines in a consecutive clinical series.

In a series of 58 tetracycline-treated patients from an intensive care unit 33 patients were given oxytetracycline and 25 patients were given doxycycline. In 50 of the patients the serum creatinine level never exceeded 2 mg/100 ml. The serum urea/creatinine ratio was repeatedly determined in all patients. The oxytetracycline group displayed significantly higher mean values for this ratio during treatment than the doxycycline group. This was interpreted as a probable antianabolic effect due to the oxytetracycline therapy.

Creatinine↗
PubMed1975

Patient material in multidisciplinary intensive care units.

The patient material in the multidisciplinary intensive care unit of Uppsala University Hospital is compared with the material from a recently performed nation-wide study on different intensive care units. A registration chart to record intensive care work and a time and motion study of nursing personnel are presented. It is concluded that such records are necessary to allow valid comparisons of the need for intensive care beds and personnel in hospitals of different sizes and degrees of specialization.

Critical Care↗