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Biomedical subjects

W Koller

Publications and source records attributed to W Koller.

At least 127 records · Page 7Linked to original sources
PubMed1983

[A model for standardized treatment and therapeutic evaluation of severe ARDS. PIF and AaDO2 quotient with a demand-adapting respirator and a conventional respirator during ARDS].

In order to achieve a uniform, easy to teach and to manage respiratory management in severe adult respiratory distress syndrome (ARDS) a combined treatment--called "step by step scheme"--was settled. It was aimed towards a regulation of the arterial blood oxygen tension at levels between 90 and 130 mmHg and this was achieved by combination of PEEP and IRV in order to minimize the inspiratory fraction of oxygen. Nine patients underwent this schedule and Benzer's AaDO2 quotient as an estimation of lung function as well as PIF (PEEP X I:E X FiO2) as quantifying parameter for the "strength" of the respirator are calculated. AaDO2 Quotient showed no statistically significant differences but PIF performed a clearly marked day of maximum respiratory support during the clinical course. This seems to be a confirmation that a variable defined by therapeutic procedures may also be an estimation of a certain degree of sickness as a pure diagnostic parameter. In plotting AaDO2 quotient versus PIF characteristically formed loops result. These loops give some evidence about the interactions between improving or worsening ARDS and properly adjusted therapeutic efforts by means of a respirator. The diagram may be also helpful in deciding conventional respirator settings or weaning procedures and show marks, where one might consider to treat by new techniques like High Frequency Ventilation, extracorporeal devices or arteriovenous hemofiltration.

Adult↗
PubMed1983

[High frequency pulsation (HFP) enabling tracheo-broncheal suctioning without interrupting mechanical ventilation].

A new technique of tracheo-broncheal suctioning is presented which enables constant artificial ventilation with high frequency pulsation (HFP), a modification of high frequency ventilation. Beyond that the high frequency pulsation method permits ventilation of the patient with adjusted end-expiratory pressure. This technique prevents the decrease of arterial oxygen pressure which is usually seen in patients who are disconnected for some time from the respirator as well as during the suction procedure and during periods of decreased end-expiratory pressures.

Blood Gas Analysis↗
PubMed1982

[Inversed ratio ventilation (IRV) following cardiosurgical procedures].

Based on our positive experiences with "Inversed Ratio Ventilation" (IRV) in the treatment of ARDS, we applied this ventilation technique in patients with risk lungs after cardiosurgical operations. Immediately, after switching from conventional ventilation mode (I/E ratio 1:2) to IRV (I/E 2:1), however significant hemodynamic reactions could be observed. Especially a significant decrease of cardiac output can be observed in this phase. IRV leads to an improvement of gas exchange and lung mechanics. These improvement become even more significant continuing IRV. A decreasing tendency of the negative hemodynamic effects can be observed parallel to lung mechanics improvement. Carefully managed respirators adjustment, "step-wise" prolongation of I/E ratio and closed observation on hemodynamic reactions leads to successful use of Inversed Ratio Ventilation in cardiosurgical patients too.

Air Pressure↗
PubMed1982

[Effect of arm splinting on the duration and possibility of monitoring invasive long-term pressure determination of the radial artery].

A special splint technique, which can improve continuous intraarterial blood pressure monitoring via the a. radialis is reported. This method could be applied successfully in 41 patients of the ICU up to 27 days. Cannulating the contralateral side because of catheter's dysfunction was necessary only in 6 patients. These observations could be seen in contrast to our results, using a conventional splint system, applied in 12 patients for comparison (maximal duration of catheter's placement: 9 days). Our experiences, using this special splint method of arm fixation, lead to the recommendation to use our method routinely in long-term monitored patients, with respect to a longer duration of catheter's intravasal placement, the possibility of undisturbed monitoring and a simple clinical handling.

Arteries↗
PubMed1982

[A new method for the microbiological evaluation of disinfecting laundering procedures for textiles].

A new method is described to evaluate the efficacy of disinfecting laundering processes. Testpieces (contaminated cotton fabric patches) are enclosed between a pair of membrane-filter discs. Being immersed in the wash liquor this test system acts as a perfusion chamber permeable for detergent and disinfectant solution but retaining the testbacteria to the testpieces. Tests performed in a shaking water bath as well as practical laundering processes with detergents showed the following: from contaminated test pieces wrapped in cotton fabric - as commonly used in such experiments - test bacteria can hardly be recovered even after a non-bactericidal washing process. This is a result of mechanical wash-off. In contrary, with the new method reductions of viable counts are mainly due to bactericidal effects as physical removal of testbacteria is prevented by the filter membranes. Thus, disinfecting laundering procedures are readily distinguishable from merely cleaning ones. As additional advantage the filter-method prevents test pieces from being contaminated by other bacteria carried by the wash liquor.

Disinfection↗
PubMed1980

[A spate of listeriosis in newborn infants in Vienna (author's transl)].

Twelve years after the last bacteriologically verified case of human listeriosis was reported in Austria, 3 cases of neonatal listeriosis have been observed in Vienna within the space of a few months. In 2 patients the disease was definitely septicaemic, whilst the third suffered from predominantly pneumonic manifestations. As the clinical picture is not uniform, neonatal listeriosis may be difficult to recognize. Therefore, the consulted physician ought always to consider this disease, when he is confronted with obscure infections in newborn infants. The most important and, indeed, only diagnostic investigation to prove suspected listeriosis is bacteriological culture. Serological findings do not offer a conclusive diagnosis in cases of this disease.

Austria↗
PubMed1980

Temporary submucosal cervical cerclage.

A submucosal, easily removable cervical cerclage was placed in 37 patients with cervical incompetence. The perinatal mortality rate compared favorably with reports using other techniques, and the cesarean section rate was not different from that in the overall obstetric population. In view of the absence of any complications, this technique would seem to be the cerclage of choice.

Adolescent↗
PubMed1979

[Yersinia enterocolitica--a still infrequently isolated pathogen in Austria (author's transl)].

Yersinia enterocolitica--recognized as a distinct taxonomic entity in 1964--belongs to the family of enterobacteriaceae. It has been isolated with increasing frequency from human and animal sources as well as from food and non-chlorinated water. Yersinia enterocolitica can produce enteritis in man, accompanied or followed in adults by erythema nodosum, arthralgia and/or acute arthritis. Rarely, septicaemia with a high mortality rate has been encountered. A cold-temperature enrichment method was used to examine 1135 faecal specimens; 11 were positive for Yersinia enterocolitica. Symptoms of enteritis were reported by all 8 patients whose faeces contained the bacterium; a brief description is given of the course of illness in each patient. Biochemical and serological properties of the isolates are discussed with special reference to some unusual results obtained with the commerical API-20 E system for identification of enterobacteriaceae when incubated overnight at 35 degrees C.

Adult↗
PubMed1979

[Blood sugar self-profiles. Improvement in diabetes control in outpatients (author's transl)].

15 insulin-dependent diabetics who had been hospitalised for evaluation and modification of their treatment regimen were trained to take their own blood samples with 10 microliter glass capillaries. Blood sugar self-profiles were analysed from each patient twice in hospital and afterwards at home. Urine samples were also self-tested for sugar. The profiles were carried out reliably and seem to cause a minimum of trouble to the patient. This method of feedback, with comparison of blood and urine sugar values, increased the patient's understanding and ability to vary his own insulin dosis. The analysis of 3 daily profiles for each patient showed increasing improvement in metabolic control. This also increased motivation to keep to a regimen in which insulin dosage, physical activity, and nutrition are in balance. For the first time daily profiles were introduced which could be carried out under the normal conditions of the patient's daily life.

Ambulatory Care↗
PubMed1979

Preprogrammed insulin infusion with a portable pump system.

A glucose-controlled insulin infusion system (Biostator) was used to determine patient insulin requirement for clinical evaluation of a portable pump system (technical development by Siemens AG). Results from 6 insulin-dependent diabetics with respect to quality of control, carbohydrate/insulin ratio, and insulin requirement are shown. Preprogrammed insulin infusion with the portable system was carried out for up to 117 days.

Adolescent↗
PubMed1978

[Diabetic control with a portable insulin infusion pump for 7 weeks (author's transl)].

A portable insulin infusion pump was used to achieve diabetic control over a period of 7 weeks in a juvenile onset-type diabetic. Insulin was infused at a basal rate and further doses could be triggered externally by the patient. Insulin requirement had been previously determined by means of an artifical beta-cell (Glucose Controlled Insulin Infusion System). This method of insulin administration resulted in a clear improvement in diabetic control. Some problems did arise in connection with materials from which the instrument and catheter were constructed. However, it was shown that a portable insulin pump can be used with out-clinic patients for a number of weeks and is also justified for at least certain cases.

Adult↗
PubMed1978

[Evaluation of procedures for hygienic disinfection of hands: comparison of two methods, for artificially contaminating hands and use of an automatic colony-counter (author's transl)].

Testing procedures for the Hygienic Disinfection of hands, two kinds of artificial contamination have been compared: Application of one drop of bacterial suspension onto each fingertip as described in the DGHM-"Richtlinien" and immersion of hands as described in our previous papers. When using our method, fingertips released higher numbers of testbacteria. Since pre- as well as post-values were elevated, disinfection-tests applying one of each contamination method resulted in log10 reductions which did not differ significantly. Using an automated scanning colony counter we were able to save 2/3 of time otherwise required for manual counts. Up to 10(2) colonies per plate manual counts were practically identical with the counters results, whereas with higher colony-numbers the counter showed an increasing tendency to under-estimate the numbers of colonies. Since colonies of skin-staphylococci are not recognised by the automated counter, we cultured our rinsing-fluids on nutrient agar containing 0.05% of sodium-desoxycholate in order to inhibit the autochthonous skin flora. This supplement influenced the colony counts of our test-bacterium to a very minor degree only, the reduction factors were not at all altered.

Bacteriological Techniques↗
PubMed1978

[Increasing incidence of Serratia marcescens bacteraemia in intensive care patients (author's transl)].

The incidence of serratia marcescens in an intensive care unit was investigated in course of several years. After a trial of Cephalosporin-Gentamycin prophylaxis, infection and death due to serratia rose dramatically. The significance of decreased resistance to infection, hygiene regimes as well as mode of administration of antibiotics is related to selection of this rare microorganism causing septicemia.

Adolescent↗