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Biomedical subjects

Wilhelm Sandmann

Publications and source records attributed to Wilhelm Sandmann.

24 records · Page 2Linked to original sources

Prophylactic nasal continuous positive airway pressure after major vascular surgery: results of a prospective randomized trial.

BACKGROUND: The efficacy of nasal continuous positive airway pressure (nCPAP) as a prophylactic method for preventing cardiopulmonary complications after major vascular surgery has not been investigated. PATIENTS/METHODS: In a prospective randomized trial, 204 patients undergoing elective midline laparotomy for vascular surgery were randomized to receive standard therapy ( n=105) or additional prophylactic nCPAP ( n=99) for the first postoperative night. Postoperative oxygenation, incidence of severe cardiac, and pulmonary complications, length of intensive care surveillance and length of total postoperative hospital stay (LOS) were compared. RESULTS: Prophylactic nCPAP significantly reduced the number of patients with severe oxygenation disturbances defined as paO(2) < 70 mmHg with FiO(2) > or = 0.7 (5 versus 17, P=.01). There were no differences with respect to death, cardiac and pulmonary complications, length of intensive care surveillance or LOS. CONCLUSION: Prophylactic 12 h nCPAP significantly reduces the occurrence of postoperative oxygenation disturbances but has no effect on cardiac or pulmonary complications, need for intensive care, LOS or mortality after major vascular surgery.

Aged↗

Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome.

Abstract. Delayed graft function (DGF) remains a grieving complication after renal transplantation. In this study, we examined various factors related to organ donation, transport, and transplantation for their influence on the incidence of DGF and on long-term prognosis. The incidence of DGF, renal function after 5 years, and allograft survival were analyzed in 200 kidneys transplanted in Düsseldorf as well as in 193 partner kidneys transplanted at 43 other centers. The main risk factors for DGF were donor age, cold ischemia time (CIT) and organ shipment. DGF itself, as well as donor age, influenced the long term prognosis. A significant relationship between the partner organs regarding clinical outcome was demonstrated. Non-immunological factors strongly influence the clinical results after renal transplantation. Organs of older donors have a limited long-term prognosis. To minimize additional risks, prevention of DGF, especially by reducing CIT, should be regarded as of paramount importance.

Adult↗

Risk factors for postoperative delirium in vascular surgery.

The aim of this study was to identify psychiatric and somatic risk factors associated with the development, severity and duration of postoperative delirium after vascular surgery. Forty-seven patients underwent aortic, carotid artery and peripheral artery surgery. Both, surgeon and psychiatrist, monitored patients preoperatively with daily follow up. Preoperative psychiatric assessment included standardized psychopathological scales for the detection of psychiatric symptoms and cognitive deficits. We diagnosed delirium using DSM IV criteria. Delirium Rating Scale was used to estimate delirium severity. Surgical parameters included patient history, diagnoses, medication and laboratory parameters. A statistical analysis was performed using multivariate regression analyses to find factors significantly associated with delirium development, severity, and duration. Thirty-six percent of the patients developed postoperative delirium after surgery. Comparison of different parameters revealed that especially preoperative depression symptoms and perioperative transfusions/infusions had significant predictive value for the development as well as for the severity of postoperative delirium.

Aged↗