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At least 1,639 records · Page 91Linked to original sources
PubMed1992

[Effects of calcium blockers on the performance of left and right ventricles during acute hypoxia].

In anesthetized and thoracotomized 20 adult dogs under artificial respiration, the effects of calcium blockers (nifedipine, diltiazem and verapamil) on the mechanics of the left and right cardiac pumps under acute hypoxia were observed. The left and right ventricular pressure (LVP and RVP) and their dp/dt (+/- dp/dtmax), aortic flow (Fa), pulmonary pressure (Ppa) and heart rate (HR) were recorded. After treatment with calcium blockers, LVP and L +/- dp/dtmax decreased, and Fa increased, while RVP, R +/- dp/dtmax and Ppa all tended to increase. These results showed that the effects of calcium blockers on the performance of the left and right ventricles were different, suggesting that the dependence of left and right myocardium on calcium was different in degree. The mechanics of the left and right ventricles responded differently to calcium blockers under acute hypoxia. After treatment with calcium blockers, pressor responses on LVP by acute hypoxia disappeared. There was a great increase in Fa. Decrease in pressor response of RVP and Ppa was also observed in acute hypoxic dogs receiving verapamil and diltiazem. Comparing the effects of nifedipine, diltiazem and verapamil on the mechanics of the left and right cardiac pumps under acute hypoxia, it appears that diltiazem exerts beneficial effect on the performance of cardiac pump under acute hypoxia.

Animals↗
PubMed2003

[Toward the settlement and development of home care].

Ever since Sendai Ohshin Clinic inaugurated the operations in 1996, the clinic has been involved in the home care of 850 people in total. At present, the clinic provides care to 200 people at their homes including 38 people with serious diseases under artificial respiration and 40 people with terminal cancer. 513 people who were under care by the clinic died at home, and it is now quite natural that people live at home to the last breath. I noticed various issued through the provision of home care in Sendai and want to present the desirable direction of medical care using a couple of key words.

Aged↗
PubMed1978

[Necessity to control endexpiratory CO2-concentration during laparoscopic sterilisation under general anaesthesia with controlled ventilation (author's transl)].

During laparoscopy and intraabdominal insufflation of CO2 cardio-respiratory accidents following increased PaCO2 are possible. The continuous measurement of endexpiratory CO2-concentration by infrared absorption spectrometry is a simple method for controlling the level of ventilation. Respiratory acidosis under controlled artificial ventilation during laparoscopy can thus be avoided.

Acidosis, Respiratory↗
PubMed2004

[Recognition and treatment of gamma hydroxybutyric acid poisoning].

The number of cases of gamma-hydroxybutyric acid (GHB) poisoning is increasing rapidly. The substance is becoming more and more popular as a party drug, while the users are often unaware of the potential dangers of GHB abuse. If a GHB overdose is treated properly and on time, the patient generally recovers completely within 6 hours. Preventing aspiration and the timely initiation of artificial respiration are particularly important.

Drug Overdose↗
PubMed1992

[Laparoastoma (open packing) in the treatment concept of infected pancreatic necroses].

Out of 284 patients with acute pancreatitis 73 (26%) had pancreas necrosis. Of these 73 cases 43 patients with infected pancreas necrosis were treated surgically, whereas conservative treatment proved successful in the remaining 30 cases with so-called sterile necrosis. Our interdisciplinary treatment combined delayed surgery for the better demarcation of the necrotic tissue, with extended intensive care therapy and epigastral laparostomy; through this laparostomy surgical revision with necrosectomy and peritoneal lavage was performed daily for 15 (+/- 6) days, necessitating long-term artificial respiration for an average of 15 (4/168) days. The mortality rate in the 43 patients with infected pancreas necrosis amounted to 16.2% (n = 7); none of the patients with sterile necrosis died. In cases of multiple organ failure the mortality rate was significantly higher (30%) than with failure of only one organ system (4.3%). The mortality rate in all cases with pancreas necrosis (n = 73) amounted therefore to 9.5%. Serious complications of laparostomy occurred in 28% (n = 12) of the 43 patients, whereby 8 of these cases were gastrointestinal fistulae, with a fatal outcome in one patient. The overall mortality rate in the total group of 284 patients with acute pancreatitis was 2.8%.

Acute Disease↗
PubMed2004

[Nutrition and health--enteral nutrition in intensive care patients].

Nutritional therapy in the intensive care unit exerts favourable effects on morbidity and mortality. Enteral nutrition is preferable to parenteral nutrition. Only perforation or total obstruction of the gastrointestinal tract, proven mesenteric ischaemia and toxic megacolon are absolute contra-indications to enteral nutrition. Early enteral nutrition is effective in decreasing infectious complications and reducing the length of stay in the hospital. Nutrition that is enriched with specific ingredients in order to modulate the immune response is referred to as immunonutrition. The use of immunonutrition, notably in surgical intensive care patients, has a favourable effect on the incidence of infectious complications, the duration of artificial respiration and the length of hospital stay. The addition of glutamine to parenteral nutrition may reduce mortality compared to standard parenteral nutrition. Implementation of a simple feeding algorithm in the intensive care unit, with special attention for the treatment of delayed gastric emptying, is cost-effective and leads to an improvement in the nutritional parameters.

Adjuvants, Immunologic↗
PubMed1979

PERFUSION FOR MYOCARDIAL REVASCULARIZATION WITHOUT AN ARTIFICIAL OXYGENATOR (New Method to Reduce Surgical Morbidity).

Thirteen patients were submitted to direct myocardial revascularization (saphenous vein graft) without the use of an artificial oxygenator. The perfusion was done by a left ventricle-to-aorta bypass and autogenous oxygenation. Most patients had three grafts implanted plus endarterectomy of the distal right coronary artery. There was one hospital death that was apparently not related to the method used. Perfusion time ranged from 45 minutes to 4 hours. Body temperature during perfusion was kept between 25 and 30 degrees C. Perfusion flow was maintained between 25 to 50 ml per kg of body weight per minute. Ischemic, hypothermic cardiac arrest was employed. We demonstrated for the first time that perfusion for this kind of heart surgery could be done with no artificial oxygenators and, apparently, is safer for the patients. There were no bleeding problems even in perfusions as long as 4 hours. There was no respiratory dysfunction, and artificial respiration was used for only 6 to 12 hours. The patients awoke at the end of surgery with no signs or symptoms of central nervous system damage, and vasopressor drugs were rarely used after surgery. Although the experience is very small, it suggests that many postoperative problems, especially those related to bleeding and respiratory dysfunction may be reduced or eliminated by this new method.

Journal Article↗
PubMed2004

[A living will--autonomy in dementive states].

Demented patients may refuse to eat at the end of life. Many caregivers believe that food is as essential as air, and hence, tube feeding is as important as mechanical ventilation. Many believe that demented patients should be fed in any event, even against their will. The aim of this study was to assess the opinions of the elderly about tube feeding and advanced medical procedures in dementia. Inhabitants of protected homes, over 70 years of age, were asked to complete a questionnaire with demographic details, self-estimation, and self grading according to mobility, quality of life, function, pain, family and environmental support. They were asked what they consider to be a situation worse than death, and then, to grade their consent to life support procedures in the different stages of dementia: percutaneous endoscopic gastrostomy, nasogastric tube, resuscitation, artificial respiration or surgery. They were also asked whether they want a living will for medical interventions in dementia for future guardian consideration. One hundred and twenty questionnaires were distributed and 61 were completed (compliance of 50.8%) including responses from 47 women (77%). The average age was 83 years. Most of the participants were women of European origin, not religious, executives with an average of 12 years of education. More than 70% of participants opposed life-supporting procedures in lower stages of dementia, and more than 80% in higher stages. Ninety-five percent of the participants believed in a living will that denied tube feeding and advanced therapies in dementia.

Aged↗
PubMed2004

Attitudes of pharmacists to the issue of applying basic first-aid.

The most frequently mentioned causes of death and disability include blood circulation system diseases, tumors and injuries. The decision to apply immediate resuscitation actions often influence the chances of the victim's survival. It is estimated that approximately 18 million citizens of Poland have been trained in the field of basic first-aid procedures. The aim of the paper was to get to know the opinions of the employees of pharmacies with a degree in pharmacy about the issue of applying basic first-aid and their knowledge of basic life support. The survey was carried out by means of a questionnaire which was mailed to the pharmacies in the area of the Lublin region, excluding the city of Lublin. 250 questionnaires were sent and 106 were sent back and filled in properly. The return rate of the questionnaires was estimated at 42.4%. Pharmacists feel they are obliged to know the rules of applying first-aid better than other social groups, and claim they should join the rescue activities in case of emergency. The respondents show willingness to participate in first-aid trainings as long as they are free. A high percentage of the respondents assess their level of knowledge in the field of emergency actions as unsatisfactory. The knowledge of resuscitation techniques is insufficient--identification of circulatory arrest, technique of indirect cardiac massage and artificial respiration all seem to cause difficulties. The pharmacists under survey would be glad to get updated guidelines concerning basic rules of behaviour in emergency.

Adult↗
PubMed2005

Selected clinical aspects of acute intoxication with baclofen.

Baclofen is a lipophilic analogue of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in central nervous system. The aim of the study was to evaluate some clinical aspects of acute intoxication with baclofen. Fifty two patients (37 females and 15 males) aged from 14 to 58 (mean 30.6 +/- 13.7) years were analyzed. Patients were admitted to the Clinic of Internal Diseases and Acute Poisonings Medical University of Gdańsk and the Centre of Acute Poisonings of Praski Hospital in Warszawa during the years 1996-2004 because of suicidal intoxication with baclofen. The doses of baclofen varied from 100 to 1500 (mean 444.8 +/- 317.8) mg. There were twenty eight patients (53.8%) in deep coma (III and IV grade of Matthew scale). Acute respiratory failure which required mechanical ventilation was observed in 18 cases (34.6%). Cardiac abnormalities included bradycardia (36.5%), hypertension (32.7%) and hypotension (3.8%). Toxic psychoses were observed in 6 cases (11.5%). The dosage of baclofen in patients with acute respiratory failure (ARF) was significantly higher than in patients without ARF. Treatment of patients with acute baclofen intoxication should take place in hospitals appropriately equipped which can provide artificial respiration.

Acute Disease↗
PubMed2005

[Follow-up study on psychic and neuropathic delayed effects of acute organophosphorus pesticides poisoning].

OBJECTIVE: To study the delayed effect on neuropsychopathy and its related factors after acute organophosphorus pesticides poisoning (AOPP). METHODS: Two hundred and fifty-seven cases of AOPP in the observation period were chosen to follow-up 2 months later from the 4 county hospitals in Shandong Province where the incidence of organophosphorus pesticide poisoning is high. RESULTS: Nine cases of organophosphate induced delayed polyneuropathy (OPIDP) were found and the incidence rate was 3.5%. The occurrence of OPIDP were related to the need for emergent artificial respiration, and the degree of poisoning, and the kinds of organophosphorus pesticides (Ops). The positive rate of symptoms of peripheral nerves, central nerves and psychogeny except auditory and visual hallucination after poisoning was significantly higher than that before (P < 0.05). The patient's situation of health, economy and work became statistically worse (P < 0.05). CONCLUSION: We found some had delayed effects on neuropsychopathy after AOPP which could debase the patient's life quality. The control measure should be administered as early as possible.

Adolescent↗
PubMed2005

Modeling of chemical control of human respiratory system.

This paper addresses the fundamental understanding of the chemical control of respiratory system that would be needed to improve the efficiency of artificial ventilators and implement appropriate controllers. Hence, non-linear model for simulation of chemical control of human respiratory system under different physiological conditions is presented. The paper also presents the non-linear dissociation behaviors for oxygen and carbon dioxide solutions in the blood and the Bohr-Haldane effects as well as a new controller model. Tests were conducted on the model under different conditions such as hypoxia, hypercapnia, hypoventilation, and hyperventilation with some combination tests, in order to verify the validity of the assumptions that were made. Results indicate a very close agreement between the responses obtained from the present model and other published experimental and theoretical results. This model can be used to design a novel artificial respirator controller meeting the bodily requirements of the patient under mechanical ventilation.

Carbon Dioxide↗