Anaesthesiologie und Reanimation
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Hypothermia of less than 35 degrees C, which frequently occurs in connection with massive blood transfusion, is a serious problem in many patients, in particular in those with polytrauma. The restoration of normal body temperature is very important and requires the use of a rapidly-acting, efficient and safe blood warmer, which is able to work effectively at high flow-rates. The LEVEL 1 (Technologies, Rockland, MA) is such a new blood warmer and works as a heat-exchanger via an aluminium column. ⋯ Six hundred ml of sodium chloride 0.9% are warmed from 4 to 35 degrees C within one minute. This device is quickly operational and has a low priming volume. The LEVEL 1 is the only device currently available which is able to warm blood sufficiently during a very rapid blood transfusion.
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Anaesthesiol Reanim · Jan 1994
Case Reports[Life threatening tension pneumothorax after puncture of the subclavian vein and dislocation of thoracic drainage].
The combination of two rare complications in intensive care caused an acute life-threatening situation. Following puncture of the left subclavian vein a pneumothorax developed over the course of a couple of days. The inserted thoracic drain dislocated into the subcutaneous tissue. ⋯ Finally, the tension pneumothorax was diagnosed by x-ray of the chest. This life-threatening situation could be treated by the insertion of a thoracic drain. The operation could be performed without any problems.
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Anaesthesiol Reanim · Jan 1994
[Malignant hyperthermia in swine: a study of atracurium in MH-susceptible swine].
Since muscle relaxants have been implicated in triggering malignant hyperthermia (MH) in MH-susceptible humans and animals, the potential of new muscle relaxants for triggering MH needs to be assessed in vivo in MH-susceptible pigs. The triggering potential of atracurium was evaluated in six MH-susceptible pigs during one hour infusion of a 90% blocking dose (0.4 mg/kg/h) of atracurium. ⋯ Rectal temperature decreased slightly (36.4 to 35.6 degrees C) and end tidal CO2 was stable at 5.46 kpa. In this study atracurium did not trigger MH in susceptible pigs.
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Anaesthesiol Reanim · Jan 1993
Randomized Controlled Trial Comparative Study Clinical Trial[A comparison of the two anticholinergic agents atropine and glycopyrrolate during antagonism of a muscle relaxation with pyridostigmine].
Central, peripheral and cardiac side-effects of both anticholinergic drugs atropine and glycopyrrolate were compared during the antagonism of muscle relaxation with pyridostigmine. In a randomized, double-blind fashion 50 patients were given 10 micrograms/kg of atropine and 50 were given 5 micrograms/kg of glycopyrrolate with 125 micrograms/kg pyridostigmine intravenously. Continuous Holter ECG-monitoring over 3 hours was performed. ⋯ Atropine as well as glycopyrrolate caused an increased heart rate within the first 4 minutes (atropine 47% vs. glycopyrrolate 27%, p < 0.01). During phase III after atropine, the heart rate decreased below the control value (p < 0.05). None of the patients showed central anticholinergic syndromes after either drug.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anaesthesiol Reanim · Jan 1993
[Early recognition of brain death--a contribution to organ explantation].
The criteria for brain death are presented and reference is made to the legally required observation period. To shorten the observation period, the Federal Medical Council (Bundesärztekammer) set out in 1986 possible aids to making decisions. The time at which extensive additional investigations should start makes it necessary to approximately determine the moment of brain death. The tear secretion test presented in this paper could be a further decision aid.