bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Diazepam and Serum Creatine Kinase after Intra‐muscular Injection of Diazepam in Two Different Vehicles
Authors: Bank‐Mikkelsen O. K. , Steiness E. , Arnold E. , Hansen T. , Søbye M. , Lunding M. 
Published: January 2009

Serum diazepam concentration and serum creatine kinase activity (serum CK) were measured in 35 patients (who were divided into three groups (A, B, and C)), over a period of 24 hours after administration of diazepam. An increase in serum CK was regarded as an indication of local muscle injury.In group A, diazepam in a polyethyleneoxydricinolate vehicle was injected intramuscularly; in group B, diazepam in a propyleneglycol‐ether alcohol vehicle was injected intramuscularly; and in group C3diazepam was administered orally, combined with intramuscular administration of the vehicle used in group B.The investigation was double‐blind and randomized.Serum diazepam absorption expressed as the area under the concentration curve was identical in groups A and C and significantly higher than in group B. Serum CK rose in all groups. The differences among the groups were not significant. There were considerable individual variations in all three groups, and almost half the patients showed no increase in serum CK at all.No negative correlation was found between serum diazepam and serum CK. Thus no effect of muscle injury—if present—on absorption rate could be demonstrated.
Two Early Danish Respirators Designed for Prolonged Artificial Ventilation
Authors: Kristensen H. Sund , Lunding M. 
Published: January 2009

Two Danish respirators are described. The first one was made by August Krogh in 1931 and was based on the principles of the Drinker tank respirator. The original feature was a motor driven by water from an ordinary water tap. It was never widely used, most likely due to practical problems connected with nursing care, etc.The polio epidemic in Copenhagen in 1952 initiated the era cf the IPPV‐methods and gave rise to the construction of a great number of new respirators. Among the first of these was the Claus Bang respirator. Although it contained many modern featurcs, it proved technically unreliable and was only used for 3–5 years.
In‐line Blood Warming and Microfiltration Devices
Authors: Linko K. 
Published: January 2009

Homogeneous microaggregate‐free whole blood at +5°C was transfused at constant pressures of 20 and 40 kPa through two micro‐filtration and blood warming devices, and the temperature of the blood was recorded before it reached the venous cannula. The flow rates with the Fenwal® system were 58 and 139 g/min, whereas the micro‐filter MF10B® combined with the Portex® Coil allowed flow rates of 143 and 224 g/min. The warming capacities of the two warmers were almost equal and this did not prove to be their weak point.The infusion temperature varied considerably during the transfusion. Increasing the priming volume of the coil would raise the mean infusion temperature.A pressure infusor (Fenwal®) was tested, and the internal pressures of the blood bag and the infusor were determined separately. The bag pressure differed significantly from the infusor pressure as the blood bag emptied, making the usefulness of the infusor manometer questionable.
In‐line Blood Warming and Microfiltration Devices: II. Influence of Blood Temperature on Flow Rate and Hemolysis During Pressure Transfusion Through Microfilters and Transfusion Sets
Authors: Linko K. 
Published: January 2009

The influence of blood temperature on flow rate and hemolysis was studied. Homogeneous aggregate‐free blood was transfused through six different micro‐filters and transfusion sets, combined with a large‐bore venous cannula (Venflon® No. 2) at a constant pressure of 20 kPa. Flow rates and plasma hemoglobin for cold (+ 5°C) and prewarmed (+ 37°C) blood were determined separately.Warming the blood from +5°C to +37°C improved the flow from 49 to 86%. The best flow rates with + 37°C blood were obtained with surface filters (MFlOB®, 275 g/l), and the poorest with depth filters (Swank®, 179 g/l). However, the transfusion set and venous cannula seemed to have more influence on the total flow resistance. The Fenwal “dry‐heat” warmer was found to have a great flow resistance.The pressure transfusion caused only a slight increase in free plasma hemoglobin of cold blood and no increase in prewarmed blood.It seems more practical to warm the entire blood unit before transfusion than to use so‐called in‐line blood warmers, because prewarming results in a flow rate approximately twice as high as that obtained with coils.
Post‐mortem Findings of Tracheal Injury After Cuffed Intubation and Tracheostomy: A clinical and histopathological study
Authors: Arola M. K. , Anttinen J. 
Published: January 2009

The tracheas of 37 tracheostomizcd patients (31 men and 6 women) were studied in connection with obduction. Twenty‐six patients had been intubated before tracheostomy and 29 of the tracheostomized patients were treated with a respirator. At autopsy, the damage caused to the tracheal wall by the cuff was studied macroscopically; the finding was photographed for later investigation and samples were taken from the damaged area for microscopic examination.The purpose of the study was to determine the damage caused to the tracheal wall by the low‐volume cuff we have used during the last 4 years. The cuff diameter was nearly the same as that of the trachea.The injuries were grouped according to their extent and depth as mild, moderate or severe, and the groups contained, respectively, 5, 12 and 20 patients. It seemed that cuff pressure played a greater part in causing damage than the duration of cuff strain. Factors in the clinical condition of patients, like hypotension, uraemia, respiratory infections, sepsis and use of steroids, may have had an effect on the development of damage. The injuries caused by the cuff used are so severe that there is every reason to use instead the low‐pressure, high‐volume cuff, which has been shown to cause less damage, whenever long‐term treatment is involved.
Prognosis after Cardiac Arrest Occurring Outside Intensive Care and Coronary Units
Authors: Wernberg M. , Thomasen A. 
Published: January 2009

Emergency calls to a total of 1686 patients with verified cardiac arrest in the University Hospital, Arhus, were made in the 8‐year period 1969–1977. Among the patients, cardiac arrest occurred outside the hospital in 1347, in the general wards in 240, while it was present on arrival at the emergency room in 99. Resuscitation was attempted in 1172 patients; 181 survived for at least 24 hours, and 72 were discharged alive, including 13 with residual brain damage.The prognosis was best when cardiac arrest occurred in the general wards (13% discharged) and poorest when it occurred outside the hospital (4% discharged). However, in the latter group, the prognosis showed considerable improvement when resuscitation was initiated at once by a doctor or by laymen present at the accident site (16% discharged). As regards the mechanism of cardiac arrest, ventricular fibrillation was found to be a relatively favourable prognostic sign (10% discharged), whereas almost none of the patients with asystole or severe bradycardia survived. The possibility of improving the prognosis of cardiac arrest occurring outside hospital by the establishment of mobile coronary care units and by instructing lay people in the technique of cardiopulmonary resuscitation is discussed.
Hernodynamic Effects of Prenalterol, a β1‐Adrenoreceptor Agonist, in Hypotension Induced by High Thoracic Epidural Block in Man
Authors: Reiz S. , Nath S. , Pontén E. 
Published: January 2009

The hemodynamic effects of prenalterol, a new β1‐adrenoreceptor agonist, on hypotension induced by a thoracic epidural block extending between TI and TI2 and thereby blorking the cardiac sympathetic supply have been studied in eight patients scheduled for abdominal aortic aneurysm resection.The thoracic epidural block induced a drop in blood pressure, due to a reduction in cardiac output and systemic vascular resistance. Intravenous infusion of 10 mg of prenalterol rapidly and effectively reversed the hypotension by an increase in cardiac output without any effects on systemic vascular resistance or heart rate. The results indicate that prenalterol is a pure β1 agonist with a marked inotropic but no chronotropic property.
Warming of Blood Units in Water Bath and Cooling of Blood at Room Temperature
Authors: Linko K. , Palosaari S. 
Published: January 2009

Warming of whole blood units in a waterbath is considered too slow for emergencies and also results in a waste of blood. In this study the blood temperature was recorded continuously during warming in various kinds of baths.The warming of + 5°C CPD blood units (500 g) in a bucket of water was considerably slower than in a stirred and thermostated (+ 39.5°C) water bath, where the blood temperature reached +35°C in 13.4 min. Addition of continuous mechanical agitation of the blood unit raised the temperature to +32°C in 5.0 min, and to + 35°C in 6.6 min. This should be sufficient for most clinical situations. Agitation did not cause significant hemolysis when compared with units warmed without agitation.The cooling rate of warmed blood (+ 37°C) at room temperature (+ 21°C) was also studied experimentally. The temperature of the blood units fell 3°C in 5 min and 5°C in 15 min. Cooling of blood simultaneously in the bag, microfilter and transfusion set resulted in an infusion temperature of +32°C at the end of the transfusion with a flow rate of 85 g/min. Thus, blood units should be warmed immediately before use. Insulation of the transfusion set may also be practicable.
Effect of Non‐Carbonic Acidosis on Total Splanchnic Perfusion and Cardiac Output During Anaesthesia with O2‐N2O‐Halothane
Authors: Juhl B. , Einer‐Jensen N. , Madsen T. 
Published: January 2009

Six dogs, premedicated with pethidine 10 mg kg‐1 b.w., were anaesthrtixd with mebumal natrium (NFN) 25 mg kg‐ 1 b.w. and 80 mg gallarnoni jodidum (NFN). Anaesthesia was continued with O2‐N2O‐halothane and artificial ventilation. Non‐rarbonic acidosis was induced by i.v. infusion of hydrochloric acid, during which the related values of pulse, blood pressure, cardiac output, total splantlinic perfusion and portal pressure were measured.The pulse remained unchanged down to pH 7.0. At this pH, arrhythmia suddenly occurred and developed into ventricular fibrillation. Before this occurred, falling rardiac output was observed (cardiac output 1 min‐1 = 21.49 + 3.21 x pH, N = 23, r = 0.75, P<0.001) and rising oxygen consumption (O2 ml min‐ 1 kg‐1 = 25.79–2.96 x pH, N = 28, r = 0.52, P<0.01), rising oxygen extraction and rising peripheral resistance, while the mean pressure in the aorta was almost unaltered. During this course towards circulatory failure, an unchanged to slightly rising total splanchnic perfusion (Qspl) was demonstrated, which with the lowest pH, reprrsented up to 40% of the cardiac output (QtOt):Qsr1/Qtol = 3.11‐0.39x pH (N = 28, r = 0.52, P<0.01) Portal pressure rises slightly during acidosis, and oxygen saturation in tlie portal vein is high. It is probable that the retained splanchnic blood flow is caused by rrtention of the portal flow. This is quite different from observations during anaesthesia with barbiturates. It is conrluded that halothanc modifies considerably the circulatory response in the systemir circulation and the splanchnic region during non‐carbonic acidosis.
The Effect of Positive End Expiratory Pressure after Three Types of Open Heart Surgery
Authors: Harboe S. , Levang O. W. , Hysing E. S. 
Published: January 2009

It has previously been shown that patients who have undergone mitral valve replacement (MVR) tolerate a positive end expiratory pressure (PEEP) of 1.0 kPa better than patients who have had aortic valve replacement (AVR). The difference was explained by the fact that the mitral patients had pre‐existing pulmonary vascular disease.In the present study the effect of PEEP up to 2.0 kPa is investigated in three types of operations: aortocoronary bypass graft (ACBG), mitral valve replacement, and aortic valve replacement; there were five patients in each group. We found that our mitral patients tolerated PEEP better than the two other groups, and that tolerance was not correlated to a higher pulmonary vascular resistance, but rather to a higher level of pulmonary capillary wedge pressure. The influence of PEEP varies in different types of patients and the effect is still difficult to predict.
Regional Lung Function Following Hip Arthroplasty and Preoperative Normovolemic Hemodilution
Authors: Rosberg B. , Wulff K. 
Published: January 2009

The effect of preoperative normovolemic hemodilution with dextran 70 as dilutional agent on postoperative regional lung function was evaluated in patients undergoing hip arthroplasty in the lateral decubitus position. The major part of the surgical blood loss of these patients was replaced with the received autologous blood. The results obtained were compared to changes in a group of patients in whom the operative bleeding was replaced with bank blood.Regional lung function, as studied with Xe133 radiospirometry, is not negatively influenced by the hemodilution technique. In both groups a reduction in perfusion, ventilation and volume of ventilated alveoli was revealed postoperativcly in the lung that was dependent during surgery, probably caused by impaired ventilation of this lung and peroperatively induced microembolism. A more rapid normalization was found in the preoperatively hernodiluted patients. The reduced volume of bank blood transfused to these patients and/or a protective effect of the preoperatively infused dextran on the microembolism evoked by the surgical trauma might explain this difference between the groups studied.
Effect of Halothane Anaesthesia on Primary Antibody Response in the Chicken
Authors: Salo M. , Viljanen M. , Kangas L. , Lehtonen O.‐P. 
Published: January 2009

The effect of a single anaesthesia of 2 hours' duration with 1% v/v halothane and of 1, 2 and 3 hours' duration with 2%, v/v halothane was studied on the primary antibody response in line‐bred chickens. In contradistinction to earlier studies, the immunization was performed during anaesthesia to resemble antigenic exposure in surgical practice. The IgG and IgM antibodies against the antigens, bovine serum albumin (BSA) and formalin‐killed Brucella abortus organisms (Brucella), were quantified by the enzyme‐linked immunosorbent assay (ELISA). The halothane concentration of the blood was measured by gas chromatography at the end of anaesthesia.Anaesthesia with 1% and 2%, v/v halothane given in the antigen‐processing phase of humoral immune response had no effect on the concentrations of IgG‐and IgM‐anti‐USA and IgG‐ and IgM‐anti‐Brucella antibodies in the primary antibody response.
Transcutaneous Oxygen Measurement in Adult Intensive Care
Authors: Löfgren O. 
Published: January 2009

Transcutaneous oxygen measurement (Ptco2 ‐measurement) gives by a non‐invasive technique continuous information about central Po2 The method has as yet been tested mainly on newborns, and systematic studies of the applicability of the method on adults are still few. The current systematic study reports on consecutive Ptco2 measurements in 15 patients, all with indwelling arterial cathelers: 13 of the patients were artificially ventilated; 5 patients had normal body structure and normal skin circulation; 5 patients were obese and had normal skin circulation; and 5 patients were hypothermic with a normal heart frequency or slight bradycardia.The Radiometer equipment TCM1 was used. The electrode surface temperature was 45.0°C (within ±0.2°C). The oxygen concentration in the inspired air was altered several times for all patients, and arterial samples were drawn at a stable Ptco2 level. On average, seven samples were drawn from each patient.The correlation between Ptco2 and Pao2 was highly significant in 4/5 patients, in both the “obese patient” group and the “normal patient” group. In the “hypo‐thermic patient” group, the correlation between Ptco2 and Pao2 was highly statistically significant in 2/5 patients. The regression line between Ptco2 and Pao2 was calculated for each patient, and a mean regression line was obtained for each group. It was found that the regression line in the “obese patient” group was displaced to the right and parallel to the regression line in the “normal patient” group, while the regression line in the “hypothermic patient” group was less sloping and showed a higher intercept.The Ptco2 monitoring technique reliably reflects changes in the central oxygenation of adult intensive care patients. In some patients with decreased skin circulation, the relationship between Ptco2 and Pao2 seemed to be constant for the same patient, yielding statistically significant correlations. However, the study cannot determine whether this would be true in all clinical situations; the relationship between Ptco2 and Pao2 should therefore be checked frequently when measurements are performed in patients with decreased skin circulation. The author's experience with the Ptco2 monitoring method in patients near death has been consistent with the obvious fact that the reliability of the method decreases with decreased skin circulation.
Effects of Changes in Acid‐Base Balance on Neuromuscular Blockade Produced by ORG‐NC 45
Authors: Funk D. I. , Crul J. F. , Pol F. M. V. D. 
Published: January 2009

The effects of acute acid‐base changes on the neuromuscular blocking action of ORG‐NC 45 (a monoquaternary homologue of pancuronium) were measured in 10 cats. utilizing a constant infusion technique. Partial NC 45 blockade was antagonized slightly in the tibialis, soleus, and diaphragm during respiratory alkalosis pH 7.53; Paco21.9 kPa), whereas metabolic alkalosis (pH 7.64; Paco, 3.5 kPa) produced significant antagonism of NC 45 block in those muscles. Respiratory acidosis (pH 6.98; Paco210.3 kPa) and metabolic acidosis (pH 7.13; Paco24.9 kPa) significantly potentiated partial NC 45 blocks in the tibialis, soleus, and diaphragm (except in the diaphragm during metabolic acidosis). Cumulative dose responses studied in six cats showed that the NC 45 dosage required to produce 85–95% tibialis block was slightly greater than controls during respiratory and metabolic alkalosis. Conversely, significantly less NC 45 was needed to produce the same degree of block during respiratory and metabolic acidosis.In vitrostudies in rat hemidiaphragms likewise showed minimal NC 45 block antagonism when pH was raised to 7.68, and significant potentiation under acidotic conditions (pH 7.05).These actions are attributed in part to an increased rate of NC 45 metabolism by alkaline hydrolysis in alkalotic states and greater molecular stability during acidosis. Possible clinical implications are discussed.
Primary and Secondary Displacement of Central Venous Catheters
Authors: Lang‐Jensen T. , Nielsen R. , Sørensen M. Bredgård , Jacobsen E. 
Published: January 2009

The purpose of this study was to investigate the frequency of primary and secondary displacement of central venous catheters. One hundred and two central venous catheters, inserted through a peripheral or a central vein before surgery or in the intensive care unit, were controlled by chest X‐ray 5–720 min after insertion. The number of primarily displaced catheters was 27. Of these, the position was corrected in 8. Thereafter, the 83 correctly placed catheters were observed for 4–560 h. The number of X‐ray controls was 2–24. The number of secondary displacements was 2, whereas 12 catheters showed minimal secondary displacement. The rate of complications was very low.We conclude that chest X‐ray immediately after insertion of central venous catheters is absolutely necessary, but since the number of secondary displacements is very low, daily chest X‐ray control is not necessary. We also conclude that the internal jugular vein is the best route for introducing a central venous catheter, since complications are very few and the number of displacements is very low.
Neuromuscular Blocking Properties of Dioxonium
Authors: Tammisto T. , Salmenperä M. 
Published: January 2009

The characteristics of the myoneural block caused by a new neuromuscuiar blocking agent, dioxonium (Dx), were evaluated in surgical patients. The force and the corresponding electromyogram (EMG) of the thumb adduction evoked by various modes of ulnar nerve stimuli were measured. Onset, maintenance and disappearance of blockade after sequential administration of Dx were compared with results obtained with d‐tubocurarine (dTc) or suxamethonium (Sx).Initially the Dx block was shown to be depolarizing with a negligible fade in the 2 Hz train of four stimuli with a single twitch suppression of 90%. On a weight basis, Dx was found to be about 15 times as potent as dTc in suppressing twitch to the 90 % level. During maintenance, the block gained nondepolarizing characteristics with profound fades in the 2 and 50 Hz trains. The transition was associated with tachyphylaxis and with a more pronounced suppression of EMG amplitude than that measured in the twitch force. After a total dose of about 100 μg/kg of Dx, the sensitivity to Dx again increased and the discrepancy between twitch tension and EMG disappeared. This pattern of changes was also seen with Sx. Spontaneous recovery occurred slightly faster than after dTc blocks of corresponding duration. With neostigmine, reversal was hastened and a full recovery with restitution of prerelaxant twitch and disappearance of fades was reached in about 20 min. Some discrepancy in EMG amplitude and twitch force persisted, however.
Pharmacokinetics of Thiopental in Caesarian Section
Authors: Christensen J. Heslop , Andreasen F. , Jansen J. A. 
Published: January 2009

Anaesthesia for a planned caesarian section in nine women was induced with an i.v. thiopental injection. The injection was stopped when the ciliary reflex disappeared. 250–300 mg was given over 60–85 seconds. The concentration of thiopental in peripheral venous blood 20 s after the disappearance of the ciliary reflex varied from 4.3 to 33.7 μg/ml. The simultaneously obtained concentrations at delivery (11–25 min after the start of the induction) were 1.7‐6.0 μg/ml in venous blood from the mothers and 1.3–5.5 μg/ml in cord vein blood. In two of the newborns, the Apgar scores were 8 and 9, in the other seven it was 10.The baby with Apgar score 8 was delivered after 25 min and had a concentration in cord vein blood of 3.5 μg/ml. The decline in the concentration of thiopental in the venous blood of the mothers was described by a three‐compartment open model. The terminal half‐life was relatively short, between 91 and 595 min. The blood levels of thiopental in the newborns were followed for 22–33 h. The terminal half‐lives in the babies ranged from 616 to 2560 min.