bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma Potassium Following Suxamethonium and Electroconvulsive Therapy
Authors: Valentin N. , Skovsted P. , Danielsen B. 
Published: December 2008

Changes in plasma potassium following intravenous administration of suxamethonium were investigated in 22 patients undergoing electroconvulsive therapy (ECT) and 18 controls. The results were as follows: The administration of thiopentone and suxamethonium caused average rises in plasma potassium of about 0.1 mmol/l. When ECT was given the rise was higher, approximately 0.25 mmol/l, unaffected by pretreatment with tubocurarine. The occurrence of dose‐dependence was not established. When suxamethonium was given during halothane anesthesia the elevations were somewhat higher than without halothane, about 0.3 mmol/l. The administration of ECT during halothane anesthesia provoked increases of about 0.5 mmol/l. The phenomenon of suxamethonium‐induced hyperkalemia is discussed, and it is concluded that ECT enhances the elevation of plasma potassium normally seen after suxamethonium, but that the elevations are clinically insignificant.ZUSAMMENFASSUNGEs wurden die Veränderungen des Plasma‐K nach i.v. Verabreichung von Suxamethonium bei 22 Patienten, die einer Elektroschock‐Therapie unterzogen wurden, und bei 18 Kontrollpersonen untersucht. Dabei ergaben sich folgende Resultate: Thiopental und Suxamethonium verursachten durchschnittliche Anstiege des Plasma‐K von etwa 0,1 mmol/1. Unter E‐Schock‐Therapie war der Anstieg höher, nämlich ca. 0,25 mmol/1, unbeeinflusst durch die Vorbehandlung mit Tubocurarin. Dabei konnte keine Dosisabhängigkeit festgestellt werden. Unter Halothan‐Narkose waren die K‐Anstiege etwas höher als ohne Halothan, nämlich etwa 0,3 mmol/1. Elektroschock‐Therapie unter Halothan‐Narkose provozierte einen Anstieg um etwa 0,5 mmol/1. Das Phänomen der Suxamethonium‐induzierten Erhöhung des Plasma‐Kalium‐Spiegels wird diskutiert und der Schluss gezogen, dass E‐Schock‐Behandlung den normalerweise unter Suxamethonium beobachteten Plasma‐K‐Anstieg verstärkt, dass diese Erhöhungen jedoch klinisch insignifikant sind.
Effects of Althesin® (Glaxo CT 1341) on Coronary Blood Flow and Myocardial Metabolism in Man
Authors: Sonntag H. , Schenk H.‐D. , Regensburger D. , Kettler D. , Hellberg K. , Knoll D. , Donath U. , Becker H. 
Published: December 2008

The influence of Glaxo CT 1341 (Althesinr̀) on coronary blood flow (MBF), myocardial oxygen consumption (MVO2), and general haemodynamics was investigated in seven patients who had no heart diseases. Besides measurement of MBF we also determined the amount of substrates: glucose, lactate, pyruvate, and free fatty acids (FFA) in arterial and coronary venous blood samples. The mean dose of 0.075 ml/kg body weight CT 1341 was given intravenously. MBF was measured by means of the argon method.After injection of CT 1341 all seven patients showed a significant increase of MBF and MVO2, a fact which can essentially be explained by the increase of heart rate. Similarly, substrate uptake and O2‐extraction rates were also markedly increased. Because of these results as well as those of the literature, precautions in the application of CT 1341 in cases with heart diseases are discussed.ZUSAMMENFASSUNGAN 7 Patienten ohne cardiale Erkrankungen wurde der EinfluB von Glaxo CT 1341 (Althesin) auf die Coronardurchblutung (MBF). den SauerStoffverbrauch des Myocards (MVO2) und die allgemeine Hümodynamik untersucht. Neben der Messung des MBF wurden auch die Substramenten von Glucose, Lactat. Pyruvat und freien Fettsäuren (FFA) im arteriellen und im Coronarvenenblut bestimmt. Die i.v. verabreichte Dosis von CT 1341 betrug im Mittel 0.075 ml pro kg Körpergewicht. MBF wurde mittels der Argonmethode gemessen.Nach der Injektion von CT 1341 zeigten aile 7 Patienten einen signifikanten Anstieg des MFB und MVO2, eine Tatsache, die im wesentlichen mit der Schlagfrequenzsteigerung erklärt werden kann. Substrat‐und SauerStoffverbrauch waren gleichzeitig deutlich erhört. Wegen dieser Befunde und ähnlicher aus der Literatur werden VorsichtmaBnahmen bei der Anwendung von CT 1341 bei Herzkranken diskutiert.
Malignant Hyperthermia in a Family
Authors: Kelstrup J. , Haase J. , Jørni J. , Reske‐Nielsen E. , Hyane H. K. 
Published: December 2008

ZUSAMMENFASSUNGAus einer dänischen Familie von insgesamt 141 Mitgliedern starben zwei an maligner Hyperthermie während Berbiturat‐Suxamethonium‐Halothan‐N2O‐O2‐Narkose. Bei der klinischen und biochemischen Untersuchung der gesamten Familie fanden wir, daß 44 der 139 lebenden Mitglieder erhöhte Serum‐Creatinin‐Phosp'hokinase (CKP)‐Werte hat‐ten. 58 Familienmitglieder hatten Störungen des Muskel‐Skelett‐Apparates. Dies steht in Einklang mit ähnlichen Familienuntersuchungen (ISAACS & BARLOW 1970; KYEI‐MENSAH et al. 1971; LARARD et al. 1972). Bei der klinischen Untersuchung wurden keine Anzeichen einer Myopathie gefunden.
Supraclavicular Catheterization of the Superior Vena Cava
Authors: Haapaniemi L. , Slätis P. 
Published: December 2008

In seeking to develop a simple and safe technique of central vein catheterization, a supraclavicular route to the superior vena cava was chosen. Advancing from a point above the medial portion of the clavicle, the needle punctures the wall at the confluence of the subclavian and internal jugular veins, and a siliconized catheter is introduced straight into the superior vena cava. The technique is described in detail.The results of 600 catheterizations are reported. Unsuccessful attempts at cannulation were recorded in 6.3%, malposition of the tip of the catheter in 1.7%, pneumothorax in 0.3% and other complications in altogether 3.3% of the cases. Attention is drawn to the potential dangers inherent in cannulation of major central veins. The supraclavicular route described seems to provide a straightforward, reproducible approach to the superior vena cava, and it seems to have a low incidence of technical failures and early and late complications.
Influence of Althesinr on Coronary Blood Flow and Myocardial Oxygen Consumption in Dogs
Authors: Patschke D. , Brückner J. B. , Gethmann J. W. , Tarnow J. , Weymar A. 
Published: December 2008

Glaxo CT 1341 (Althesin) is a new steroid anaesthetic agent dissolved in Cremophor EL. Its influence on hemodynamics was studied in dogs, especially regarding the myocardial contractility, coronary perfusion and myocardial oxygen consumption.The unpremedicated experimental animals were induced with 3 mg/kg piritramide intravenously and normoventilated with a mixture of 70% N2O and 30% O2. All animals were pretreated with a powerful antihistaminic agent (Tavegilr̀) in order to block reactions to histamine released by Cremophor EL. Five hours later the animals received single intravenous doses of Althesin (1.0 and 2.0 mg/kg).Significant hemodynamic changes (P < 0.025‐0.0005) were caused by 2.0 mg/kg. Heart rate, cardiac output and mean pulmonary pressure increased, total peripheral resistance decreased; while central venous pressure, mean aortic pressure and renal blood flow remained unchanged. The resulting increased cardiac work caused a rise in coronary blood flow of 88%, an increased myocardial oxygen consumption of 66% and a decreased coronary resistance of 48%. As coronary arteriovenous difference in oxygen decreased slightly, Althesin has coronary dilatory properties. Myocardial depression was seen in a marked fall of dp/dtmax (the rate of change of the left ventricular pressure) (30%), in a decreased stroke volume and in an increased left ventricular end‐diastolic pressure. Maximal hemodynamic responses occurred within the first minute after injection and returned to their preinjection levels after approximately 20 min.A recommended dose in man is 2 mg/kg Althesin Myocardial depression and increased oxygen consumption suggest a cautious use of Althesin in cases of heart and coronary insufficiency.
The Ejector Flowmeter and Its Clinical Application
Authors: Jørgensen S. 
Published: December 2008

The ejector flowmeter is designed for the quantitative removal of excess anaesthetic gases.By passing compressed air or gas at 2.0‐3.5 kg/cm2 pressure through a narrow injector nozzle across the upper end of an ordinary flowmeter tube, a sufficient vacuum is created in the flowmeter to obtain an adjustable removal of gas through the flowmeter; for instance, an anaesthetic gas mixture. The driving gas conveys the anaesthetic gas mixture through a narrow antistatic rubber tube to the nearest ventilation channel or along the floor or ceiling into fresh air through an opening in an outer wall.The ejector flowmeter may be mounted on any anaesthetic machine, being independent of national standard dimensions. It can be attached to all current anaesthetic circuits, including those with an anaesthesia ventilator. The float secures visual control of proper flowmeter function. The evacuation capacity is adjustable up to 15 1/min, and the full capacity is 20‐25 1/min. The consumption of driving gas is about 6 1/min. This elimination of gas involves no explosion risk.
Malignant Hyperthermia in a Family: A Clinical and Serological Investigation of 139 Members
Authors: Kelstrup J. , Reske‐Nielsen E. , Haase J. , Jørni J. 
Published: December 2008

In a family of 147 members, two have died from malignant hyperthermia induced by general anaesthesia, and six from other causes. The remaining 139 family members have all been examined clinically and serologically. Forty per cent of the family members had musculoskeletal disorders and 30% had elevated values of creatine phosphokinase in serum.The mode of inheritance is shown not to be autosomal dominant. Doubt is expressed concerning the value of the determination of creatinine phosphokinase (CPK) in serum. It is concluded that it is uncertain whether such determination can predict the risk of the individual patient for developing malignant hyperthermia. Emphasis is laid upon prophylaxis by issuing cards to members of families at risk, by questioning all patients preoperatively about anaesthesiological complications among family members, and by temperature monitoring. It is suggested that any case of malignant hyperthermia give rise to investigation of the family.
Trauma: Hormonal Factors with Special Reference to Diabetes Mellitus
Authors: Efendic S. , Cerasi E. , Luft R. 
Published: December 2008

Three aspects of the role of hormones in stress will be reviewed: 1) changes in hormone secretion during stress, 2) metabolic alterations as a consequence of these changes in hormone production, and 3) the significance of hormones as permissive factors in stress reactions. It is emphasized that body tissues in general ‐ except for the central nervous system ‐ can make use of free fatty acids as a source of energy. In order to provide the central nervous system with its requirement for glucose, the glucose uptake in other tissues is restrained by two hormonally controlled mechanisms: 1) depression of insulin secretion and 2) increase in the concentration of free fatty acids in plasma (which by direct means depresses glucose uptake). Thus, these hormonal interactions provide large amounts of metabolic fuel and distribute them in an effective manner, so that the body can meet stress.In diabetics, an increased secretion of stress hormones in connection with trauma is observed. The metabolic and therapeutic implications of this finding are discussed.
Therapy with Fat Emulsion
Authors: Hallberg D. 
Published: December 2008

Fat emulsions for paranteral nutrition are indicated to maintain a physiological nutrition during impaired function of the gastrointestinal tract. Modern fat emulsions seem to metabolize in the same way as chylomicrons.It is usually possible to infuse a dose of fat up to 3–4 g/kg b.w./24 h. Fat emulsions as such have no osmolal effects and are therefore also indicated during treatment of hyperosmolal fluid balance disturbances.
High‐Frequency Positive‐Pressure Ventilation (HFPPV) Applied for Small Lung Ventilation and Compared with Spontaneous Respiration and Continuous Positive Airway Pressure (CPAP)
Authors: Jonzon A. , Sedin G. , Sjöstrand U. 
Published: December 2008

The respiratory and circulatory conditions in high‐frequency positive‐pressure ventilation (HFPPV) in the dog and during routine surgery in man have been investigated previously. From this previous experimental and clinical experience, the insufflation‐expiratory systems could be modified for small lung ventilation (HFPPV‐infant), and the insufflation frequency‐insufflation time systems could be combined into one function. This modified HFPPV system works without any separate insufflation catheter. The respiratory and circulatory conditions during ventilation with this modified system were investigated in a series of healthy cats anaesthetized with pentobarbital.The present version of HFPPV utilizes humidified, warmed, compressed air (gas mixture) which is obtained by means of a slightly modified pneumatic part of a commercially available incubator system. By means of intermittent opening of an electronically controlled valve, this gas mixture gives an intermittent positive pressure ventilation at high frequency.It is possible to regulate alveolar ventilation during HFPPV both by means of driving‐pressure and expiratory‐resistance adjustments, as well as by regulation of the insufflation frequency and insufflation time. In the cat with normal‐compliant lungs, HFPPV gives adequate alveolar ventilation at continuous positive and low intratracheal pressures. As it has been shown that methods with continuous positive airway pressure increase arterial oxygenation and prevent airway closure, HFPPV was compared with yet another positive airway technique, continuous positive airway pressure (CPAP). The experimental studies on HFPPV and CPAP in the cat with normal‐compliant lungs revealed that HFPPV ‐ in contrast to CPAP ‐ gives adequate alveolar ventilation without circulatory interference.The electronically coupled function of insufflation frequency and time (“respirator setting”) in HFPPV was also tested, and it was shown that the arterial Po2 is mainly influenced by the respirator driving pressure but that the arterial Pco2 and pH are additionally influenced by the respirator setting.
Miscarriages Among Operating Theatre Staff
Authors: Rosenberg P. , Kirves A. 
Published: December 2008

Altogether 300 married Finnish women working as anaesthesia, scrub, casualty and intensive care unit nurses were interviewed about the fate of their pregnancies since 1965. The scrub nurses had the highest frequency of miscarriages; 21.5% of the pregnancies ended in spontaneous abortion. Intensive care unit nurses had a miscarriage rate of 16.7%, anaesthesia nurses 15.0% and casualty department nurses 8.3% of the pregnancies, respectively. The difference between the rate of the combined number of miscarriages of operating room nurses (anaesthesia and scrub) and that of the others was statistically significant.Scrub nurses seemed to have the earliest miscarriages (mean 9.3 weeks), and intensive care unit nurses also had earlier mean time of miscarriages (10.4 weeks) than anaesthesia nurses (11.1 weeks). Gross abnormalities were not observed in the children, but two cases of foetal death in the third trimester of pregnancy (anaesthesia and intensive care unit nurses) and two cases of mental retardation (scrub and intensive care unit nurses) were registered.The results do not indicate foetal lethality of anaesthetic gases in operating room but rather an increased rate of spontaneous miscarriages due to stress.
Comparative Nitrogen Balance Studies with an Amino‐Acid Solution Based on Nutritional Studies Against Two Protein‐Based Solutions
Authors: Vinnars E. , Bergström J. , Fürst P. 
Published: December 2008

This trial presents the results of a cross‐over study in which the nitrogen balance was assessed in a non‐catabolic patient using the amino‐acid solution Intramin forter̀, based on studies of human requirements, and a second amino‐acid solution based on the amino‐acid pattern of egg protein.A second study reports on the nitrogen balance findings in five postoperative, catabolic patients to whom Intramin forte was given. The results are compared to previously published findings in a group of similar, probably less surgically traumatized, patients treated with a hydrolysate of casein.Significant differences regarding the nitrogen balance when comparing the effect of these solutions were not obtained.
Carbon Dioxide Elimination from Circle Systems
Authors: Jørgensen B. , Jørgensen S. 
Published: December 2008

Ten various circle systems were studied in model experiments. All the experiments were performed using a Waters cannister containing 675–685 g of Durasorbr̀. 300 ml of carbon dioxide were supplied to the system per min. The efficacy of these systems was expressed as the time taken to demonstrate a concentration of 0.6% carbon dioxide in the gas mixture supplied to the patient connection during each respiratory cycle. The carbon dioxide elimination was studied at a gas flow of 2, 4 and 6 1 per min. All the systems showed an effective carbon dioxide elimination for 6 h or more at a flow of 2 1. An increasing efficacy was found with increasing flow, but to a varying extent.A circle system where all the components, including the cannister and directional valves, can be replaced after use is recommended owing to the risk of cross contamination. A soda‐lime charge of 600–700 g is advantageous. For anesthetic procedures of less than 1 h, other techniques should be employed as they are more economical.
The Influence of Acid‐Base Changes on Central Nervous System Toxicity of Local Anaesthetic Agents I: An Experimental Study in Cats
Authors: Englesson S. 
Published: December 2008

A method is described of stabilising the metabolic and respiratory acid‐base status of 90 cats in which 127 local anaesthetic toxicity studies were performed. Nine different local anaesthetic agents were studied. These agents were infused intravenously at a constant rate until the appearance of generalised seizure activity in the EEG from the cortex and amygdala via implanted electrodes. A fall in Paco2, or hydrogen ion activity (aH+) was found to decrease local anaesthetic toxicity, such that a linear correlation was found between the log of the toxic dose and Paco2 and aH+. No correlation was found to the metabolic variable chosen (“non‐respiratory” hydrogen activity, aH+NR). The conclusion was that both hydrogen ion activity and Paco2 are of importance in modifying the CNS toxic threshold dose of local anaesthetic agents.ZUSAMMENFASSUNGEs wird eine Methode der Stabilisation des metabolischen und respiratorischen Säure‐Basen‐Status bei 90 Katzen beschrieben, bei welchen 127 Toxizitätsuntersuchungen mit Lokalanaesthetika durchgeführt wurden. Neun verschiedene Lokalanaesthetika, die untersucht wurden, wurden mit gleichbleibender Geschwindigkeit so lange i.v. infundiert, bis im EEG des Cortex und der Mandelkerne‐via implantierter Elektroden registriert‐generalisierte Krampfpotentiale auftraten. Dabei zeigte sich, daß ein Abfallen des Paco2 oder der Wasserstoffionen‐Aktivität (aH+) die Toxizität der Lokalanaesthetika reduzierte und zwar so, daß eine lineare Korrelation zwischen dem Logarithmus der toxischen Dosis und dem PaCo2 bzw. aH+ festgestellt werden konnte. Zu der gewählten metabolischen Variablen (“nicht‐respiratorische” Wasserstoffionen‐Aktivität, aH+NR) konnte keine Korrelation gefunden werden. Die Schlußfolgerung war, daß sowohl die Wasserstoffionen‐Aktivität als auch das PaCO2 von Bedeutung fur die Modifizierung der toxischen Schwellendosen von Lokalanaesthetika im ZNS sind.
Cerebral Metabolic Changes in Arterial Hypocapnia of Short Duration
Authors: Carlsson C. , Nilsson L. , Siesjö B. K. 
Published: December 2008

In order to study the energy metabolism of the brain in pronounced hypocapnia, lightly anaesthetized rats were hyperventilated to arterial CO2 tensions of minimally 10 mmHg during 2, 5 and 45 min, respectively. There were marked increases in the tissue concentrations of lactate (and pyruvate) already at 2 min, but no changes in phosphocreatine, ATP, ADP or AMP at 2 or 5 min. It is concluded that the lactic acidosis observed in the tissue during hyperventilation is unrelated to a derangement of the energy state of the tissue. Measurement of other glycolytic substrates seems to indicate an activation of phosphofructokinase, but the possibility that the accumulation of lactate (and pyruvate) at the present degree of hypocapnia is secondary to an activation of other enzymatic steps cannot be ruled out.ZUSAMMENFASSUNGUm den Energiestoffwechsel des Gehirns unter ausgeprägter Hypokapnie zu studieren, wurden oberflächlich narkotisierte Ratten auf arterielle CO2‐Spannungen von minimal 10 mm Hg während 2, 5 bzw. 45 Minuten hyperventiliert. Schon nach zwei Minuten zeigten sich deutliche Anstiege der Gewebekonzentrationen von Laktat (und Pyruvat), aber keine Veränderungen des Phosphor‐Kreatins, der ATP, ADP oder AMP nach 2 bzw. 5 Minuten. Es wird daraus geschlossen, daß die in den Geweben während der Hyperventilation beobachtete Laktatazidose in keiner Beziehung zu einer Stöning des Energiezustandes der Gewebe steht. Messungen anderer glykolytischer Substrate scheinen auf eine Aktivation der Phosphofruktokinase hinzuweisen, aber die Möglichkeit, daß die Anhäufung von Laktat (und Pyruvat) bei den gegenständlichen Werten der Hypokapnie die Folge einer Aktivation anderer enzymatischer Schritte sein könnte, ist nicht auszuschließen.
Uterine Blood Flow in Dogs During Various Depths of Halothane Anesthesia Measured by Local Injection of Xenon
Authors: Einer‐Jensen N. , Juhl B. 
Published: December 2008

The correlated values of cardiac output (measured by Cardio‐Greenr̀) and uterine blood flow (measured with 133xenon) were determined on eight dogs. This was done both under basis anesthesia with O2‐N2O‐barbiturate‐gallamonium with controlled ventilation and during the addition of 0.5% and 1.0% halothane to the inspiratory air. A fall in cardiac output and uterine blood flow was demonstrated during the addition of halothane. With 0.5% halothane, the fall was on an average 30% and 17% of the initial values respectively and with 1.0% halothane, it was 49% and 42% of the initial values. The uterine blood flow varied considerably from animal to animal, and these values were not correlated to the Paco2 changes carried out within the range of Paco2, from 25 to 66 mmHg.ZUSAMMENFASSUNGBei 8 Hunden wurden die Korrelationswerte des Herzminutenvolumens (HMV) (gemessen mit Cardio‐Green®) und der Uterusdurchblutung (gemessen mit 133Xenon) bestimmt. Dies wurde sowohl unter Basisnarkose mit O2‐N2O‐Barbiturat‐Gallamin‐Basisnarkose mit kontrollierter Beatmung als auch während eines Zusatzes von 0.5–1.0% Halothan im Inspirationsgemisch durchgeführt. Unter Halothan zeigte sich ein Abfall des HMV und der Uterusdurchblutung. Bei 0.5% Halothan betrug der Abfall 30 bzw. 17% der Ausgangswerte und bei 1.0% Halothan 49 bzw. 42%. Die Uterusdurchblutung schwankte beträchtlich von Tier zu Tier, doch standen diese Werte nicht in Korrelation zu PaCo2‐Veränderungen, die in einem Bereich von 25‐66 mm Hg variiert wurden.