Search results for "Extracorporeal"

Extracorporeal circulation and cardiac arrest in an awake patient: a safe approach for single lung pulmonary artery stenting?

2005

We describe the anesthetic concept and approach in a single lung patient scheduled for pulmonary artery stenting due to recurrence of a pulmonary artery sarcoma after left pneumectomy.

Reoperation and the centrifugal pump?

1992

Postperfusion syndrome is still a problem in long cardiac operations using extracorporeal circulation (ECC). To evaluate whether or not centrifugal blood pumping during open heart surgery is beneficial, a randomized, prospective study was undertaken of 50 consecutive patients undergoing elective coronary artery bypass grafting. The patients were divided into two groups of 25 each. In group 1 a centrifugal pump (Biomedicus) was used as arterial blood pump, while in group 2 a roller pump (Stockert) was used. The two groups did not differ significantly and the number of variables during surgery was kept low (identical perfusion set, two surgeons, minimal cardiotomy suction). The parameters stu…

Acute respiratory distress syndrome in traumatic brain injury: how do we manage it?

2017

Abstract: Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice. In this review, we will explore the strategies of the best …

Extracorporeal circulation activates endothelial nitric oxide synthase in erythrocytes.

2007

Background Extracorporeal circulation used in cardiopulmonary bypass and hemodialysis is often associated with severe hypotension, which is an important predictor for mortality and morbidity. One pathophysiological hypothesis includes nitric oxide (NO) generation. Recently, a functional NO synthase (endothelial type NO synthase [eNOS]), was found to be expressed in human red blood cells. However, to date, activation of red blood cell eNOS has not been shown. We hypothesized that eNOS in circulating red blood cells might be activated during extracorporeal circulation and thus contribute to hypotension through vasodilation upon NO release. Methods We collected blood samples from 28 patients e…

Determinants of Survival in Patients with Extracorporeal Support

2018

Dosimetric feasibility study for an extracorporeal BNCT application on liver metastases at the TRIGA Mainz

2010

This study investigates the dosimetric feasibility of Boron Neutron Capture Therapy (BNCT) of explanted livers in the thermal column of the research reactor in Mainz. The Monte Carlo code MCNP5 is used to calculate the biologically weighted dose for different ratios of the (10)B-concentration in tumour to normal liver tissue. The simulation results show that dosimetric goals are only partially met. To guarantee effective BNCT treatment the organ has to be better shielded from all gamma radiation.

Ureteral Stones: Shockwave Lithotripsy or Ureteroscopy, Which is Best?

2021

Background Renal stone disease is common and can cause emergency presentation with acute pain due to ureteric colic. International guidelines have stated the need for a multicentre randomised controlled trial (RCT) to determine whether a non-invasive outpatient (shockwave lithotripsy [SWL]) or surgical (ureteroscopy [URS]) intervention should be the first-line treatment for those needing active intervention. This has implications for shaping clinical pathways. Objective To report a pragmatic multicentre non-inferiority RCT comparing SWL with URS. Design, setting, and participants This trial tested for non-inferiority of up to two sessions of SWL compared with URS as initial treatment for ur…

Extracorporeal Stimulation of Sacral Nerve Roots for Observation of Pelvic Autonomic Nerve Integrity: Description of a Novel Methodological Setup.

2017

Introduction: Neurophysiologic monitoring can improve autonomic nerve sparing during critical phases of rectal cancer surgery. Objectives: To develop a system for extracorporeal stimulation of sacral nerve roots. Methods: Dedicated software controlled a ten-electrode stimulation array by switching between different electrode configurations and current levels. A built-in impedance and current level measurement assessed the effectiveness of current injection. Intra-anal surface electromyography (sEMG) informed on targeting the sacral nerve roots. All tests were performed on five pig specimens. Results: During switching between electrode configurations, the system delivered 100% of the set cur…

Application of High Energy Shock Waves to Single Cells

1989

Extracorporeal shock wave lithotripsy has been in clinical use since 1980 with several hundred thousand patients treated to date. Striking complications, like perirenal hematomas, are rare with a range of approximately 0.5%–1.5%. High dose applications in pigs and dogs have shown devastating effects on renal parenchyma with intrarenal hemorrhage and later fibrosis (Muschter et al. 1987). However, very little is known about shock wave effects on single cells like cellular blood components. Chaussy and coworkers (Chaussy 1982; Eisenberger et al. 1977) could show an increase of free hemoglobin after exposing canine erythrocytes to shock waves. Russo and associates (1986) found a profound influ…

Überprüfung der Läsionsgefahr des N. ischiadicus des Kaninchens durch die Applikation niedrig- und mittelenergetischer extrakorporaler Stoßwellen

2008

Aim The aim of the study was to evaluate the likeliness for peripheral nerve lesions following extracorporeal shock wave application. Material and method 82 rabbit sciatic nerves were randomized to undergo low-energetic (0.08 mJ/mm2), middle-energetic (0.28 mJ/mm2) or no (controls) shock wave therapy. After 1 to 28 days an independent neuropathologist checked the specimen for signs of neural lesions. Results Only after 14 and 28 days vacuolic swelling of the axons was noted, somewhat pronounced in the middle-energetic group. In no case was there any disruption of the nerve's continuity. We did not observe any neurapraxia. Conclusion Shock wave application does not threaten peripheral nerve …