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  • Articles  (3)
  • Indomethacin  (2)
  • Case control study  (1)
  • 1
    ISSN: 1435-2451
    Keywords: Patent ductus arteriosus ; Respiratory distress syndrome ; Indomethacin ; Ductus arteriosus persistens ; Atemnotsyndrom ; Indometacin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Ligatur des offenen Ductus arteriosus ist auch bei kleinsten Frühgeborenen ein risikoarmer Eingriff und stellt immer eine vitale Indikation dar. Neben der Operation ist in indizierten Fällen auch der Verschluß mit Prostaglandin-Inaktivatoren möglich. Von 1976–1985 wurden 215 Frühgeborene behandelt. Bei 52 Säuglingen kam es zum Spontanverschluß. Bei 68 war Indomethacin erfolgreich. Bei 42 führte Indometacin nicht zum Verschluß, so daß eine Operation erforderlich wurde. 53 Säuglinge wurden wegen Kontraindikationen für Indometacin primär operiert. Die Gesamtletalität betrug 20%, wobei die kombinierte Gruppe die höchste Letalität aufwies.
    Notes: Summary Ligation of patent ductus arteriosus can be safely performed even in the smallest prematures and may be life-saving. Medical treatment with prostaglandin-inhibitors may be substituted in selected cases. From 1976–1985 a total of 215 prematures was treated. 52 of those experienced spontaneous closure. In 68 infants closure occurred following indomethacin-treatment. 48 had operation after failure of medical therapy and 53 with contraindications to indomethacin were primarily operated. The overall mortality reached 20% and was highest among those with combined medical and surgical treatment.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Tachyarrhythmias ; Surgical intensive care ; Case control study ; Incidence ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Incidence, types, and factors associated with new onset tachyarrhythmias (TA) in surgical intensive care patients.¶Design: Pairwise-matched case-controlled study. Setting: Surgical intensive care unit (ICU) with nine intensive care beds. Patients: During a 1-year period, all TA patients (n = 89) were included in the study. Control patients (n = 82) without TA were matched according to age, sex, and surgical region. Methods: TA workup included: 12-lead ECG, arterial blood gas, serum electrolyte (K+, Mg2+), and serum CK/CKMB isoenzyme analysis. Pre-existing cardiovascular and pulmonary disease, cardiovascular risk factors, preoperative regular medication, and admission SAPS were recorded in all patients. A multiple organ dysfunction syndrome (MODS) score, the presence or absence of SIRS or sepsis, and hemodynamics (MAP and CVP) before onset of TA were evaluated in TA patients, while in control patients highest MODSscore, the presence or absence of SIRS or sepsis, mean hemodynamic and laboratory values calculated from highest and lowest readings during ICU stay were used for statistical comparison. Logistic regression analysis was performed to identify variables multivariately associated with TA. Results: Eighty-nine (14.8 %) of 596 patients developed TA. Atrial fibrillation was most frequent (60.7 %). Presence of SIRS or sepsis (adj. OR = 36.45; 95 % CI: 11.5–115.5), high admission SAPS (adj. OR = 1.25/point; 95 % CI: 1.08–1.44), high CVP (adj. OR = 1.27/mmHg; 95 % CI: 1.09–1.48), and low arterial oxygen tension (adj. OR = 0.97/mmHg); 95 % CI: 0.95–0.99) were found to be significant predictors for development of TA. Conclusions: In surgical patients hypoxia, high cardiac filling pressures, a greater degree of physiologic derangement at admission, and the presence of SIRS and sepsis are independent risk factors for the development of TA.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1076
    Keywords: Indomethacin ; Drug level monitoring ; Very low birth weight infants ; Ductus arteriosus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract First results are described of individually tailored indomethacin dose rates employing on-line drug level monitoring for pharmacologically induced ductal constriction in very low birth weight infants with symptomatic patent ductus arteriosus (sPDA). In addition prolonged indomethacin therapy was introduced. From our data it appears that the effective threshold indomethacin level for the induction of ductus constriction has to be about 1000 ng/ml 10 h postdosing, while ductus closure can be maintained with a dose rate that exceeds a plasma level of 500 ng/ml for at least 1 week. These maintenance levels were also effective in completely suppressing the urinary metabolite excretion rates of PGI2 and PGE2, which are potential mediators of ductal relaxation. On-line indomethacin level monitoring appears to be practically essential for prolonged indomethacin therapy to overcome the marked variation of indomethacin disposition in preterm infants with sPDA.
    Type of Medium: Electronic Resource
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