C. Puchstein

Universitätsklinik Marien Hospital Herne

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Papers

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Changes in Intracranial Pressure and Compliance during Adenosine Triphosphate-induced Hypotension in Dogs

Anesthesia & Analgesia (1984)

Hugo Van Aken C. Puchstein Ch. Anger Achim Heinecke P. Lawin

Intracranial pressure (ICP) was measured during induced hypotension with increasing doses of adenosine triphosphate (1-5 mg X kg-1 X min-1 ATP) in dogs without (group I) and with (group II) intracranial hypertension. After administration of 1 mg X kg-1 X min-1 ATP, ICP increased significantly from 11 +/- 4 mm Hg to 14 +/- 5 mm Hg (mean +/- SEM) (P less than 0.05; group I) and from 27 +/- 2 mm Hg to 38 +/- 6 mm Hg (P less than 0.05; group II), while mean arterial pressure (MAP) decreased from 103 +/- 10 mm Hg to 86 +/- 6 mm Hg (P less than 0.05; group I) and from 110 +/- 11 mm Hg to 90 +/- 11 mm Hg (P less than 0.05; group II). In both groups a slow decrease of ICP after the initial increase occurred with further lowering of MAP, but ICP remained significantly above control values even with a dose of 5 mg X kg-1 X min-1 ATP (P less than 0.05). Ventricular volume-pressure response curves (VPR) before and during intravenous infusion of 3 mg X kg-1 X min-1 ATP were constructed to determine changes in intracranial compliance (ICC). In both groups I and II ATP decreased ICC. On the basis of these results it is recommended that in the presence of intracranial mass lesions ATP should not be given to induce arterial hypotension before the dura is opened.

Mean arterial pressure

10.1213/00000539-198404000-00001

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Citations (7)

Caloric requirements in burned patients.

PubMed (1989)

M Pfisterer H. Lessire Ruben H. de Kleine G Nolte C. Puchstein

Adequate nutritional support is an important goal for the management of burn patients. Caloric requirements are higher than in any other major trauma or disease. The development of hypermetabolism and hypercatabolism leads to an increase in resting energy expenditure which depends on the severity of the injury. Therefore, with the intent to counteract these developments and their complications, a balanced carbohydrate, fat and protein intake should be adjusted to the actual needs. This paper gives a survey of the metabolic consequences of burns, reviews the underlying pathophysiology and tries to give practical guidelines for the nutritional support of the burn patient.

Hypermetabolism

Resting energy expenditure

Caloric intake

Caloric theory

Severe burn

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Citations (2)

Eiweißorientierte peripher-venöse Ernährung nach operativem Trauma

Transfusion Medicine and Hemotherapy (1989)

N. Mertes M. Pfisterer G Winde G. Nolte R. Keferstein

Die hochkalorische vollständige parenterale Ernährung in der postoperativen Phase ist nicht bei jedem Patienten sinnvoll, bei dem sich eine enterale Nahrungszufuhr vorübergehend verbietet. Vor allem die niedrigkalorische, eiweißorientierte, periphervenöse Ernährung kann bei mittelschwerer Katabolie eine gute Alternative darstellen. In einer offenen prospektiven Studie wurden 18 weibliche Patienten nach Dickdarmeingriffen während 4 Tagen mit einer Komplettlösung, bestehend aus Sorbit 80 g, Xylit 40 g, 70 g AA und einem Elektrolyt-zusatz, ernährt. Bei dieser 700 kcal-Diät waren die Stickstoffbilanzen mit einem mittleren täglichen Verlust von 4 g nur leicht negativ. Die Routinelaborparameter änderten sich kaum. Die Homöostase der freien Plasmaaminosäuren konnte aufrecht erhalten werden, so daß die Voraussetzung für eine optimale Verwertung der zugeführten Nährlösung gegeben sein dürfte. Allgemeine Nebenwirkungen konnten nicht festgestellt werden. Die untersuchte eiweißorientierte Komplettlösung nach dem Kartof-fel-Ei-Muster kann für die hypokalorische periphervenöse Ernährung empfohlen werden.

10.1159/000222345

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Citations (0)

[Immunomodulation after parenteral glutamine administration in colorectal surgery].

PubMed (1996)

Morlion Bj Siedhoff Hp U. Joosten M. Köller W. König

The influence of parenteral L-alanyl-L-glutamine dipeptide on the cysteinyl-leukotriene (cys-LT) synthesizing capacity from neutrophils was studied in patients undergoing colonic surgery. The decrease in cys-LT, observed postoperatively, could be normalized with parenteral glutamine, while the cys-LT decrease persisted in controls. We conclude that the provision of glutamine in the postoperative state improves normalization of neutrophil functions (e.g., generation of cys-LT), which is an essential prerequisite for host defences.

Leukotriene B4

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Citations (3)

Informationen für die Klinik

Transfusion Medicine and Hemotherapy (1989)

P.H. Schober R. Kurz H.E. Musil E. Jarosch G.F. Hebenstreit

10.1159/000222349

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Citations (0)

Informationen für die Klinik

Transfusion Medicine and Hemotherapy (1989)

V. Hach-Wunderle D. Teixidor P. Zumpe P. Kühnl I. Scharrer

10.1159/000222363

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Citations (0)

P.98 What is the optimum ω-3 to ω-6 fatty acid (FA) ratioof parenteral lipid emulsions in postoperative trauma?

Clinical Nutrition (1997)

Bart Morlion E. Torwesten Katja Wrenger C. Puchstein Peter Fürst

Lipid emulsion

Fat emulsion

10.1016/s0261-5614(97)80222-1

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Citations (38)

Treatment of hypertensive crises in neurosurgery

Annales Françaises d Anesthésie et de Réanimation (1989)

C. Puchstein

10.1016/s0750-7658(89)80043-7

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Citations (4)

Influence of Ketanserin, an Hypertensive Agent with Specific 5-HT2-Receptor Blocking Activity, on Intracranial Pressure

Survey of Anesthesiology (1984)

Hugo Van Aken Ch. Anger C. Puchstein J C Thijs P. Lawin

Clinic for Anesthesiology and Surgical Intensive Care, Westphalian Wilhelm University, Münster, Germany

Ketanserin

Blocking (statistics)

10.1097/00132586-198408000-00020

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Citations (0)

Influence of ketanserin, an antihypertensive agent with specific 5-HT2-receptor blocking activity, on intracranial pressure

Critical Care Medicine (1984)

Hugo Van Aken Ch. Anger C. Puchstein J. C. THUS P. Lawin

During administration of ketanserin, a selective 5-HT2-receptor blocker, intracranial pressure (ICP) was measured in dogs without (group 1) and with (group 2) intracranial hypertension (ICP greater than 20 mm Hg). A bolus of 1 mg/kg body weight and subsequent infusion of 13.25 +/- 1.2 mg/kg of ketanserin decreased mean arterial pressure 35% +/- 18% in group 1 and 35% +/- 19% in group 2. In both groups, there was no change in ICP or in ventricular volume-pressure response curves (intracranial compliance [ICC]) after the administration of ketanserin. Ketanserin may be a safe antihypertensive drug for avoiding and treating hypertension in neurosurgical patients.

Ketanserin

Bolus (digestion)

10.1097/00003246-198401000-00002

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Citations (6)