Search

Your search keyword '"Habler, O."' showing total 329 results
Start Over Author "Habler, O."
329 results on '"Habler, O."'

68. Riesenhämangiom des Zungenkörpers

Author

Lang, P., primary, Thrun, B., additional, Hofstetter, B., additional, Haberl, C., additional, Strehlke, P., additional, Hagenmaier, C., additional, Schwenzer, K., additional, and Habler, O., additional

Published
2002
Full Text
View/download PDF

77. The Limit of Anemia Tolerance during Hyperoxic Ventilation with Pure Oxygen in Anesthetized Domestic Pigs.

Author

Pape, a., Steche, M., Laout, M., Wedel, M., Schwerdel, F., Weber, C.F., Zwissler, B., and Habler, O.

Subjects
ANEMIA, HEMODILUTION, HEMOGLOBINS, HYDROXYETHYL starch, TREATMENT of blood circulation disorders, CARDIOVASCULAR disease treatment, BLOOD loss estimation
Abstract

Background: During acellular replacement of an acute blood loss, hyperoxic ventilation (HV) increases the amount of O2 physically dissolved in the plasma and thereby improves O2 supply to the tissues. While this effect could be demonstrated for HV with inspiratory O2 fraction (FiO2) 0.6, it was unclear whether HV with pure oxygen (FiO2 1.0) would have an additional effect on the physiological limit of acute normovolemic anemia. Methods: Seven anesthetized domestic pigs were ventilated with FiO2 1.0 and subjected to an isovolemic hemodilution protocol. Blood was drawn and replaced by a 6% hydroxyethyl starch (HES) solution (130/0.4) until a sudden decrease of total body O2 consumption (VO2) indicated the onset of O2 supply dependency (primary endpoint). The corresponding hemoglobin (Hb) concentration was defined as 'critical Hb' (Hbcrit). Secondary endpoints were parameters of myocardial function, central hemodynamics, O2 transport and tissue oxygenation. Results: HV with FiO2 1.0 enabled a large blood-for-HES exchange (156 ± 28% of the circulating blood volume) until Hbcrit was met at 1.3 ± 0.3 g/dl. After termination of the hemodilution protocol, the contribution of O2 physically dissolved in the plasma to O2 delivery and VO2 had significantly increased from 11.7 ± 2 to 44.2 ± 9.7% and from 29.1 ± 4.2 to 66.2 ± 11.7%, respectively. However, at Hbcrit, cardiovascular performance was found to have severely deteriorated. Conclusion: HV with FiO2 1.0 maintains O2 supply to tissues during extensive blood-for-HES exchange. In acute situations, where profound anemia must be tolerated (e.g. bridging an acute blood loss until red blood cells become available for transfusion), O2 physically dissolved in the plasma becomes an essential source of oxygen. However, compromised cardiovascular performance might require additional treatment. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2014
Full Text
View/download PDF

79. Letter

Author

Kleen, M., primary, Habler, O., additional, and Messmer, K., additional

Published
1998
Full Text
View/download PDF

90. Neuromuscular Blockade with Rocuronium Bromide Increases the Tolerance of Acute Normovolemic Anemia in Anesthetized Pigs.

Author

Pape, A., Kertscho, H., Stein, P., Lossen, M., Horn, O., Kutschker, S., Zwissler, B., and Habler, O.

Subjects
BLOOD transfusion, ANEMIA, SWINE, BROMIDES, HEMODYNAMICS
Abstract

Background: The patient's individual anemia tolerance is pivotal when blood transfusions become necessary, but are not feasible for some reason. To date, the effects of neuromuscular blockade (NMB) on anemia tolerance have not been investigated. Methods: 14 anesthetized and mechanically ventilated pigs were randomly assigned to the Roc group (3.78 mg/kg rocuronium bromide followed by continuous infusion of 1 mg/kg/min, n = 7) or to the Sal group (administration of the corresponding volume of normal saline, n = 7). Subsequently, acute normovolemic anemia was induced by simultaneous exchange of whole blood for a 6% hydroxyethyl starch solution (130/0.4) until a sudden decrease of total body O2 consumption (VO2) indicated a critical limitation of O2 transport capacity. The Hb concentration quantified at this time point (Hbcrit) was the primary endpoint of the protocol. Secondary endpoints were parameters of hemodynamics, O2 transport and tissue oxygenation. Results: Hbcrit was significantly lower in the Roc group (2.4 ± 0.5 vs. 3.2 ± 0.7 g/dl) reflecting increased anemia tolerance. NMB with rocuronium bromide reduced skeletal muscular VO2 and total body O2 extraction rate. As the cardiac index increased simultaneously, total body VO2 only decreased marginally in the Roc group (change of VO2 relative to baseline -1.7 ± 0.8 vs. 3.2 ± 1.9% in the Sal group, p < 0.05). Conclusion: Deep NMB with rocuronium bromide increases the tolerance of acute normovolemic anemia. The underlying mechanism most likely involves a reduction of skeletal muscular VO2. During acellular treatment of an acute blood loss, NMB might play an adjuvant role in situations where profound stages of normovolemic anemia have to be tolerated (e.g. bridging an unexpected blood loss until blood products become available for transfusion). Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2012
Full Text
View/download PDF

94. EFFECT OF HYPERTONIC SALINEDEXTRAN ON POSTSTENOTIC MYOCARDIAL PERFUSION METABOLISM AND FUNCTION DURING RESUSCITATION FROM HEMORRHAGIC SHOCK IN ANESTHETIZED PIGS

Author

Welte, M., Lackermeier, P., Habler, O., Kleen, M., Kemming, G., Frey, L., Zwissler, B., and Messmer, K.

Abstract

Resuscitation using small volumes of hypertonic saline solutions normalizes cardiac output without fully restoring arterial pressure. This study compared the efficacy of either 7.2 saline/10 dextran 60 (HSDex) or the identical sodium load of normal saline (NS) to improve regional myocardial blood flow (MBF), contractile function, and oxygen metabolism in the presence of a critical coronary stenosis. Fourteen anesthetized, open-chest pigs (25 ± 3.6 kg) were instrumented to assess left anterior descending coronary artery (LAD) flow, post-stenotic oxygen, and lactate metabolism, regional myocardial segment shortening (SS, sonomicrometry), and MBF (radioactive microspheres). After implementation of a critical LAD-stenosis, shock was induced by hemorrhage (mean arterial pressure (MAP) 45–50 mmHg for 75 min). Resuscitation was started by infusion (2 min) of either HSDex (n = 7, 10 of blood loss) or NS (n = 7, 80 of blood loss); 30 min later 6 dextran 60 (10 of blood loss) was administered in both groups. The LAD-stenosis did not affect myocardial metabolism, SS, or MBF at rest. After hemorrhage, MBF remained unchanged from baseline in non-stenotic but decreased by 53 in post-stenotic myocardium (p < .05). The endo-epicardial flow ratio fell below 1.0 in both areas. SS decreased by 10–15 only in post-stenotic myocardium (p < .05). Resuscitation with both HSDex and NS restored cardiac index (Cl) but not MAP. MBF increased above baseline values with either solution in non-stenotic while it remained at shock levels in post-stenotic myocardium, where ischemia persisted as evidenced by lactate production and depressed SS. Neither in non-stenotic nor in post-stenotic myocardium was the epi-endocardial flow ratio normalized upon resuscitation with HSDex or NS. We conclude that in the presence of a flow-limiting coronary stenosis, initial fluid resuscitation with both HSDex and the identical sodium load of NS failed to restore perfusion pressure, redistributed MBF in favor of normally perfused myocardium, and did not reverse ischemia in post-stenotic myocardium.

Published
1997

95. Effects of inhaled prostacyclin as compared with inhaled nitric oxide in a canine model of pulmonary microembolism and oleic acid edema

Author

Zwissler, B., Welte, M., Habler, O., Kleen, M., and Messmer, K.

Abstract

Objective:: Recently, it has been shown that the inhalation of nitric oxide (NO) and of prostacyclin (PGI"2) elicits selective pulmonary vasodilation in a canine model of pulmonary hypertension induced by hypoxic pulmonary vasoconstriction. The present study was designed to investigate whether inhaled NO or PGI"2-aerosol, respectively, is also effective in decreasing pulmonary artery pressure in a canine model of acute pulmonary microembolism and oleic acid edema. Design:: Prospective, randomized, cross-over design. Setting:: University animal research laboratory. Participants:: Eight anesthetized, mechanically ventilated dogs (28 +/- 1 kg). Interventions:: Acute pulmonary microembolization (PME) was induced using glass microbeads (mean diameter: 100 @mm) and 0.01 mL/kg of oleic acid. Subsequently, inhaled PGI"2 (concentration: 10 @mg/mL) or NO (50 ppm), respectively, was randomly administered for 15 minutes each and then withdrawn. Measurements and Main Results:: Central hemodynamics (heart rate [HR], cardiac output [CO], stroke volume [SV], mean arterial pressure [MAP], systemic vascular resistance [SVR], mean pulmonary artery pressure [PAP], pulmonary vascular resistance [PVR]) and gas exchange (PaO"2/F"1O"2 ratio, intrapulmonary shunt [Qs/Qt], alveolar-arterial oxygen difference, [AaDO"2]) were assessed. Measurements were performed at control, after PME, and during administration of PGI"2 and NO, respectively. PME induced a significant increase (p < 0.001) of MAP (+9%), PAP (+68%), and PVR (+163%), whereas HR, CO, and SV remained unchanged and lung function deteriorated. Inhalation of NO slightly decreased PAP (-10%; p < 0.05) and PVR (-26%; p < 0.01) and improved AaDO"2 and PaO"2/F"1O"2. In contrast, inhalation of PGI"2 had no consistent effect on pulmonary vascular tone or gas exchange. Conclusion:: The data demonstrate that inhaled NO may elicit selective pulmonary vasodilation and improve gas exchange in a canine model of pulmonary microembolism and respiratory insufficiency. However, the degree of these effects was relatively small. The aerosolization of PGI"2 under conditions of positive-pressure ventilation did not exert a significant vasodilatory effect on pulmonary vessels and did not improve pulmonary gas exchange in this model.

Published
1995
Full Text
View/download PDF

97. Aerosol production and aerosol droplet size distribution during mechanical ventilation (IPPV) with a new ultrasonic nebulizer

Author

Gi, Kemming, Wolfgang Kreyling, Habler O, Merkel M, Kleen M, Welte M, Messmer K, and Zwissler B

Subjects
Adult, Aerosols, Nebulizers and Vaporizers, Intubation, Intratracheal, Humans, Infant, Ultrasonics, Equipment Design, Models, Theoretical, Epoprostenol, Intermittent Positive-Pressure Ventilation
Abstract

Administration of drugs via the airway is increasingly practiced in ICU- and surgical patients. For this purpose, aerosols may be produced by either jet nebulization or ultrasonic droplet generation. In mechanically ventilated patients, aerosol delivery is often insufficient. The influence of the ventilatory pattern on nebulizer efficacy is poorly understood. In the present in vitro study we determined the efficacy of a new ultrasonic nebulizer in delivering aerosolized epoprostenol using defined ventilator settings. We determined aerosol delivery rates, the aerosol droplet size distribution and the impact of the connection tubing on drug delivery, applying adult and infant ventilation patterns. Aerosol production rates ranged from 0.28 to 0.57 ml per minute. Using an adult ventilator setting volume controlled ventilation (CMV) led to a higher aerosol production rate than pressure controlled ventilation (PCV) at identical tidal volumes and mean airway pressures (0.57 ml/min,CMV vs 0.39 ml/min, PCV). With an infant ventilator setting, nebulizer rates were lower than those found for the adult ventilator setting, but did not differ substantially between CMV and PCV mode (0.29 ml/min, CMV vs 0.28 ml/min, PCV). Aerosol delivery rates distal to the endotracheal tube changed according to aerosol production rates (adult mode: 0.18 ml/min, CMV vs 0.10 ml/min, PCV; infant mode: 0.03 ml/min, both CMV and PCV). In the infant ventilation mode, a higher percentage of the aerosol was trapped in the catheter mount as compared to the adult ventilation mode. Mass median droplet diameters for each of the four ventilator settings were almost identical (4.63 to 5.09 micron) and smaller than indicated in the product specifications (8 micron). Delivery rates and sizes of droplets delivered by the new ultrasonic nebulizer SUN 345(R) agree well with previously reported data from comparable settings using diverse nebulizer devices.

98. Effects of hemodilution on splanchnic perfusion and hepatorenal function. I. Splanchnic perfusion

Author

Kleen, M., Habler, O., Hutter, J., Armin Podtschaske, Tiede, M., Kemming, G., Corso, C., Batra, S., Keipert, P., Faithfull, S., and Messmer, K.

Subjects
Hemodilution, Dogs, Liver, Regional Blood Flow, Intestine, Small, Hemodynamics, Animals, Intestine, Large, Splanchnic Circulation, Kidney, Pancreas, Liver Circulation
Abstract

Perfusion of intestinal organs increases in response to acute normovolemic hemodilution (ANH). However, detailed studies on distribution of regional splanchnic organ perfusion during ANH are lacking. We therefore carried out this study to test the hypothesis that ANH does not cause disturbance of physiologic patterns of regional splanchnic organ blood flow. After governmental permission, 22 anesthetized dogs were instrumented to allow invasive hemodynamic measurements and intracardial injection of radioactive microspheres (diameter 15 micro m) for determination of regional organ perfusion. Measurements were made at baseline (hematocrit 37 +/- 3%) and after ANH with 6% hydroxyethyl starch (mol. wt. 200000 / 0.5) to hct 20 +/- 1%. After completion of the protocol, splanchnic organs were removed and dissected into small samples according to anatomical and functional principles. Regional perfusion was determined based on the microsphere content of each sample. Hepatic, intestinal, and pancreatic blood flow increased with ANH. Hepatic arterial blood flow rose by 86%, whereas portal venous perfusion increased by 28%. Small intestine mucosal perfusion was augmented by 68% while the non-mucosal tissue compartment of the gut wall received 32% more blood flow after ANH which is in proportion to the increase in cardiac index after ANH. This redistribution of intestinal flow might be the basis for the preservation of tissue oxygenation during moderate isovolemic anemia.

99. Effects of hemodilution on splanchnic perfusion and hepatorenal function. II. Renal perfusion and hepatorenal function

Author

Habler O, Kleen M, Hutter J, Armin Podtschaske, Tiede M, Kemming G, Corso C, Batra S, Keipert P, Faithfull S, and Messmer K

Subjects
Male, Hemodilution, Blood Volume, Hemodynamics, Natriuresis, Kidney, Diuresis, Renal Circulation, Dogs, Liver, Regional Blood Flow, Animals, Female, Splanchnic Circulation
Abstract

Hepatorenal perfusion and function were assxssed in 22 dogs undergoing acute normovolemic hemodilution (ANH) to a hematocrit (Hct) of 20% using 6% hydroxyethyl starch (200.000/0.5) as the diluent. Organ perfusion was determined with the radioactive microspheres method. Renal function was assessed by urinary output, creatinine clearance and fractional sodium excretion. Blood volume as well as hepatic function were derived from indocyanine green (ICG) dilution kinetics. Hepatocellular integrity was determined by serum enzymatic activity of glutamate-oxalacetate-transaminase (GOT) and glutamate-pyruvate- transaminase (GPT). ANH to Hct 20% did not change blood volume and mean aortic pressure, while heart rate was slightly elevated (p0.05) by 5 beats per minute and cardiac output increased by 29% (p0.05). In contrast to the liver, where arterial and portal venous blood flow increased (86% and 28%, respectively; p0.05), total renal blood flow as well as intraorgan distribution of renal blood flow remained unchanged post-ANH. While creatinine clearance remained unchanged following ANH, urinary output and fractional urinary excretion increased (p0.05). In response to enhanced hepatic blood flow after ANH, intravascular half-life of ICG was reduced (p0.05) and ICG clearance increased (p0.05). Serum enzymatic activity of GPT decreased upon ANH (p0.05), while GOT activity remained unchanged. ANH to a Hct 20% does not impair hepatorenal function. Increased urinary output points out the necessity for proper adjustment of crystalloid infusion to maintain normal intravascular volume and avoid hypovolemia and the associated risk of tissue hypoxia.

100. Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines

Author

Goodnough, L. T., Maniatis, A., Earnshaw, P., Benoni, G., Beris, P., Bisbe, E., Fergusson, D. A., Gombotz, H., Habler, O., Monk, T. G., Ozier, Y., Slappendel, R., Szpalski, M., Goodnough, L. T., Maniatis, A., Earnshaw, P., Benoni, G., Beris, P., Bisbe, E., Fergusson, D. A., Gombotz, H., Habler, O., Monk, T. G., Ozier, Y., Slappendel, R., and Szpalski, M.

Abstract

Previously undiagnosed anaemia is common in elective orthopaedic surgical patients and is associated with increased likelihood of blood transfusion and increased perioperative morbidity and mortality. A standardized approach for the detection, evaluation, and management of anaemia in this setting has been identified as an unmet medical need. A multidisciplinary panel of physicians was convened by the Network for Advancement of Transfusion Alternatives (NATA) with the aim of developing practice guidelines for the detection, evaluation, and management of preoperative anaemia in elective orthopaedic surgery. A systematic literature review and critical evaluation of the evidence was performed, and recommendations were formulated according to the method proposed by the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical patients have a haemoglobin (Hb) level determination 28 days before the scheduled surgical procedure if possible (Grade 1C). We suggest that the patient's target Hb before elective surgery be within the normal range, according to the World Health Organization criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease (Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia should be viewed as a serious and treatable medical condition, rather than simply an abnormal laboratory value. Implementation of anaemia management in the elective orthopaedic surgery setting will improve patient outcomes

Catalog

Books, media, physical & digital resources
See catalog results