Vergleichende Untersuchungen über Ventilation und Gasaustausch nach Operationen

Evaluation of Carbohydrates in Parenteral Nutrition

“…The increased lipolysis serves a metabolic purpose. Rodewald (1962) showed that the respiratory quotient was decreased postoperatively, indicating that the high need of calories was mainly covered by fat combustion. Hallberg (1965 a, b) also found that fat emulsion disappeared more rapidly than normally from the plasma after operation.…”

Studies of Disturbances in Gas Exchange Following Intracardiac and Extrathoracic Operations

“…Biicherl [9] has described increased frequency of p ro tracted hypoventilation following cardiac operations w ith the aid of a heart-lung m achine. His experience cannot be corroborated, in this degree, by personal observations and the rep o rts presented by o th er au th o rs [7,28,37,39]. In less com m on cases, resp irato ry acidosis has of course been observed in association w ith postoperative cardiac or pulm onary com plications.…”

“…Rodewald [39] pointed ou t the decrease in alveolar and arte rial 0 2-pressure th a t resulted from dim inution of the respiratory quotient. The degree of hypoxem ia provoked by a decrease in RQ, how ever, is significant as com pared w ith th e oxygen deficiency th a t is to be ascribed to a pulm onary sh u n t or a disturbance in distrib u tio n .…”

“…The severity of disturbances in gas ex change based on general hypoventilation shows considerable in dividual differences according to th e n ature of th e operation and its procedure. The anaesthetics of the b a rb itu ra te series in particu lar exert a depressing influence on ven tilation which, in the case of indiscrim inate application, can lead to considerable alveolar hypo v en tilation w ith decreased oxygen pressures and increased carbon dioxide pressure [33,34].A n um ber of investigators have also m entioned hypoxem ia following thoracic an d in tracard iac surgery; anom alies of diffusion, pulm onary sh u n t an d disturbances in gas d istrib u tio n have been m entioned as possible causes [7,8,9,15,23,26,29,39,42].The findings are not confined to in trath o ra cic operations. Sim ilar com plications occur following surgery of the extrem ities and abdom inal operations [18,23,39,45].…”

“…Sim ilar com plications occur following surgery of the extrem ities and abdom inal operations [18,23,39,45]. As a rule, however, the ex ten t of the functional dam age in these cases is less th a n th a t in in trath o racic operations, where the diagnosis and trea tm e n t of these changes are of considerable practical im portance [7,39]. On the basis of some exam ples, th e e x ten t and n atu re of disturbances in pulm onary function following various surgical produces will be dis cussed.…”