Kazmaier, Stephan

[["dc.bibliographiccitation.firstpage","E49"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","The Heart Surgery Forum"],["dc.bibliographiccitation.lastpage","U2"],["dc.bibliographiccitation.volume","8"],["dc.contributor.author","Baryalei, M. M."],["dc.contributor.author","Tirilomis, Theodor"],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Schoendube, Friedrich Albert"],["dc.contributor.author","Aleksic, I."],["dc.date.accessioned","2018-11-07T08:28:04Z"],["dc.date.available","2018-11-07T08:28:04Z"],["dc.date.issued","2005"],["dc.description.abstract","Background: Myocardial bridging of the left anterior descending ( LAD) artery may result in clinical symptoms. Surgery with cardiopulmonary bypass (CPB) is a therapeutic option with considerable risk. We hypothesized that off-pump supraarterial myotomy could be an effective treatment modality. Methods: Between October 1998 and May 2000, 13 patients were referred for surgery. All were symptomatic despite medical therapy. Anteroseptal ischemia had been proven by thallium scintigraphy in all 13 patients, exercise testing was positive in 11. All patients were operated on with an off-pump approach after median sternotomy. Results: Mean patient age was 61 +/- 8 years ( range, 43-71 years). Coronary artery disease mandating additional bypasses was present in 3 patients. The bypasses were done off pump in 2 patients. Conversion to on-pump surgery was necessary in 3 of 13 patients (23%) because of hemodynamic compromise ( 1 patient), opening of the right ventricle ( 1 patient), and injury to the LAD ( 1 patient). Supraarterial myotomy was performed in all patients. One patient who underwent surgery with CPB developed postoperative anteroseptal myocardial infarction. Postoperative exercise testing was performed in all patients and did not reveal any persistent ischemia. Mortality was 0%. All patients were free from symptoms and had not undergone repeat interventions after an average of 51 +/- 7 months of follow-up. Conclusions: Off-pump supraarterial myotomy effectively relieves coronary obstruction but has a certain periprocedural risk as evidenced by 1 myocardial infarction, 1 right ventricular injury, and 1 LAD injury. Long-term freedom from symptoms and from reintervention favor further investigation of this surgical therapy."],["dc.identifier.doi","10.1532/HSF98.20041116"],["dc.identifier.isi","000233336200012"],["dc.identifier.pmid","15769716"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/16336"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Forum Multimedia Publishing, Llc"],["dc.relation.issn","1098-3511"],["dc.title","Off-pump supraarterial decompression myotomy for myocardial bridging"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","538"],["dc.bibliographiccitation.issue","9"],["dc.bibliographiccitation.journal","AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie"],["dc.bibliographiccitation.lastpage","544"],["dc.bibliographiccitation.volume","36"],["dc.contributor.author","Grune, Frank F. G."],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Weyland, Wolfgang"],["dc.contributor.author","Rieke, H."],["dc.contributor.author","Weyland, A."],["dc.date.accessioned","2018-11-07T08:39:46Z"],["dc.date.available","2018-11-07T08:39:46Z"],["dc.date.issued","2001"],["dc.description.abstract","Objective: This controlled study was designed to investigate 1.) the effects of 0,8% halothane and 2.) the effects of a variation in PaCO2 on the relationship between global cerebral blood flow (CBF) and middle cerebral artery flow velocity (CBFVMCA). Method: With ethical committee approval and informed patient consent we investigated 10 patients undergoing coronary artery bypass surgery. Measurements were performed under fentanyl/midazolam anaesthesia prior to the start of surgery. First, during a baseline period, ventilation was changed in a random sequence to achieve two different levels of arterial PCO2. (30 and 50 mmHg, respectively). Consequently, measurements were repeated during application of 0.8% halothane at identical PaCO2 levels. Measurements of global CBF were performed by the Kety-Schmidt-technique with argon as an indicator. Simultaneously, CBFVMCA was recorded by use of a 2-MHz transcranial Doppler system. Results: Application of 0.8% halothane caused a significant decrease in cerebrovascular resistance (CVR) both at hypocapnia and hypercapnia by 36 and 23%, respectively. Because of a concomitant reduction in cerebral perfusion pressure (CPP), however, CBF remained unchanged during application of halothane. The relationship between CBF and CBFVMCA was not altered when compared to the baseline period. Similarly, CO2 reactivity of CBF and CBFVMCA remained unchanged. CO2 reactivity of CBF significantly exceeded CO2 reactivity of CBFVMCA. Conclusion: The results of this clinical study demonstrate that Doppler-sonographic estimation of relative changes in CBF is not altered by application of 1 MAC halothane indicating that the decrease in CVR is not associated with a vasodilation of the proximal segments of basal cerebral arteries. The difference between CO2 reactivity of CBF and CBFVMCA, however, suggests that CO2-induced changes in CBF are slightly underestimated by TCD monitoring of CBFVMCA."],["dc.identifier.doi","10.1055/s-2001-17259"],["dc.identifier.isi","000171381700003"],["dc.identifier.pmid","11577352"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/19075"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Georg Thieme Verlag Kg"],["dc.relation.issn","0939-2661"],["dc.title","The relationship between cerebral blood flow (CBF) and the cerebral blood flow velocity (CBFV): Influence of halothane and cerebral CO2 reactivity."],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","601"],["dc.bibliographiccitation.issue","10"],["dc.bibliographiccitation.journal","European Journal of Anaesthesiology"],["dc.bibliographiccitation.lastpage","610"],["dc.bibliographiccitation.volume","17"],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Rathgeber, J."],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Buscher, H."],["dc.contributor.author","Busch, T."],["dc.contributor.author","Mensching, K."],["dc.contributor.author","Sonntag, H."],["dc.date.accessioned","2018-11-07T09:26:52Z"],["dc.date.available","2018-11-07T09:26:52Z"],["dc.date.issued","2000"],["dc.description.abstract","The aim of the present multiple cross-over study was to compare the effects of biphasic positive airway pressure (BIPAP) ventilation with synchronized intermittent mandatory ventilation combined with pressure support ventilation (S-IMV/PSV) in sedated and awake patients after coronary artery bypass grafting (CABG) surgery. Twenty-four patients with no evidence of preoperative respiratory dysfunction and an uncomplicated intraoperative course were investigated. The patients were randomly assigned to one of two groups starting with either BIPAP or S-IMV/PSV mode. Haemodynamic measurements and blood gas analyses were performed during sedation with 2.0 mg kg(-1) h(-1) propofol in the primary mode, after switching to the alternative ventilatory mode, and in the primary mode again. The same sequence of measurements was repeated in awake patients who had reached extubation criteria. In awake patients, PSV was performed instead of S-IMV. Statistical analysis of data was performed using non-parametric tests. Inspiratory peak pressure increased significantly during S-IMV/PSV in sedated patients in both groups. Other ventilatory parameters did not differ significantly between BIPAP and S-IMV/PSV in both groups. Similarly, haemodynamic parameters and blood-gas analyses did not vary with the ventilatory mode. Our results demonstrate that BIPAP ventilation has comparable effects on haemodynamics and pulmonary gas exchange compared with S-IMV/PSV and PSV when used for short-term ventilatory support in patients after cardiac surgery."],["dc.identifier.isi","000089883800002"],["dc.identifier.pmid","11050517"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/30399"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Blackwell Science Ltd"],["dc.relation.issn","0265-0215"],["dc.title","Comparison of ventilatory and haemodynamic effects of BIPAP and S-IMV/PSV for postoperative short-term ventilation in patients after coronary artery bypass grafting"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","863"],["dc.bibliographiccitation.issue","7"],["dc.bibliographiccitation.journal","Acta Anaesthesiologica Scandinavica"],["dc.bibliographiccitation.lastpage","867"],["dc.bibliographiccitation.volume","45"],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Sonntag, H."],["dc.contributor.author","Weyland, A."],["dc.date.accessioned","2018-11-07T08:46:11Z"],["dc.date.available","2018-11-07T08:46:11Z"],["dc.date.issued","2001"],["dc.description.abstract","Background: Measurements of intrathoracic blood volume (ITBV) provide volumetric information about cardiac preload and are used to investigate the cause of alterations in cardiac output (CO). On the other hand, CO is required to calculate ITBV Thus, concerns have been raised with respect to a mathematical coupling of data. The aim of this prospective, clinical study was to investigate whether a variation in CO induced by high-dose beta-blockade influences thermodilution measurements of ITBV in the absence of changes in intravascular volume in patients undergoing minimally invasive coronary artery bypass grafting. Methods: Sixteen patients undergoing elective minimally invasive direct coronay artery bypass (MIDCAB) surgery were studied. Transpulmonary thermodilution measurements of ITBV and CO were simultaneously performed before bypass grafting, during beta-blockade induced by high-dose esmolol and at the end of surgery. Results: During esmolol administration, CO significantly decreased by 33%, whereas ITBV remained unchanged compared to control values (876 +/- 46 ml m(-2) during control versus 860 +/- 61 ml m(-2) during esmolol administration). After the end of esmolol administration, CO significantly increased by 79%. Again, ITBV remained virtually unchanged (860 +/- 61 ml m(-2) during esmolol administration versus 911 +/- 38 ml m(-2) after esmolol administration). Conclusions: The results of the present study demonstrate that substantial alterations in CO as a consequence of high-dose esmolol infusion are not associated with changes in ITBV. Because haemodynamic changes were induced by factors other than variation of preload, these findings suggest that changes in cardiac output do not influence thermodilution measurements of ITBV in this setting."],["dc.identifier.doi","10.1034/j.1399-6576.2001.045007863.x"],["dc.identifier.isi","000170483000013"],["dc.identifier.pmid","11472289"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/20627"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Munksgaard Int Publ Ltd"],["dc.relation.issn","0001-5172"],["dc.title","Changes in cardiac output and intrathoracic blood volume: a mathematical coupling of data?"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","578"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","BJA British Journal of Anaesthesia"],["dc.bibliographiccitation.lastpage","583"],["dc.bibliographiccitation.volume","84"],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Hanekop, Gerd-Gunnar"],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Weyland, A."],["dc.contributor.author","Busch, T."],["dc.contributor.author","Radke, Oliver C."],["dc.contributor.author","Zoelffel, R."],["dc.contributor.author","Sonntag, H."],["dc.date.accessioned","2018-11-07T10:52:39Z"],["dc.date.available","2018-11-07T10:52:39Z"],["dc.date.issued","2000"],["dc.description.abstract","Remifentanil may be an alternative to conventional opioids for minimally invasive direct coronary artery bypass surgery because of its extremely short duration of action. The aim of this study was to investigate the effects of remifentanil on myocardial blood flow, metabolism and systemic haemodynamic variables in patients with coronary artery disease. After approval by the local ethics committee, 12 male patients were investigated before elective coronary artery bypass grafting. Systemic haemodynamic variables, myocardia[ blood flow and metabolism were measured when patients were awake and when they were anaesthetized with high-dose remifentanil (2.0 mu g kg(-1) min(-1)), or with remifentanil 0.5 mu g kg(-1) min(-1) combined with propofol (target-controlled infusion aiming at a plasma concentration of 2.0 mu g ml(-1)). Myocardial blood flow was measured using a modified Kety-Schmidt technique. High-dose remifentanil anaesthesia significantly reduced cardiac index (Cl) (-25%) as a consequence of a decrease in stroke volume index (SVI) (-14%) and heart rate (-13%). Mean arterial pressure (MAP) was 30% lower than that in the awake patient. Myocardial blood flow and myocardial oxygen uptake (MVo(2)) decreased by 30% and 42%, respectively. In contrast to high-dose remifentanil anaesthesia, systemic vascular resistance index (-14%) during remifentanil/propofol anaesthesia was significantly lower than that in the awake patient. Other haemodynamic variables, and myocardial blood flow and MVo(2), did not significantly differ from the high-dose remifentanil period. In conclusion, high-dose remifentanil reduces SVI, heart rate, MAP, myocardial blood flow and MVo(2) and its effects do not differ from those of remifentanil/propofol anaesthesia."],["dc.identifier.isi","000086890700007"],["dc.identifier.pmid","10844832"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/49161"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Prof Sci Publ"],["dc.relation.issn","0007-0912"],["dc.title","Myocardial consequences of remifentanil in patients with coronary artery disease"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","354"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","BJA British Journal of Anaesthesia"],["dc.bibliographiccitation.lastpage","357"],["dc.bibliographiccitation.volume","84"],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Weyland, A."],["dc.contributor.author","Buhre, K."],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Mursch, K."],["dc.contributor.author","Schmidt, M."],["dc.contributor.author","Sydow, M."],["dc.contributor.author","Sonntag, H."],["dc.date.accessioned","2018-11-07T08:59:12Z"],["dc.date.available","2018-11-07T08:59:12Z"],["dc.date.issued","2000"],["dc.description.abstract","The use of the sitting position in neurosurgery is often associated with decreased arterial pressure (MAP) and stroke volume index (SVI). A shift in blood from the intra- to the extrathoracic compartment may be responsible for this cardiovascular response. However, little is known of the amount of shift in blood volume after transfer from the supine to the sitting position. Therefore, we measured simultaneously changes in intrathoracic blood volume (ITBV) caused by a change in body position in anaesthetized patients. Measurements of cardiac index (CI), ITBV, pulmonary (PBV) and total circulating (TBVcirc) blood volumes were performed in the supine and sitting position. CI, ITBV, PBV and TBVcirc were measured using a thermo-dye dilution technique. Fluid input was restricted to 14 ml kg(-1) before induction of anaesthesia. Change in body position caused a significant decrease in ITBV and was accompanied by a significant decrease in CI, SVI and MAP. Changes in ITBV correlated (r=0.78) with changes in SVI. Thus a change in blood volume distribution between the intra- and extrathoracic compartment occurred after a change from the supine to the sitting position. Indicator dilution enables quantification of this shift and may be helpful in guiding fluid therapy in selected patients."],["dc.identifier.isi","000085638000012"],["dc.identifier.pmid","10793596"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/23835"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Prof Sci Publ"],["dc.relation.issn","0007-0912"],["dc.title","Effects of the sitting position on the distribution of blood volume in patients undergoing neurosurgical procedures"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","210"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Journal of Neurosurgical Anesthesiology"],["dc.bibliographiccitation.lastpage","216"],["dc.bibliographiccitation.volume","12"],["dc.contributor.author","Weyland, A."],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Grund, S."],["dc.contributor.author","Ludwig, H."],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Weyland, Wolfgang"],["dc.contributor.author","Sonntag, H."],["dc.date.accessioned","2018-11-07T10:41:59Z"],["dc.date.available","2018-11-07T10:41:59Z"],["dc.date.issued","2000"],["dc.description.abstract","Cerebral perfusion pressure is commonly calculated from the difference between mean arterial pressure and intracranial pressure because intracranial pressure is known to represent the effective downstream pressure of the cerebral circulation. Studies of other organs, however, have shown that effective downstream pressure is determined by a critical closing pressure located at the arteriolar level. This study was designed to investigate the effects of PCO2-induced variations in cerebrovascular tone on the effective downstream pressure of the cerebral circulation. Sixteen patients recovering from head injury were studied. Intracranial pressure was assessed by epidural pressure transducers. Blood flow velocity in the middle cerebral artery was monitored by transcranial Doppler sonography. Effective downstream pressure was derived from the zero flow pressure as extrapolated by regression analysis of instantaneous arterial pressure/middle cerebral artery flow velocity relationships. PaCO2 was varied between 30 and 47 mm Hg in randomized sequence. Intracranial pressure decreased from 18.5 +/- 5.2 mm Hg, during hypercapnia to 9.9 +/- 3.1 mm Hg during hypocapnia. In contrast, effective downstream pressure increased from 13.7 +/- 9.6 mm Hg to 23.4 +/- 8.6 mm Hg and exceeded intracranial pressure at hypocapnic PaCO2 levels. Our results demonstrate that, in the absence of intracranial hypertension, intracranial pressure does not necessarily represent the effective downstream pressure of the cerebral circulation. Instead, the tone of cerebral resistance vessels seems to determine effective downstream pressure. This suggests a modified model of the cerebral circulation based on the existence of two Starling resistors in a series connection."],["dc.identifier.doi","10.1097/00008506-200007000-00002"],["dc.identifier.isi","000087969500002"],["dc.identifier.pmid","10905568"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/46674"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Lippincott Williams & Wilkins"],["dc.relation.issn","0898-4921"],["dc.title","Cerebrovascular tone rather than intracranial pressure determines the effective downstream pressure of the cerebral circulation in the absence of intracranial hypertension"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","662"],["dc.bibliographiccitation.issue","10"],["dc.bibliographiccitation.journal","European Journal of Anaesthesiology"],["dc.bibliographiccitation.lastpage","667"],["dc.bibliographiccitation.volume","18"],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Buhre, K."],["dc.contributor.author","Kazmaier, Stefan"],["dc.contributor.author","Sonntag, H."],["dc.contributor.author","Weyland, A."],["dc.date.accessioned","2018-11-07T08:34:28Z"],["dc.date.available","2018-11-07T08:34:28Z"],["dc.date.issued","2001"],["dc.description.abstract","Background and objective Assessment of cardiac preload is of major importance in the management of critically ill patients. Echocardiographic determined left ventricular end-diastolic area and indicator dilution derived intrathoracic blood volume are used as surrogates for cardiac preload. However, no controlled comparison studies on the relationship between induced changes in end-diastolic area and intrathoracic blood volume and concomitant changes in stroke volume index are available. Methods The effects of a change in body position on these variables were investigated in 10 anaesthetized patients. Results Intrathoracic blood volume and end-diastolic area decreased by 18 +/- 11% and 27 +/- 13% respectively. Stroke volume index concomitantly decreased by 19 +/- 11%. Correlation analysis revealed a close relation between stroke volume index and intrathoracic blood volume (r = 0.75) and end-diastolic area (r = 0.76). Conclusions Within the observed range of data, intrathoracic blood volume and end-diastolic area are equivalent indices of cardiac preload."],["dc.identifier.isi","000171314800004"],["dc.identifier.pmid","11553242"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/17823"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Blackwell Science Ltd"],["dc.relation.issn","0265-0215"],["dc.title","Assessment of cardiac preload by indicator dilution and transoesophageal echocardiography"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]