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| 1 | Different cava reconstruction techniques in liver transplantation:piggyback versus cava resection显示文摘BACKGROUND: Originally, cava reconstruction(CR) in liver transplantation meant complete resection and reinsertion of the donor cava. Alternatively, preservation of the recipients inferior vena cava(IVC) with side-to-side anastomosis(known as 'piggyback') can be performed. Here, partial clamping maintains blood flow of the IVC, which may improve cardiovascular stability, reduce blood loss and stabilize kidney function. The aim of this study was to compare both techniques with particular focus on kidney function.METHODS: A series of 414 patients who had had adult liver transplantations(2006-2009) were included. Among them,176(42.5%) patients had piggyback and 238 had classical CR operation, 112(27.1%) of the patients underwent CR accompanied with veno-venous bypass(CR-B) and 126(30.4%)without a bypass. The choice of either technique was based on the surgeons' individual preference. Kidney function [serum creatinine, calculated glomerular filtration rate(GFR), RIFLE stages] was assessed over 14 days.RESULTS: Lab-MELD scores were significantly higher in CR-B(22.5±11.0) than in CR(17.3±9.0) and piggyback(18.8±10.0)(P=0.008). Unexpectedly, the incidences of arterial stenoses(P=0.045) and biliary leaks(P=0.042) were significantly increased in piggyback. Preoperative serum creatinine levels were the highest in CR-B [1.45±1.17 vs 1.25±0.85(piggyback)and 1.13±0.60 mg/dL(CR); P=0.033]. Although a worsening of postoperative kidney function was observed among all groups,this was most pronounced in CR-B [creatinine day 14: 1.67±1.40 vs 1.35±0.96(piggyback) and 1.45±1.03 mg/dL(CR); P=0.102].Accordingly, the proportion of patients displaying RIFLE stages≥2 was the highest in CR/CR-B(26%/19%) when compared to piggyback(18%).CONCLUSIONS: Piggyback revealed a shorter warm ischemic time, a reduced blood loss, and a decreased risk of acute kidney failure. Thus, piggyback is a useful technique, which should be applied in standard procedures. When piggyback is unfeasible,cava replacement, which displayed a lower incidence of vascular and biliary complications in our study, remains as a safe alternative. | Volker Schmitz Wenzel Schoening Ines Jelkmann Brigitta Globke Andreas Pascher Marcus Bahra Peter Neuhaus Gero Puhl | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，3： | 5 |
| 2 | Effectiveness of various airway management techniques in a bench model simulatiing a cardiac arrest patient显示文摘 | Voller Wenzel Peter Schmucker Volker Dorges | 2001 | The Journal of Emergency Medicine2001，20，1： | 1 |
| 3 | Developing a vasopressor combination in a pig model of adult asphyxial cardiac arrest显示文摘 | Viktoria D Mayr Volker Wenzel | 2001 | Circulation2001，104，14： | 1 |
| 4 | Repeated administration of vasopressin but not epinephrine maintains coronary perfusion pressure after early and late administration during prolonged cardio-pulmomary resuscitation in pigs显示文摘 | Volker Wenzel MD Karl H Lindner MD | 1999 | Circulation1999，99，： | 1 |
| 5 | Effects of environment, disease progress, plant height and heading date on the detection of QTLs for resistance to Fusarium head blight in an European winter wheat cross显示文摘 | Anja Klahr Gerhard Zimmermann Gerhard Wenzel Volker Mohler | 2007 | Euphytica2007，，1： | 1 |
| 6 | Comparing two different arginine vasopressin doses in advanced vasodilatory shock: a randomized, controlled, open-label trial显示文摘 | Christian Torgersen Martin W. Dünser Volker Wenzel Stefan Jochberger Viktoria Mayr Christian A. Schmittinger Ingo Lorenz Stefan Schmid Martin Westphal Wilhelm Grander Günter Luckner | 2010 | Intensive Care Medicine2010，，1： | 1 |
| 7 | 电气网络故障的在线分析显示文摘对电网自动化系统SCADA中一个新的子系统——电网故障在线分析系统的原理、结构及处理方法进行了概述,表明了SCADA系统未来的发展趋向。 | Volker Dillmann Bernd Wenzel 夏晓明 | 1992 | 四川电力技术1992，15，5： | 0 |
| 8 | 麻醉及相关学科在发展中国家的现状:一项赞比亚共和国的全国性调查显示文摘背景世界上很多外科手术是在发展中国家进行的。为了改善急症患者和危重患者的生存率,必须确定发展中国家麻醉实施存在的基本问题和麻醉面临的需求。本次调查研究者评估了目前赞比亚共和国麻醉以及相关学科(包括危重症医学、急诊医学以及疼痛治疗)的现状。方法向在赞比亚共和国卫生部注册的87所可行大或小型外科手术的医院发放问卷,问卷包括111个问题,分为5组,分别涉及:医院总体信息、麻醉、重症监护、急诊医学及疼痛治疗。结果对其中68所医院的问卷进行统计学分析(78%)。手术种类中最常见的是妇产科、腹部外科手术。氯胺酮分离麻醉是最常用的全身麻醉方法(50%)。全身麻醉患者中10%进行气管插管,大部分(78%)医院麻醉实施由非注册医师完成。68所医院中只有5所(7%)回信称配备重症监护室,共有29个床位服务整个国家。麻醉医师基本不参与急诊工作和疼痛治疗。结论赞比亚共和国的麻醉医学极不发达,缺乏医疗相关资源。 | Stefan Jochberger, MD Feruza Ismailova, MD Wolfgang Lederer, MD Vikto-ria D. Mayr, MD Günter Luckner, MD Volker Wenzel, MD Hanno Ulmer,PhD Walter R. Hasibeder, MD Martin W. Dünser, MD 王倩(译) | 2009 | 麻醉与镇痛2009，，2： | 0 |
| 9 | 最大程度降低胃胀气与优化胸外心脏按压的关系显示文摘在一个实验模型中,我们对手控呼吸囊-活瓣装置(Smart Bag MO)的效应进行了评估,该装置通过限制最大吸气流量达到降低无保护性气道患者胃膨胀风险的效果。在模拟心肺复苏的不间断胸外心脏按压过程中,使用“关闭”状态下的Smart Bag MO或成人自动充气呼吸囊.活瓣装置进行通气,如果吸气时间达到0.5秒的话,就能够提供足够的潮气量。而使用“开放”状态下的Smart Bag MO进行通气,即使通气时间窗达到0.5秒,仍不能提供足够的潮气量,从而将导致患者通气不足。 | Holger Herff Peter Paal Achim von Goedecke Thomas Mitterlechner Thomas Danninger Volker Wenzel 董良(译) 郭曲练(校) | 2009 | 麻醉与镇痛2009，，1： | 0 |
| 10 | 过敏性休克的治疗:证据在哪里显示文摘在本期《Anesth&Analg》杂志上,Dr.Schummer等刈报道了有6例严重心血管衰竭的过敏性休克患者,对常规的液体治疗及儿茶酚胺治疗几乎没有反应,但是在使用精氨酸血管加压素(AVP)后得到明显的改善。病例的陈述非常有说服力,毫无疑问,这些患者的确发生了过敏性休克,而且尽快采用除AVP以外的治疗也应该是有效的。 | Martin W. Dunser Christian Torgersen Volker Wenzel 宋文涛(译) 姚尚龙(校) | 2010 | 麻醉与镇痛2010，，4： | 0 |
| 11 | 在Bench模型中模拟未插管呼吸暂停患者梗阻气道的通气策略显示文摘背景Smart Bag MO是一种设计用于成人的流量限制型球囊面罩装置,它可减少在无气道保护的情况下发生胃反流的风险。其在严重气道梗阻时的应用特性尚不明确。方法建立Bench模型以模拟无气道保护情况下发生呼吸暂停的患者,分别使用流量限制型球囊装置和标准球囊装置通气。测定并对比两者在气道阻力为4、10、20cmH2O·L-1·S-1时的呼吸力学和潮气量。结果使用流量限制型球囊装置较标准球囊装置能延长吸气时间。流量限制型球囊装置和标准球囊装置在模拟无气道梗阻组中肺潮气量分别为750±70ml和780±30ml(无统计学差异);模拟中度气道梗阻组中肺潮气量分别为800±70ml和850±20ml(无统计学差异);模拟严重气道梗阻组中肺潮气量分别为210±20ml和170±10ml(P〈0.01)。流量限制球囊装置和标准球囊装置在模拟无气道梗阻组中气道峰压分别为15±2cmH2O和22±4cmH2O(P〈0.01);模拟中度气道梗阻组中气道峰压分别为22±1cmH2O和39±7cmH,O(P〈0.01);模拟严重气道梗阻组中气道峰压分别为26±1cmH,O和61±3cmH,O(P〈0.01)。流量限制球囊装置和标准球囊装置在模拟无气道梗阻组中的胃胀气速率为0ml/min;模拟中度气道梗阻组中速率分别为0ml/min和200±20ml/min(P〈0.01);模拟严重气道梗阻组中速率分别为0ml/min和1240±50ml/min(P〈0.01)。结论在模拟严重气道梗阻组中,与标准球囊装置相比,流量限制型球囊装置能延长吸气时间、增大潮气量、降低气道压并能避免胃胀气的发生。 | Holger Herff Peter Paal Achim von Goedecke Thomas Mitterlechner Christian A. Schmittinger Volker Wenzel 李心怡(译) 王焱林(校) | 2011 | 麻醉与镇痛2011，7，1： | 0 |
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