Göhl, M.

Mewes, M.

Müller-Esch, G.

Peters, A.

Scriba, Peter Christian

English

Universität München: Elektronischen Publikationen

329 
CIMETIDINE VERSUS CIMETIDINE PLUS PIRENZEPINE IN PREVEN-
TING UPPER GASTROINTESTINAL TRACT BLEEDING IN PATIENTS OF 
AN INTENSIVE CARE UNIT - A RANDOMISED, PROSPECTIVE, 
CONTROLLED CLINICAL TRIAL -
R.-D. Hanrath, H.K. Bouillon, W.-P. Fritsch, T. SCholten, 
Med. Kliniken, Universität Düsseldorf, FRG 
Introduction: The combination of cimetidine and pirenzepi-
ne results in a stronger and langer lasting suppression of 
gastric acid secretion than cimetidine alone. Therefore 
cimetidine plUS pirenzepine should be more effective in 
the prevention of upper GI-tract bleeding than cimetidine 
alone. Methods: Patients admitted to the medical intensi-
ve care unit of the University of Düsseldorf from May 1982 
to November 1982 were included in the study. Upon admission 
all patients were randomized into one of the two treatment 
groups A or B by a table of random numbers. Patients with 
upper GI-tract bleeding, recent GI-tract operations,etc. 
were excluded from the protocol. Those in group A received 
200 mgs cimetidine iv every 3 hours during the entire stay 
in the intensive care unit. Those in group B additionally 
received 40 mgs of pirenzepine!day by continuous infusion. 
Results: 95 patients of group A and 105 patients of group 
B met the criteria. The distribution of patients with 
regard to sex, age, and severity of illness were compa-
rable for both treatment groups. There was only 1 patient 
with acute upper GI-tract bleeding and 1 with chronic 
bleeding in group B. No bleeding was observed in group A. 
Conclusions: In patients of a medical intensive care unit 
the prophylaxis of upper GI-tract bleeding by cimetidine 
alone proved to be effective. Therefore no additional po-
sitive effect of a combined treatment with cimetidine plus 
pirenzepine could be shown. 
223 
330 
COMPUTER-ASSISTED ME'lHOD FOR EI1AU1ATICN AND OCCUMENTATICN 
OF DATA FRON GWCOSE CCNTROLLED INSULIN INFUSICN SYSTEMS 
IN CRITlCALLY ILL PATIENTS. G.Müller-Esch, A. Peters, 
M. Göhl, M. Mewes, P. C. Scriba,Klinik für Irmere Medi-
zin, Medizinische Hochschule Lübeck, Lübeck, Gemany. 
Glucose controlled insulin infusion systems (GeIIS) seem 
to be a valuable tool in the metabolic treatment of 
critica11y i11 patients. 'lhe incidence of 4320 measure-
ments frcm the GeIIS during a 24-11our centrol period is 
the rrain reason for developing this method, which permits 
a comfortable handling of a vast nurnber of data. 'lhe 
procedure is based on a BASIC catplter prOgrarrure, that 
will be derronstratec.. 
InputIrode: An interface between the GeIIS and the micro-
carputer PC 800 (MAGIRlJS IJA,TEN'I'Ex::HNIK) has been errq:>loyed 
to transfer all data directly at oile minute intervals. 
Further, Ccmre1ts concerning actual therapy can be 
inserted rranuall y. 
Calculatiens:The following parameters,characterizing the 
state of carbohydrate metabolism, rray be calculated: 
- MaG = mean blood glucose 
- M-value =. a measure for the duration and the degree of 
J:a thological blood glucose levels (1) 
- MAGE = mean amplitude of glycemic excursions (2) 
- an index, indicating the sensitivity to insulin. 
Record:Blood glucoSl:, insulin rate and dextrose rate are 
plotted continuously. Camnents will be printed, too. 
Documentation: All recorded data are stored on a 5 inch 
flowy disko 
Conclusion: The method permits carplete processing of 
GeIIS-data, \\hich is alJrost ~ssible when confined to 
ffi3Ilual canputation. Its usefulness in the treatment of 
critica11y il1 J:atients, especially during metabolic 
therapy with glucose-insulin-potassium in acute Il\Yocar -
dial infarction, will be derronstrated (Supported by the 
Federico Foundation) • 
1. Schlichtkrull, J. et al. :Acta med.Scand. 177 (1965), 95 
2. Service, F. J. et al.: Diabetes 19(1970), 644 


Computer-assisted method for evaluation and documentation of data from glucose controlled insulin infusion Systems in critically ill patients

Peters, Achim

Open Access LMU

329 CIMETIDINE VERSUS CIMETIDINE PLUS PIRENZEPINE IN PREVEN-TING UPPER GASTROINTESTINAL TRACT BLEEDING IN PATIENTS OF AN INTENSIVE CARE UNIT - A RANDOMISED, PROSPECTIVE, CONTROLLED CLINICAL TRIAL -R.-D. Hanrath, H.K. Bouillon, W.-P. Fritsch, T. SCholten, Med. Kliniken, Universität Düsseldorf, FRG Introduction: The combination of cimetidine and pirenzepi-ne results in a stronger and langer lasting suppression of gastric acid secretion than cimetidine alone. Therefore cimetidine plUS pirenzepine should be more effective in the prevention of upper GI-tract bleeding than cimetidine alone. Methods: Patients admitted to the medical intensi-ve care unit of the University of Düsseldorf from May 1982 to November 1982 were included in the study. Upon admission all patients were randomized into one of the two treatment groups A or B by a table of random numbers. Patients with upper GI-tract bleeding, recent GI-tract operations,etc. were excluded from the protocol. Those in group A received 200 mgs cimetidine iv every 3 hours during the entire stay in the intensive care unit. Those in group B additionally received 40 mgs of pirenzepine!day by continuous infusion. Results: 95 patients of group A and 105 patients of group B met the criteria. The distribution of patients with regard to sex, age, and severity of illness were compa-rable for both treatment groups. There was only 1 patient with acute upper GI-tract bleeding and 1 with chronic bleeding in group B. No bleeding was observed in group A. Conclusions: In patients of a medical intensive care unit the prophylaxis of upper GI-tract bleeding by cimetidine alone proved to be effective. Therefore no additional po-sitive effect of a combined treatment with cimetidine plus pirenzepine could be shown. 223 330 COMPUTER-ASSISTED ME'lHOD FOR EI1AU1ATICN AND OCCUMENTATICN OF DATA FRON GWCOSE CCNTROLLED INSULIN INFUSICN SYSTEMS IN CRITlCALLY ILL PATIENTS. G.Müller-Esch, A. Peters, M. Göhl, M. Mewes, P. C. Scriba,Klinik für Irmere Medi-zin, Medizinische Hochschule Lübeck, Lübeck, Gemany. Glucose controlled insulin infusion systems (GeIIS) seem to be a valuable tool in the metabolic treatment of critica11y i11 patients. 'lhe incidence of 4320 measure-ments frcm the GeIIS during a 24-11our centrol period is the rrain reason for developing this method, which permits a comfortable handling of a vast nurnber of data. 'lhe procedure is based on a BASIC catplter prOgrarrure, that will be derronstratec.. InputIrode: An interface between the GeIIS and the micro-carputer PC 800 (MAGIRlJS IJA,TEN'I'Ex::HNIK) has been errq:>loyed to transfer all data directly at oile minute intervals. Further, Ccmre1ts concerning actual therapy can be inserted rranuall y. Calculatiens:The following parameters,characterizing the state of carbohydrate metabolism, rray be calculated: - MaG = mean blood glucose - M-value =. a measure for the duration and the degree of J:a thological blood glucose levels (1) - MAGE = mean amplitude of glycemic excursions (2) - an index, indicating the sensitivity to insulin. Record:Blood glucoSl:, insulin rate and dextrose rate are plotted continuously. Camnents will be printed, too. Documentation: All recorded data are stored on a 5 inch flowy disko Conclusion: The method permits carplete processing of GeIIS-data, \\hich is alJrost ~ssible when confined to ffi3Ilual canputation. Its usefulness in the treatment of critica11y il1 J:atients, especially during metabolic therapy with glucose-insulin-potassium in acute Il\Yocar -dial infarction, will be derronstrated (Supported by the Federico Foundation) • 1. Schlichtkrull, J. et al. :Acta med.Scand. 177 (1965), 95 2. Service, F. J. et al.: Diabetes 19(1970), 644 

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The publ isher makes no war ranty , express or imp l ied , wi th respect to the mater ia l conta ined here in . tt p u b l i s h e s 1. O r i g i n a l p a p e r s r e p o r t i n g p r o g r e s s a n d r e s u l t s in a l l a r e a s of i n t e n s i v e c a r e m e d i c i n e a n d i ts r e l a t e d f i e l d s . R e v i e w a r t i c l e s reflecting the preaerrt sjtate'qf^ "~ knowledge in special areas or s u m m ^ 2 i S i § ? - ^ ^ ' limited themes in which discussion hS^Batfoek clearly defined conclusions. j München Spr inger -Ver lag Spr inger -Ver lag Spr inger -Ver lag New York Inc. Journa l Product ion Depar tment I He ide lberger Platz 3 175 Fifth Avenue Postfach 1 0 5 2 8 0 D-1000 Ber l in 33, FRG New York, NY 10010, USA D-6900 He ide lberg 1 , FRG Tel . (0 30) 82 07-1 Tel . (212) 4 77-82 00 Tel . (062 21) 4 87-431 Telex 0183 319 Telex 00232 32 235 Telex 04-61 723 II Number 1 Editorial R. Hayward Amr inone - P romis ing Innovat ion for T rea tment of the Fai l ing Heart 1 Review Articles C. Blakely, J . T inker Vasodi la tors in Acute Ci rcu la tory Fa i lure 5 Original Articles J . Pfenninger, G. Kaiser , J . Lütschg, M. Sutter Treatment and Outcome of the Severe ly Head In jured Chi ld 13 A. Perel , D.C. Wi l l i amson , J . H . Mode l l Effect iveness of CPAP by Mask for Pu lmonary Edema Associated wi th Hypercarb ia 17 D.F. Zandst ra , C P . Stoutenbeek, J . P . A lexander Ant ipyret ic Therapy wi th Dic lo fenac Sod ium 21 Methods and Devices A. Pere l , M. Berger , S. Cotev The Use of Cont inuous Flow of Oxygen and PEEP Dur ing Apnea in the Diagnosis of Bra in Death 25 A . B . Egol , K.K. Guntupal l i In t ravenous Infusion Device Art i fact in the EEG-Confusion in the Diagnos is of E lec t rocerebra l S i lence 29 Case Reports F. Brivet, J . F. Del f ra issy, M. Duche, P. Ber t rand , J . Dormont Acute Cyan ide Po ison ing: Recovery wi th Nonspeci f ic Suppor t i ve Therapy 33 A. Gi ls ton A Hypothermic Reg ime for Acute Respi ra tory Fai lure 37 Book Reviews 39 Announcements 40 Abstracts of the Spring Meeting 1982 of the Intensive Care Society, Britain 41 European Society of Intensive Care Medicine - Application Form 47 Number 2 Editorial S.C. Davies, S . J . Mach in Prostacycl in (PGI 2) 49 Original Articles W. Hess, J . B . Brückner , D. Patschke, G. Z i m m e r m a n n The Effects of Glycery l Tr in i t ra te , Isosorb ide Dini t rate and Sod ium Ni t ropruss ide on Haemodynamics , Coronary B lood Flow and Myocard ia l Oxygen Consumpt ion - An Exper imenta l Study 53 M. Brandl , T. Pasch, H.-D. Kamp, J . G r i m m Compar ison of the Effects of Dopamine and Dobutamine During Cont inuous Posi t ive-Pressure Vent i la t ion 61 P. Prokocimer, J . Garb ino , M. Wolff, B. Regn ier Inf luence of Posture on Gas Exchange in Art i f ic ia l ly Vent i lated Patients w i th Focal Lung Disease 69 K. van Deyk, V. Hempe l , F. Münch , M. Kopp, H. Graf, E. Epple Inf luence of Parentera l Fat Admin is t ra t ion on the Pu lmonary Vascular System in M a n 73 E. P. Calandre, A . J . Perez de la Cruz, A. M. Mora les , N.P. Al ferez, E. Moreno , G.V. Mata Moni tor ing Aminophy l l i ne Therapy Using Jusko 's Dosage Guidel ines 79 Methods and Devices B.A. Shap i ro , R.D. Cane, J . Kavanaugh The Rel iabi l i ty of Electrolyte Measu remen ts in P lasma 83 P. Davies, D.W. Ryan Stevens-Johnson Synd rome Managed in the Cl in i t ron Bed 87 J . Ibanez, J . M . Raur ich , S .G . Mor i s Measu remen t of Funct ional Residual Capaci ty Dur ing Mechan ica l Vent i la t ion. Compar i son of a Computer ized Open Ni t rogen Washout Method wi th a Closed He l ium Di lut ion Method 91 Case Reports Y. M. Ber t rand , M.S. Reynaert , A. De Meulder , A. Louon, G. Bauer Revers ib le Card iac T amponade Dur ing Pro longed Parentera l Feeding 95 C. Kr ier , F. F le ischer, J . Späth, B . T e r w e y Catheter Embol iza t ion Fo l lowing Med ian Sternotomy Correspondence Book Review 97 100 102 Number 3 Editorial J . H . Kerr, B. Hayes An " A l a r m i n g " Si tuat ion in the Intensive Therapy Unit 103 Review Articles D.J . Jeffr ies V i ruses and Intensive Care 105 Original Articles E. Dominguez de Vi l lo ta , A. A lgo ra , J . J . Rubio , M. Roig, J . M . Mosquera, P. Ga ldos , V. Dfez-Balda Sep t i caemia in a Med ica l Intensive Care Unit. C l in ica l , B iochemica l and Mic rob io log ica l Data of 109 Cases 109 A . C . McCar tney, J . G . Banks, G . B . C lements , J . D . S le igh , M. Tehran i , I .McA. Led ingham Endo toxaemia in Sept ic Shock: Cl in ica l and Post Mor tem Cor re la t ions 117 H. Van Aken , Ch. Puchste in, Ch. Anger , P. Lawin The Inf luence of Urap id i l , a New Ant ihyper tens ive Agent , on Cerebra l Perfus ion Pressure in Dogs With and Without Int racrania l Hyper tens ion 123 III H . B . J . Fischer, G. Ward Catheter Tip Embo l i sm - A Cont inu ing Iat rogenic Compl ica t ion of Centra l Venous Catheter isat ion 127 Methods and Devices L. G o l d e r m a n , J . Gel ier t , R. Teschke Quant i tat ive Assessment of Carbon Tet rach lor ide Leve ls in Human B lood by Head-Space Gas Chromatography : App l i ca t ion in a Case of Suic ida l Carbon Tet rach lo r ide Intoxicat ion 131 J . L ink Increase of Expi ra tory Resistance by the PEEP-Valve of the Servovent i la tor 137 Case Reports C. P. Stoutenbeek, H. K. F. van Saene, D. R. M i randa, D. van der Waai j Ac inetobacter Mediast in i t is and Pneumon ia in a Thoro t ras toma Patient 139 Correspondence Book Reviews Announcements 142 143 144 Number 4 Abst rac ts of the 2nd European Meet ing on Intensive Care Geneva, Swi tze r land , 1 7 - 2 0 May 1983. Edi ted by P. Suter Geneva Number 5 Editorial P.E. Hewitt , S .C . Davies The Cur ren t State of DIC 249 Original Articles W. Ba ige lman , R. Katz, G. Geary Patient Readmiss ion to Cr i t ical Care Units Dur ing the Same Hospi ta l izat ion at a Commun i t y Teach ing Hospi ta l 253 M. Ash ley, A . E . C a m e r o n , I. P. S lee High Frequency Jet Vent i la t ion - Its Use in Respi ra tory Insuff ic iency 257 R.D. Perez-Chada, J.-P. Gardaz, R.G. Madgwick , M.K. Sykes Card io resp i ra to ry Effects of an Inspiratory Hold and Cont inuous Posit ive Pressure Vent i la t ion in Goats 263 G. Gold farb , O. Noue l , Th . Poynard , B. Rueff Eff ic iency of Resp i ra tory Ass is tance in Ci r rhot ic Patients wi th L iver Fai lure 271 A. Koht, R. Cane, L . J . Ceru l lo Se rum Potass ium Leve ls Dur ing Pro longed Hypothermia 275 D.W. Ryan The Inf luence of Env i ronmenta l Tempera tu re (32 °C) on Catabo l i sm Using the Cl in i t ron F lu id ised Bed 279 L. F. Lauwers , R. Dae lemans, L. Baute, H. Verb raeken Scopo lamine Intoxicat ions 283 J .F . Hansbrough, J . A . Nar rod , R. Ruther ford Ar te r iovenous Fistulas Fo l lowing Centra l Venous Cather izat ion 287 Mandatory Insuff lation of the 291 Methods and Devices A. Lev, E. Barz i lay Synchron ized Intermit tent Endot rachea l Tube Cuff S . V . S . Ri thal ia, J . T inker Cont inuous Flush Devices for Vascu lar Pressure Moni tor ing 295 Case Reports J . C . Thi js , A . J . Schneider , J . M . van Korde laa r Spontaneous Rupture of the Sp leen Compl ica t ing Portal Hyper tens ion 299 Correspondence Book Reviews Announcements 301 302 302 Number 6 Editorial J . H. N e w m a n ARDS: New Insights and Unsolved Prob lems 303 Original Articles A. Pesent i , A. R ibon i , R. Marco l in , L. Gat t inoni Venous Admix tu re (Qva/Q) and True Shunt (Qs/Qt) in ARF Patients: Effects of PEEP at Constant F,02 307 J . G . L . Pr ior, C . J . Hinds, J . Wi l l i ams, P.F. Pr ior The Use of Etomidate in the Managemen t of Severe Head Injury 313 Y. M. Ber t rand , A. Hermant , P. Mah ieu , J . Roels In t racrania l Pressure Changes in Patients w i th Head T r a u m a Dur ing Haemod ia lys is 321 L. Cynober , F. Nguyen Dinh, R. Saizy, F. B londe , J . G. G iboudeau P lasma A m i n o Ac id Levels in the First Few Days Af ter Burn Injury and Thei r Predic t ive Value 325 J . Gel ier t , L. Go lde rmann , R. Teschke Effect of C0 2 - I nduced Hypervent i la t ion on Carbon Tet rach lo r ide (CCI 4) Levels Fo l lowing Acute C C I 4 Poisoning 333 Methods and Devices M.J . Roberts, M.L . Boust red, C . J . Hinds A Mul t ipat ient Mass Spect rometer Based System for the Measu remen t of Metabol ic Gas Exchange in Art i f ic ia l ly Vent i la ted Intensive Care Patients 339 Short Reports A . G . H . Cole, J . H . Kerr Parat racheal Abscess After T racheos tomy Correspondence Book Reviews 345 348 350 IV 223 330 COMPUTER-ASSISTED METHOD FOR EVALUATION AND DOCUMENTATION OF DATA FROM GLUCOSE CONTROLLED INSULIN INFUSION SYSTEMS IN CRITICALLY ILL PATIENTS. G.Müller-Esch, A. Peters, M. Göhl, M. Mewes, P. C. Scriha,Klinik für Innere Medi-zin, Medizinische Hochschule Lübeck, Lübeck, Gentany. Glucose controlled insulin infusion systems (GCIIS) seem to be a valuable tool in the metabolic treatment of critically i l l patients. The incidence of 4320 measure-ments from the GCIIS during a 24-hour control period i s the main reason for developing this method, which permits a comfortable handling of a vast number of data. The procedure is based en a BASIC computer programme, that will be demonstratea. Inputmode: An interface between the GCIIS and the micro-computer PC 800(MAGIRUS DATENTECHNIK) has been employed to transfer a l l data directly at one minute intervals. Further, comments concerning actual therapy can be inserted manually. Calculations:The following parameters,characterizing the state of carbohydrate metabolism, may be calculated: - MBG = mean blood glucose - M-value = a measure for the duration and the degree of pathological blood glucose levels (1) - MAGE = mean amplitude of glycemic excursions (2) - an index, indicating the sensitivity to insulin. Record:Blood glucose, insulin rate and dextrose rate are plotted continuously. Comments will be printed, too. Documentation: All recorded data are stored on a 5 inch floppy disk. Conclusion: The method permits complete processing of GCIIS-data, which is almost impossible when confined to manual computation. Its usefulness in the treatment of critically i l l patients, especially during metabolic therapy with glucose-insulin-potassium in acute myocar -dial infarction, will be demonstrated (Supported by the Federico Foundation). 1. Schlichtkrull, J . et al.:Acta med.Scand. 177(1965), 95 2. Service, F. J . et al.: Diabetes 19(1970), 644 

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Computer-assisted method for evaluation and documentation of data from glucose controlled insulin infusion Systems in critically ill patients

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