Blutalkohol 2005 - BADS (Bund gegen Alkohol und Drogen im ...

Breitmeier/Besch/Gebel/Panning,
Measuring of end-expired breath ethanol concentration following percutaneous ethanol injections
Seiten 421–430
(PEI) carried out on patients suffering from hepatocellular Carcinoma
Aus dem Institut für Rechtsmedizin der Medizinischen Hochschule Hannover 1 )
(Direktor: PROF. DR. H. D. TRÖGER)
und der Abteilung Anästhesiologie I der Medizinischen Hochschule Hannover 2 )
(Direktor: PROF. DR. S. PIEPENBROCK)
sowie der Abteilung Gastroenterologie und Hepatologie der Medizinischen Hochschule Hannover 3 )
(Direktor: PROF. DR. M. P. MANNS)
DIRK BREITMEIER 1 ), THOMAS BESCH 2 ), MICHAEL GEBEL 3 ), BERNHARD PANNING 2 )
Measuring of end-expired breath ethanol concentration following
percutaneous ethanol injections (PEI) carried out on
patients suffering from hepatocellular Carcinoma
– A comparison between venous and arterial ethanol concentrations
and end-expired breath depends on the measuring instrument –
Messung der Atemalkoholkonzentration im Rahmen der perkutanen
Ethanolinstillationstherapie bei Patienten mit einem
hepatozellulären Karzinom
– Ein Vergleich von Atemalkoholkonzentrationen mit venösen
und arteriellen Blutalkoholkonzentrationen in Abhängigkeit vom
Messgerät –
Introduction
When using percutaneous ethanol injection therapy (PEI) 96 % alcohol is injected under
ultrasonic guidance into the hepatocellular carcinoma of the anaesthetised patient. PEI is
the only therapy left for patients with a uni- or multilocular hepatocellular carcinoma in a
progressive state with or without liver cirrhosis, when surgical resection or chemoembolization
is no longer possible. During treatment as well as afterwards major deficits and
symptoms or severe drunkenness can be observed in relation to the injected amount of
alcohol. Therefore continuous monitoring of alcohol concentration is urgently needed to
supervise the patient and improve the therapy. Since all hitherto known devices were normally
used with breathing patients and patients who are awake, methods had to be developed
to allow these measurings to be taken with patients breathing not spontaneous, and
are connected to a ventilator under general anesthesia. In contrast to measuring alcohol
levels in conscious patients the tested devices were inserted into intubated patients as part
of the main or secondary flow procedure. Since one device used in this study (Alcomed
3011 by Envitec Wismar) sucks in air from the ventilator through a test tube everytime
measuring was triggered manually, the point of time for taking the measuring had to be
chosen such that sample taking of breath took place during expiration. When choosing the
right point of time it is absolutely necessary to use only alveolar breath for measuring.
In the following we want to find out if the measuring of alcohol levels in breath of intubated
patients is feasible and produces acceptable results. Advantages and disadvantages
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BLUTALKOHOL VOL. 42/2005