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Biomedical subjects

P Fauchald

Publications and source records attributed to P Fauchald.

At least 127 records · Page 7Linked to original sources
PubMed1986

Transcapillary colloid osmotic gradient and body fluid volumes in renal failure.

The aim was to study the transcapillary fluid balance in dialysis patients during and after ultrafiltration. Plasma and subcutaneous interstitial fluid (wick technique) colloid osmotic pressure, plasma volume (I125-albumin space) and extracellular fluid volume (radiosulfate space) were measured in nine patients on maintenance hemodialysis before (pre-dialysis state) and after (dry-weight state) ultrafiltration. In the pre-dialysis state, interstitial colloid osmotic pressure was reduced compared to normal controls (12.7 +/- 3.5 versus 15.8 +/- 2.7 mmHg, mean values +/- SD) and transcapillary colloid osmotic gradient increased (15.3 +/- 3.0 versus 12.8 +/- 2.7 mmHg). Ultrafiltration resulted in a parallel decrease of plasma volume and interstitial fluid volume of 19 to 20%, and an increase in mean interstitial colloid osmotic pressure of 3.4 mmHg and in mean transcapillary colloid osmotic gradient of 1.9 mmHg. The mean ultrafiltration rate was 21.9 +/- 1.9 ml/min and the plasma refilling rate was 16.5 +/- 2.7 ml/min. It is concluded that the changes in plasma and interstitial fluid colloid osmotic pressure tend to preserve plasma volume and limit the interdialytic increase in interstitial fluid volume.

Aged↗
PubMed1986

An evaluation of ultrafiltration as treatment of therapy-resistant cardiac edema.

In six patients with therapy-resistant cardiac edema, ultrafiltration on two consecutive days removed on an average 7750 ml fluid and reduced body weight by 7.3 kg. A difference between the mean ultrafiltration rate (17.4 ml/min) and the calculated plasma refilling rate (12.7 ml/min) led to a reduction in plasma volume during treatment together with an increase in plasma colloid osmotic pressure. Systemic blood pressure, heart rate and cardiac output were unchanged during ultrafiltration while systemic vascular resistance increased and pulmonary capillary wedge pressure and right atrial pressure decreased significantly. No complications were recorded during or after treatment. Ultrafiltration is a safe method of fluid removal in patients with therapy-resistant cardiac edema and can be used as preparation for cardiac catheterization or surgery.

Adult↗
PubMed1985

Transcapillary colloid osmotic gradient, plasma volume and interstitial fluid volume in long-term type 1 (insulin-dependent) diabetes.

Plasma and subcutaneous colloid osmotic pressure, transcapillary escape rate of albumin, plasma volume and extracellular fluid volume were measured in 10 long-term Type 1 (insulin-dependent) diabetic patients without clinical nephropathy. Interstitial colloid osmotic pressure was reduced compared with normal subjects (12.9 +/- 3.0 versus 15.8 +/- 2.7 mmHg, p less than 0.05) and the transcapillary colloid osmotic gradient increased (17.0 +/- 2.4 versus 12.8 +/- 2.7 mmHg, p less than 0.01). Plasma volume was in the normal range and interstitial fluid volume increased by approximately 21% compared with normal subjects (p less than 0.01). Transcapillary escape rate of albumin was significantly increased compared with normal subjects (8.9 +/- 1.9 versus 5.1 +/- 1.6% h, p less than 0.01). A negative correlation was found between the transcapillary colloid osmotic gradient and interstitial fluid volume (r = 0.6, 0.01 less than p less than 0.05). These results suggest that the increased small vessel permeability in long-term diabetes leads to wash-out of interstitial proteins and the resulting increased transcapillary colloid osmotic gradient tends to preserve the plasma volume and to limit the tendency to increased interstitial fluid volume.

Adult↗
PubMed1985

Colloid osmotic pressures, plasma volume and interstitial fluid volume in patients with heart failure.

In 13 patients with heart failure colloid osmotic pressure in plasma (IIp) and in subcutaneous interstitial fluid from thorax (IIi) (wick technique), plasma volume (PV) and interstitial fluid volume (IFV) were measured and correlated to haemodynamic parameters (cardiac index (CI) and right atrial pressure (RAP]. In seven patients with anasarca measurements of IIp, IIi, PV and IFV were repeated after fluid withdrawal (mean 7786 ml) by ultrafiltration. In the patients, IIi was reduced compared with normal subjects (11.5 +/- 3.4 versus 15.8 +/- 2.7 mmHg, p less than 0.01 (mean +/- SD] and transcapillary colloid osmotic gradient (IIp - IIi) increased (14.6 +/- 2.3 versus 12.8 +/- 2.7 mmHg, p less than 0.05). The IFV in the patients was increased to 137% of values in normal subjects (p less than 0.01) and the ratio PV/IFV significantly reduced. Correlations were found between IIi and CI (r = 0.69, p less than 0.01) and IIi and RAP (r = 0.78, p less than 0.01). Ultrafiltration led to a parallel decrease in PV and IFV and increase in IIp. The results indicate that reduced IIi is an important factor limiting peripheral oedema in heart failure and the reduction is more pronounced in severe heart failure. The reduction of IIi is due to both dilution of interstitial proteins and to reduction of interstitial protein mass by lymphatic wash-out.

Adult↗
PubMed1985

An evaluation of ultrafiltration as treatment of diuretic-resistant oedema in nephrotic syndrome.

Plasma volume, plasma colloid osmotic pressure, creatinine clearance and sodium excretion were measured before and after ultrafiltration treatment in six patients with diuretic-resistant nephrotic syndrome. The mean total ultrafiltrate volume in two sessions on two successive days was 7460 ml, the mean ultrafiltration rate was 22.0 ml/min and the calculated plasma refilling rate was 19.9 ml/min. Plasma volume and creatinine clearance were unchanged and sodium excretion was reduced after treatment. A short-lasting drop in blood pressure was seen in 3 of the 12 treatment sessions. No other complications were noted. Ultrafiltration is a safe and useful alternative in the treatment of the few patients with massive oedema due to nephrotic syndrome not responding to conventional therapy.

Blood↗
PubMed1985

Interstitial fluid volume, plasma volume and transcapillary colloid osmotic gradient in patients with hepatic cirrhosis and fluid retention.

Colloid osmotic pressure in plasma (IIp) and in subcutaneous interstitial fluid (IIi) (wick technique), plasma volume (PV) and interstitial fluid volume (IFV) were measured in 12 patients with hepatic cirrhosis and fluid retention. The value of IIp (mean +/- SD) was 21.4 +/- 4.2 mmHg (28.6 +/- 3.4 mmHg in normal subjects (p less than 0.01)), mean IIi was 8.6 +/- 2.2 mmHg (15.8 +/- 2.7 mmHg in normal subjects (p less than 0.01)) and mean transcapillary colloid osmotic gradient (IIp-IIi) was 12.7 +/- 3.8 mmHg compared to 12.8 +/- 2.7 mmHg in normal subjects (p greater than 0.1). Mean PV was increased by 21% compared to normal values (p less than 0.01) and IFV increased by 43% (p less than 0.01). The study demonstrates that reduction in IIp in hepatic cirrhosis is accompanied by a decrease of IIi in subcutaneous tissue resulting in unchanged transcapillary colloid osmotic gradient. The reduction in IIi can partly be explained by simple dilution and partly by a decrease in interstitial protein mass. The wash-down of interstitial proteins in non-splanchnic tissues reduces the tendency to oedema and hypovolaemia.

Adult↗
PubMed1985

Immunoreactive parathyroid hormone and calcitonin in plasma and ultrafiltrate before and after haemodialysis.

The effects of haemodialysis on circulating immunoreactive parathyroid hormone (iPTH) and calcitonin (iCT) were determined in relation to alterations in total (Ca) and ionized (Ca2+) plasma calcium. The hormones were measured in plasma, in dialysate and in ultrafiltrate in eight patients with elevated iPTH concentrations. There was a small, but significant reduction in plasma iPTH during haemodialysis concomitant with an increase in Ca and Ca2+. Only small changes were found in plasma iCT during dialysis. Ultrafiltrate iPTH concentrations were reduced from 46% of plasma values at the beginning of dialysis to 27% of plasma values at the end of 4 h dialysis. Gel chromatography of plasma and ultrafiltrate showed corresponding molecular profiles of intact iPTH and hormone fragments suggesting that none of the PTH peptides were restricted by the dialysis membrane. Clearance of intact iPTH (dialysance) was as expected according to molecular weight. From the PTH clearance we calculated that only 5 to 10 micrograms of intact hormone were removed during dialysis. We therefore conclude that the reduction in plasma iPTH during dialysis is probably related to a relative suppression of PTH secretion rather than due to loss of hormone during dialysis.

Adult↗
PubMed1984

Interstitial fluid volume, plasma volume and colloid osmotic pressure in patients with nephrotic syndrome.

Colloid osmotic pressure in plasma (IIp) and in subcutaneous interstitial fluid (IIi) (wick technique), plasma volume (PV) and interstitial fluid volume (IFV) were measured in nephrotic patients (n = 11) and in healthy controls. Six of the patients were treated with ultrafiltration and the parameters were measured before and after withdrawal of mean 7460 ml (total ultrafiltrate in two sessions). In the nephrotic patients mean IIp was 11.6 mmHg and IIi was 3.9 mmHg compared to 28.6 mmHg and 15.8 mmHg, respectively, in healthy controls. PV was in the normal-to-high range and IFV was increased to 150% of the valued in controls. No statistically significant change in PV, IIp or IIi was found after ultrafiltration, and IFV was reduced by 20%. The results indicate that reduction in IIi is an important oedema-preventing factor and that the reduction in interstitial protein mass is more than proportional compared to the degree of hypoproteinaemia. Ultrafiltration in the rate and magnitude we have used, leads to reduction in IFV, but small changes in PV, IIp or IIi.

Adult↗
PubMed1980

Pharmacokinetics and saluretic effect of muzolimine in severe cardiac failure.

Pharmacokinetics and effects on renal electrolyte excretion of a new diuretic drug, muzolimine (Bay g 2821), were investigated in 6 patients with severe congestive cardiac failure (New York Association classification Groups III and IV). After a single oral dose of 30 mg muzolimine, mean urinary excretion rate of sodium increased from 1.37 to 4.30 mmol/hour during the initial 24 hours, that of chloride from 0.86 to 3.97 mmol/hour, that of potassium from 1.23 to 1.63 mmol/hour, and that of water from 25.8 to 49.9 ml/hour. The saluretic effect lasted for 10 to 14 hours in 1 patient, 14 to 24 hours in 2, and more than 24 hours in 3 patients. Peak plasma concentrations of muzolimine occurred 1 to 7 hours after administration and averaged 487 ng/ml (range 268 to 868). Mean biological half-life of muzolimine in plasma was 14.3 hours (range 9.0 to 21.2 hours). The saluretic effect of muzolimine in congestive cardiac failure, thus, is of long duration, which may be explained by its long biological half-life.

Aged↗
PubMed1980

Effect of single and twice daily doses of primidolol (UK-11,443) in hypertension.

A study was carried out in 15 adult in-patients with moderately severe hypertension to investigate the efficacy and safety of single and twice daily doses of primidolol (UK-11,443), a new antihypertensive agent with both alpha- and beta-adrenoceptor blocking activity. Patients received placebo for the first 3 days and then the trial drug, at a starting dosage of either 50 mg or 100 mg, for a further 4 days. There were significant decreases in baseline values for some of the cardiovascular parameters from Day 1 to Day 7, and in all the parameters (blood pressures and heart rate, lying and standing) in terms of the values 3 hours post-dose on Days 1 and 7. Probably because of the lowering of baseline values, however, the overall change in the cardiovascular parameters from baseline to 3 hours post-dose was not significantly different when primidolol and placebo were compared. The only side-effects considered to be related to primidolol were mild postural dizziness of short duration (2 patients), mild nausea (1 patient) and orthostatic vertigo (1 patient). No clinically important laboratory abnormalities occurred.

Adrenergic beta-Antagonists↗