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PubMedDate not supplied

Extracellular flush solution that contains blood, mannitol, albumin, and prostacyclin protects rat lungs from six hours of ischemia.

We have used an isolated rat lung model to compare the quality of preservation of different flush techniques with each other and with topical cooling alone. Lung injury was assessed by recording lung weights after reperfusion after 4 and 6 hours of ischemia. The flush solutions studied were intracellular (Collins-Sacks), traditional extracellular, extracellular with low potassium plus dextran, and extracellular containing blood, mannitol, albumin, and prostacyclin (Wallwork's solution). Flushing with Wallwork's solution before both 4 and 6 hours of ischemia gave superior protection from lung edema after reperfusion over all the other methods.

Albumins↗
PubMed1987

Menopausal hot flushes and plasma beta-endorphins.

Plasma beta-endorphin levels were measured in five women in physiologic menopause suffering from frequent episodes of hot flushes, recorded objectively by the measurement of finger temperature. Significantly lower levels of plasma beta-endorphin levels were found at the onset of the hot flushes than five to 20 minutes before (P less than .001). After the flush there was a significant rise of plasma beta-endorphin levels at five, ten, and 15 minutes (P less than .002).

Body Temperature Regulation↗
PubMed1987

Hickman catheter clots: a common occurrence despite daily heparin flushing.

Central vein thrombosis is the major Hickman catheter complication in our patient population. After noting clots attached to the disposable infusion plug of these catheters, we prospectively determined whether the presence of clots indicated a high-risk group for thrombosis. Forty-three patients (41 with solid tumor, two with acute leukemia) were studied. Catheters were flushed daily with heparin (10 units/ml), and urokinase (5000-10,000 units) was injected when blood could not be drawn. Clots within the catheter lumen were detected visually after expressing, onto a 4 X 4-inch gauze pad, the first 5-10 ml of admixed blood and flush solution or iv infusion fluid drawn from the catheter prior to blood drawing. Clots were detected in 153 of 508 specimens (30%). Forty of 43 patients had clots, varying in length from fragments to 5 cm, in at least one specimen. Inpatients and outpatients had a similar percentage of clotted specimens. Eight patients developed clinical (six) or autopsy-proven (two) thrombosis. There was no difference between patients with and without thrombosis in percent of discards positive for clots. This study indicates that clots are frequently present in the lumina of Hickman catheters. It is likely that these clots embolize to the lungs when catheters are flushed. Consequences of embolization are unknown.

Blood Specimen Collection↗
PubMed1987

An antegrade surgical uterine flush technique for ova collection in the ewe.

A surgical uterine flush technique was evaluated for percentage of ova/corpora lutea (CL) collected and development of reproductive adhesions in 79 superovulated ewes. The median collection rate for ova/CL was 70%, and 47 of 79 ewes had greater than or equal to 67% ova/CL. At 50 to 80 days after uterine flushing, celiotomies were performed on 50 of the 79 ewes to evaluate the reproductive tract for adhesions. Adhesions of the reproductive tract were not found. Thirty ewes were given prostaglandin F2 alpha, were mated, and became pregnant. The ova collection rates were comparable with rates reported in ewes in which oviductal flush methods were used; however, adhesions did not develop and reproductive function was maintained after surgery.

Animals↗
PubMed1979

[Hypothermic storage under aerobic conditions--the effect of different flushing solutions on kidney functional recovery].

Canine kidneys (n = 17) were flushed with COLLINS (C2), SACKS II, LAMBOTTE (KMgS), ROSS (hypertonic citrate), or RINGER glucose-mannitol solution following a 30-min period of normothermic ischemia. After 24 h hypothermic preservation with retrograde oxygen persufflation (ROP) and autotransplantation, the immediate functional recovery was determined using inulin and PAH clearance methods and compared with the normal contralateral kidney. While a good functional recovery was found in the COLLINS group, significantly exceeding results from hypothermic ischemic storage preservation, in experiments using other flush solutions ROP preservation resulted in only a small immediate function. Thus the experiments indicate that COLLINS solution C2 is the optimal flush solution for ROP preservation.

Aerobiosis↗
PubMed1985

Use of a chemical tracer to evaluate water movement through two automatic watering rack manifolds during flushing.

A sodium fluorescein solution was introduced into an upfeed serpentine and a horizontal automatic watering rack manifold. Water samples were collected from nine drinking valves on each manifold prior to and after flushing at 12 pounds per square inch water pressure for 15 seconds, one minute, and five minutes. The water samples were assayed for fluorescein and it was found that the chemical was effectively removed by flushing from the upfeed serpentine manifold, while significant levels of fluorescein remained in the horizontal manifold even after five minutes flushing.

Animals↗
PubMedDate not supplied

[Vasomotor sudden flushes (author's transl)].

The most typical disorder encountered during the menopause is the sudden flush, but the etiopathogenicity of these disorders is still a matter of hypotheses only. Increased levels of FSH and LH have been evoked ; recent cutaneous temperature studies have demonstrated a significant increase in LH but not of FSH, E1, and E2, during sudden flushes. The degree and rapidity of estradiol level variations have also been suggested as relevant factors. Current opinion conduces to be favoured with the involvement of gonadotropins, catecholamines, and indolamines, and perhaps prostaglandins at the hypothalamic level. Whatever the cause may be, vasomotor flushes are present in 55 to 75 % of menopausal women, and may be accompanied with sudoral crises, palpitations, or lipothymia. Women with a harmonious family life are better able to endure these disorders, treatment being most necessary when they result from a greatest disorder. Therapy is essentially estrogen therapy (after exclusion of cancer), progestogens, or veralipride, a non hormonal agent which produces 80 % of positive results, without apparently the disadvantage of estrogen therapy.

Climacteric↗
PubMed1983

[The alternative to hormonal treatment of menopausal vasomotor flushes: veralipride].

The effectiveness on hot flushes and clinical tolerance of veralipride were compared to those of natural estrogens in a randomized double blind trial. Forty-three patients who had undergone spontaneous menopause at least 6 months earlier were included in the study. For 20 days, twenty-one women were given 100 mg per day veralipride and twenty-two were given 1.25 mg of the reference estrogen. Three women in the estrogen group discontinued the trial without sound reasons. The number, duration and severity of hot flushes were assessed and scored at the onset of the trial and after 7 and 20 days of treatment. Statistical analysis showed no significant difference concerning effectiveness or tolerance. However, veralipride seemed to provide better control of severe hot flushes.

Adult↗
PubMed1983

Biofeedback training in the therapy of flushing.

Biofeedback training was used in a study of seven patients with spontaneous and ingestant-provoked flushing reactions. The patients were challenged before and after biofeedback training with chocolate, wine, and hot coffee. While there was no significant improvement in the group for flushing reactions provoked in the laboratory setting, five of the seven patients observed enhanced control in spontaneous flushing.

Biofeedback, Psychology↗
PubMed1980

Clonidine (Dixarit) for menopausal flushing.

Clonidine, 0.05 mg twice daily, was evaluated in a multicentre, randomized, placebo-controlled, double-blind crossover study in 66 patients who had had menopausal flushing for less than 1 year. Although the placebo effect was substantial, clonidine reduced the frequency of attacks significantly more than did placebo. In three of the four trials the patients' comparisons of symptoms before and after crossover indicated significantly greater improvement when the crossover was from placebo to clonidine rather than the reverse. The frequency, severity and duration of attacks were reduced by clonidine in 78%, 89% and 88% of the patients respectively, and by placebo in 50%, 53% and 50%. Side effects were minimal and their pattern was the same for clonidine as for placebo. Clonidine's action as a peripheral vascular stabilizer makes it potentially useful for the treatment of menopausal flushing. It would be prudent to include clonidine at the beginning of treatment so that its efficacy could be assessed in each individual. Its use would enhance the effects of the usual management of the menopausal syndrome, which consists of explanation, reassurance and, sometimes, the use of tranquillizers. Clonidine is a symptomatic medication that makes flushing more tolerable and should reduce the number of patients who would otherwise be exposed to the risks of estrogens.

Adult↗
PubMed1994

Veralipride for hot flushes induced by a gonadotropin-releasing hormone agonist: a controlled study.

OBJECTIVES: To evaluate the efficacy of veralipride, a benzamide derivative, in the treatment of hot flushes induced by GnRH agonists (GnRH-a) and to study peripheral blood mononuclear cell beta-endorphin concentrations during drug administration. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: Academic department of obstetrics and gynecology. PATIENTS: Forty women of mean age 43 +/- 5 years who experienced disturbing hot flushes during a 4-month course of tryptorelin depot for myoma-associated menorrhagia. INTERVENTIONS: Treatment with oral veralipride 100 mg/d (20 subjects) or matching placebo (20 subjects) during the third month of GnRH-a administration. MAIN OUTCOME MEASURES: Modifications of frequency and severity of hot flushes as shown by a 0 to 6-point vasomotor scoring system and variations of beta-endorphin levels in peripheral blood mononuclear cells. RESULTS: Two subjects in each group dropped out of the study. The median (range) vasomotor score at the end of the second month of treatment was 4 (3 to 6) in both the veralipride and placebo group. At the end of the third and fourth months the median (range) scores were, respectively, 2 (0 to 6) versus 4 (1 to 6) and 2 (0 to 5) versus 4 (1 to 6). No significant variations in mononuclear cell beta-endorphin concentrations were recorded. Serum PRL levels rose from 11.7 +/- 5.7 to 132.3 +/- 65.0 ng/mL (conversion factor to SI unit, 1.0) during veralipride administration and returned to 10.6 +/- 3.7 ng/mL after drug withdrawal. CONCLUSION: Veralipride reduced vasomotor symptoms induced by a GnRH-a. Transient hyperprolactinemia was the main side effect observed. The mode of action of the drug in GnRH-a-treated patients and possible interactions with endogenous opioid peptides need further elucidation.

Adult↗
PubMed1994

Performance of indirect embolectomy aided by a new developed flush-suction catheter system. Forty-seven experimental embolectomy procedures in test animals.

Embolectomy by means of the Fogarty catheter is the therapy of choice in the event of acute occlusions of limb arteries. However, less invasive catheter procedures have become established means to perform embolectomies lately. In order to improve the results after using the above mentioned methods, we have developed a new embolectomy procedure. The system applied consists of a flush-suction catheter as well as a high pressure pump. There is a jet-suction unit on the head of the tubular two-lumen catheter to gather thromboembolic material from the circumference of the head, to erode the collected material and evacuate it. The flushing pressure is generated by the pump. For the experimental testing of the system, the flush-suction embolectomy has been performed in 19 pigs after 47 artificial produced extremities embolism. Angiographically and angioscopically it could be proved that even older thrombotic material could be removed completely and without significant trauma of the vessel. At the pathologic investigation of the vessel in which embolectomy had been performed in no case an essential vessel-wall damage could be found. In almost each case the embolic material was removed completely. Only in 5 cases (10.6%) we have distal microembolism. Due to the experimental tests, the system turns out to be reliable as far as the technique is concerned. In addition, in the event of clinical application, the system allows the expectation of a reduction of the time interval between diagnosis and therapy, as well as a percutaneous application.

Angiography↗
PubMed1994

Flushing with autologous blood improves intraoperative hemodynamic stability and early graft function in clinical hepatic transplantation.

Hemodynamic instability and hyperkalemia are common after reperfusion and may cause ischemic damage on the hepatic allograft. Two techniques for flushing hepatic grafts before reperfusion were studied to evaluate their effects on intraoperative hemodynamic and metabolic status and on early graft function in 83 consecutive adult hepatic transplantations. In the first 41 patients (group 1), the hepatic grafts were rinsed with 500 milliliters of lactated Ringer's solution (LR). In the subsequent 42 patients (group 2), in addition to LR rinse, the first 500 milliliters of portal blood to flush and reperfuse the liver were drained through the cannula inserted into the donor vena cava before unclamping the vena cava. After reperfusion, the mean arterial pressure decreased 30 +/- 4 percent in group 1 versus 17 +/- 2 percent in group 2 (p < 0.02), and serum K+ increased by 1.9 +/- 0.2 in group 1 versus 0.8 +/- 0.2 milliequivalents per liter in group 2 (p < 0.01). Hyperkalemic cardiac arrest was only seen in two patients in group 1. The K+ concentration in the first 100 milliliters of discarded blood was found to be 40 +/- 2 milliequivalents per liter. The 500 milliliters of discarded blood contained 8.3 +/- 0.4 milliequivalents, which was correlated with graft liver weight (p < 0.001). Early graft function, as measured by serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, total bilirubin and prothrombin time on postoperative day No. 2, was significantly better in group 2 than in group 1 (p < 0.05). The six-month graft and patient survival rates in group 1 were 66 and 75 percent, versus 90 and 95 percent in group 2 (p < 0.01 and p < 0.02, respectively). Further flushing with 500 milliliters of autologous portal blood resulted in smaller intraoperative shifts in serum K+, greater hemodynamic stability, better graft function and improved graft and patient survival.

Adult↗
PubMed1995

Regeneration after in situ flushing of partially hepatectomised rat livers.

The effect of various components of the transplant procedure upon the regenerative process in reduced liver grafts is not known. In this study, partially hepatectomised rat liver remnants were flushed with 5 ml of either Ringer's lactate, Euro Collins solution or University of Wisconsin solution at 4 degrees C and then 5 ml Ringer's lactate at 4 degrees C. After partial hepatectomy alone, the peak increase in thymidine kinase was measured at 24 hours (36,021 +/- 8,060 disintegrations per minute per milligram protein; the mitotic index was 25 +/- 7). In all the groups in which the remnant was flushed, peak thymidine kinase and mitotic index were measured at 48 hours. The pattern of ornithine decarboxylase activity was disorganised in all groups. Flushing of the liver remnant therefore delays the regenerative response by 24 hours. In large animals, including humans, regeneration appears to commence within the first 5 days after resection. A comparable delay doubling this time might coincide with the onset of rejection and further compromise liver function.

Animals↗
PubMedDate not supplied

Effects of varying intervals between heparin flushes on pediatric catheter longevity.

The effectiveness of 4-, 6-, and 8-hour heparin flushing intervals on the logevity of 22- and 24-gauge intermittent i.v. catheters was examined in 83 pediatric patients. Catheters lasted 18-20 hours longer with 6- and 8-hour flushing intervals than with 4-hour intervals. A comparison of 22- and 24-gauge catheters revealed that there was no difference in longevity based on size. Also, use of medications did not affect catheter longevity. Age differences in catheter longevity were noted (greater longevity in older children) and is a result that needs further research. Based on the results of this study, if longer flushing intervals were used, fewer i.v.'s would have to be restarted and nursing time caring for i.v.'s would be decreased.

Adolescent↗
PubMed1997

[Clinical pilot study on repeated use of heparin, vancomycin, colimycine locked flush solution for central intravenous implanted catheter in oncology].

With an anti-infectious and an antithrombotic prophylaxis aims, a locked flush solution including heparin and vancomycin, was used systematically for implantable venous access system for each patient, from january to april 1995. Since the 6th of april 1995, in order to widen the antibiotic spectrum on Gram negative bacteriae, we added colimycin at the flush solution. In 1995, 342 hospitalised patients held this type of venous access and received chemotherapy and/or radiochemotherapy for cancer. Two thousand six hundred thirty three manipulations were done, 575 with the first flush solution, 2058 with the second. During the year, 15 implantable access system (4.4%) were considered as infected, only 3 (0.9%) were removed, in the first period. THe infectious rate seemed to be stable, but the bacterial assessment to be modified between the two periods. The Gram negative bacterial infections seemed to decrease with colimycin addition (33% versus 50%). These results must be confirmed by a long term and/or randomized study.

Anti-Bacterial Agents↗
PubMed1997

Preharvest nitroprusside flush improves posttransplantation lung function.

BACKGROUND: Morbidity as a result of early allograft dysfunction remains a significant problem in clinical lung transplantation. We previously demonstrated that nitroprusside (NP), a potent nitric oxide donor, administered before storage and again during reperfusion, reduced lung reperfusion injury. The purpose of the present study was to determine whether these observations were storage effects, reperfusion effects, or both. MATERIALS AND METHODS: Fifteen dogs underwent left lung allotransplant. Donor lungs were flushed with modified Euro-Collins solution and stored for 21 hours at 1 degree C. Immediately after transplantation, the contralateral right main pulmonary artery and bronchus were ligated to assess isolated allograft function. Hemodynamics and arterial blood gas analysis (FIO2 1.0) were assessed for 6 hours before sacrifice. Allograft myeloperoxidase (MPO) activity and wet to dry weight (W/D) ratio were assessed. Animals were divided into three groups for timing of NP administration. Group I (n = 5) animals received no NP. In group II (n = 5), donor lungs received NP (10 mg/L) in the flush solution only. In group III (n = 5), recipient animals received NP (0.2 mg/kg) just before reperfusion, as well as a continuous infusion (0.1 mg/kg/hr) during the assessment period. RESULTS: Significant improvement in gas exchange was apparent in groups II and III compared with group I, but there was no significant difference between groups II and III. After 6-hour reperfusion, mean PaO2 values were 85.46 +/- 13.32 mm Hg in group I, 298.74 +/- 61.25 mm Hg in group II (p < 0.05), and 311.12 +/- 43.39 mm Hg in group III (p < 0.05). Systemic vascular resistance was significantly lower in group III than in group I (p < 0.05). MPO activities decreased in groups II (p < 0.05) and III (p < 0.05), indicating reduced neutrophil sequestration. W/D ratio was significantly lower in groups II and III. CONCLUSION: Both methods of NP administration are effective, but NP administration in the recipient is accompanied by a decrease in systemic vascular resistance. From a clinical point of view, NP administration in the flush solution is a sufficiently effective and practical method to reduce lung allograft reperfusion injury.

Analysis of Variance↗
PubMed1986

Flushing in the carcinoid syndrome and plasma kallikrein.

To examine the role of kallikrein in the etiology of flushing in the carcinoid syndrome, chromogenic substrates specific for kallikrein were used to measure two isoenzymes of this substance. The plasma and glandular kallikrein levels were determined in 20 carcinoid patients and in 17 controls. Kallikrein levels were not significantly different between these two groups. Twelve carcinoid patients and six controls were given alcohol and the kallikrein activity was measured before and at 2, 5, and 10 minutes after alcohol ingestion; kallikrein activity did not change significantly. Kallikrein was absent from the primary tumors of seven patients with carcinoids. These studies, therefore, indicate that kallikrein with subsequent induction of bradykinin formation is not solely responsible for the flushing in the carcinoid syndrome.

Adult↗