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PubMedDate not supplied

[Effect of perftoran on microcirculation and target organs in early atherogenesis].

Effects of perfluoran, a plasma substitute with a gas-transport function, were studied at the stage of dyslipidogenic microangiopathy in rabbits. Changes in microcirculation, hemorheology, morphology of the liver, phospholipid composition of hepatocytic membranes were examined histologically, histochemically, electron microscopically and biochemically. Perfluoran produced a positive effect on microcirculation, phospholipid composition of hepatocytic membranes. Individual features of these parameters' dynamics were determined for animals.

Animals↗
PubMed1992

Comparative effects of verapamil and volume overload on atrial natriuretic factors and the renin-angiotensin aldosterone-vasopressin system.

The authors compared the effects of verapamil (120 mg three times daily for 3 days) with those of acute volume expansion with normal saline on the plasma levels of atrial natriuretic factors (ANF), renin (PRA), angiotensin II (AII), aldosterone (ALD), and arginine-vasopressin (AVP) in healthy subjects. A randomized, double-blind, placebo-controlled study of crossover design was employed, where each individual received two acute volume overloads 1 week apart, one during placebo and the other during treatment with verapamil. Verapamil reduced blood pressure (BP) and increased the plasma levels of ANF, PRA, AII, ALD, and AVP. Strong positive correlations were observed between PRA, AII, ALD, and AVP, but not with ANF. Acute volume expansion (1500 mL saline in 15 minutes, in supine legs-up position) similarly to verapamil increased ANF levels; however, opposite to verapamil, it reduced PRA-AII-ALD, did not modify AVP levels, and increased BP. The mechanisms of these changes are discussed. In verapamil-treated subjects, volume expansion produced an additional increase in ANF and inhibited the PRA-AII-ALD axis, suggesting that in young healthy individuals, verapamil does not interfere with the reflex compensatory hormonal mechanisms activated under circumstances of acute volume-salt overload, with rapid expansion of the central vascular compartment. Our study indicates that verapamil and volume expansion represent two different stimuli for ANF secretion associated with opposite changes in the PRA-AII-ALD axis. In addition, verapamil can be used as a tool to study and understand the simultaneous increases in ANF and in PRA, AII, and AVP, characteristics of congestive heart failure.

Adult↗
PubMed2005

Comparison of a small volume of hypertonic saline solution and dextran 40 on hemodynamic alternations in conscious calves.

The hemodynamic effects of rapid intravenous (IV) administration of 10% dextran 40 in saline solution (D40) and 7.2% hypertonic saline solution (HSS) in calves were compared. Calves received isotonic saline solution (ISS), HSS or D40 (3 calves/group) and were monitored of blood pressure, and cardiac output (CO) for 180 min. HSS and D40 infusions induced a significant increase in relative plasma volume reaching 134.9+/-2.8 and 125.0+/-1.9%, respectively at the end of fluid infusion. In the HSS group, CO, cardiac index (CI) and stroke volume (SV) remained constant at low levels after 90 minutes despite the maximal values of CO, CI and SV at the end of infusion, reaching 21.0+/-6.3 l/min (p<0.05), 177.8+/-14.2 ml/min/kg (p<0.001) and 0.20+/-0.03 l/beat (at t=10 min, p<0.001), respectively. In contrast, CI and SV in the D40 group showed significant increases to 14.7+/-2.9 l/min and 153.5+/-17.2 ml/min/kg, respectively, at the end of fluid infusion. And those values remained constant at higher levels than those of the before infusions values throughout the experimental periods. Positive effects for hemodynamic alternations of D40 in calf practice were milder and longer than those of HSS. Therefore, the D40 infusion should be explored as a possible treatment for dehydrated calves, since rapid infusion of D40 may be safe and more beneficial for rehydrating more than HSS treatment.

Animals↗
PubMed1992

Histamine and antihistamines in anaesthesia and surgery: from experimental pharmacology to clinical decision making.

The problem of whether antihistamines (histamine H1 + H2-antagonists) should be administered prophylactically before surgical interventions rose after animal experiments with hypnotics, opioids, muscle relaxants and plasma substitutes. It could, however, not be solved by classical biomedical research, but needed a heuristic problem-solving strategy. This strategy was formalized and in this way changed into a scientific structure by the thinking-aloud technique and the building of a decision tree with 9 nodes and various study designs to answer questions at particular decision nodes. The first question, whether the incidence of the reactions was high, was answered by several controlled clinical trials. The second question of life-threatening degrees of severity in single cases, was answered by a drug surveillance study. The third question, of whether severe incidents could always be avoided was answered by medical audit. The same was the case if death had to be considered as the final therapeutic failure. The fifth question was, "are the risks of histamine release comparable to other risks in the perioperative period?" They were--if thromboembolism, infection and stress ulcers were considered. The sixth and seventh questions referred to an experimentally and clinically effective prophylaxis. They were answered by animal and clinical studies with histamine antagonists, mainly with dimetindene and cimetidine. Undesired, adverse reactions to prophylaxis are rare since the drugs are given only once. Prophylaxis was calculated to be fairly cost-effective. Problem-solving strategies are very helpful in transferring facts and conclusions from experimental basic research to clinical decision making. This was convincingly demonstrated in antihistamine prophylaxis in anaesthesia and surgery.

Anesthesia↗
PubMed1991

Pentafraction-Du Pont versus albumin for resuscitation of a lethal intestinal ischemic shock in rats.

This study compares the effect of pentafraction-Du Pont 6% (PF), albumin 5% (ALB), and Ringer's lactate (RL) on plasma volume (PV) expansion and survival in a lethal intestinal ischemic shock model. Shock was induced by exteriorizing the small intestines and occluding the mesenteric vessels for 75 min. Changes in PV were estimated using hematocrit (Hct). The solutions were administered continuously for 6 hr in volumes to maintain a stable Hct, or 15 ml/100 g body weight (bwt) for PF and ALB and 44 ml/100 g bwt for RL. Hct and bwt were measured hourly during the infusion and at 24 h. Untreated animals in shock developed hemoconcentration (Hct 62%) corresponding to a PV of 41% of baseline preshock level, with 9% (3/35) of the animals surviving 72 hr. RL expanded PV to 87% of preshock level, with a 57% (20/35) 72 hr survival rate and 46% (16/35) surviving greater than 7 days. Only 34% as much ALB was needed to induce a greater PV expansion of 101% with a 72 hr survival rate of 51% (18/35) and 46% (16/35) surviving greater than 7 days. When PF was used, PV expanded to 109% of preshock level with survival rates improving to 80% (28/35) at 72 hr and 71% (25/35) greater than 7 days compared to RL and ALB (P less than 0.05). There were no significant differences in survival rates between RL and ALB treated animals. We conclude that PF improves survival following intestinal ischemic shock compared to ALB and RL. PF is a safe and effective alternative to albumin for resuscitation in this shock model.

Albumins↗
PubMed2006

Hydroxyethylstarch 200 and 240 differently affect aortic distensibility but not viscosity and blood pressure upon acute isovolumic hemodilution.

OBJECTIVES: It has been shown that a hydroxyethylstarch solution significantly increases the aortic distensibility coefficient (ADC) as compared to other non-hydroxyethylstarch colloid solutions. In order to investigate whether the effect of hydroxyethylstarch on ADC is class-specific, we investigated the effect of two hydroxyethylstarch solutions (HES 200: Elohes and HES 240: Hesteril) on the ADC and compared them with two other colloid solutions: 5% albumin and fluid gelatin (Gelofusin) in a rabbit model of acute isovolumic hemodilution. METHODS: Twenty-eight male New Zealand white rabbits were anesthetized and randomly allocated to receive (n=7, each): albumin, hydroxyethylstarch-200, hydroxyethylstarch-240 and gelatin for acute isovolumic hemodilution by exchanging 13 ml.kg(-1) body weight of blood with an identical volume of the test solution. Blood viscosity, mean arterial pressure, aortic blood flow and heart rate were measured and ADC was calculated. RESULTS: All groups were comparable with respect to arterial pressure, heart rate and aortic blood flow velocity before and after isovolumic hemodilution. After hemodilution, ADC coefficient remained unchanged as compared with pre-hemodilution values with albumin, hydroxyethylstarch-240 and gelatin, whereas a sustained 3 fold increase was observed with hydroxyethylstarch-200. CONCLUSION: These results demonstrate that minor physicochemical differences between two hydroxyethylstarch solutions result in measurable differences in ADC and suggest that the clinical effects of colloids should probably be analyzed for each type of colloid and not for classes of colloids (e.g. hydroxyethylstarch or fluid gelatins).

Animals↗
PubMed2006

[Results of perftorane local use in complex treatment of patients with odontogenic phlegmons of the face and neck].

Combined treatment of 96 patients with odontogenic phlegmons of the face and neck included local application of perftorane (plasma substitute with gas transport function). The addition of perftorane to complex therapeutic measures provides significant improvement of the patients' general status and speeds up reparative processes in the wound. It facilitates secondary suturing, shortens treatment time, provides wound healing by primary intention, improves functional and cosmetic results.

Adolescent↗
PubMed1991

Effects of a highly concentrated hypertonic saline-dextran volume expander on cardiopulmonary function in anesthetized normovolemic horses.

Conventional fluid resuscitation is unsatisfactory in a small percentage of equine emergency surgical cases because the large volumes of fluids required cannot be given rapidly enough to adequately stabilize the horse. In anesthetized horses, the volume expansion and cardiopulmonary effects of a small volume of highly concentrated hypertonic saline-dextran solution were evaluated as an alternative initial fluid choice. Seven halothane-anesthetized, laterally recumbent, spontaneously ventilating, normovolemic horses were treated with a 25% NaCl-24% dextran 70 solution (HSD) at a dosage of 1.0 ml/kg of body weight, IV, infused over 10 minutes, and the effects were measured for 120 minutes after infusion. Plasma volume expansion was rapid and significant (from 36.6 +/- 4.6 ml/kg to 44.9 +/- 4.8 ml/kg), and remained significantly expanded for the duration of the experiment. Packed cell volume, total blood hemoglobin, and plasma protein concentrations significantly decreased, confirming rapid and sustained volume expansion with hemodilution. Cardiac index and stroke index immediately increased and remained high for the entire study (from 69.6 +/- 15.3 ml/min/kg to 106.6 +/- 28.4 ml/min/kg, and from 1.88 +/- 0.49 ml/beat/kg to 2.50 +/- 0.72 ml/beat/kg, respectively). Systemic vascular resistance significantly decreased immediately after HSD infusion and remained decreased for the duration of the study (from 1.41 +/- 0.45 mm of Hg/ml/min/kg to 0.88 +/- 0.22 mm of Hg/ml/min/kg). Arterial and venous blood oxygen content decreased significantly because of hemodilution, but actual oxygen transport transiently increased at the 10-minute measurement before returning toward baseline.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1991

[Study of chemically modified hemoglobin as an artificial oxygen carrier in the model of hemorrhagic shock in dogs].

Hemodynamic and gas-transporting properties of the chemically modified hemoglobin solution have been studied on the model of hemorrhagic shock in dog. It has been shown that the polymerized hemoglobin solution exerts the hemodynamic action just as the plasma substitute "polyglucin" does. However, in contrast to the latter, polyhemoglobin circulating in the vascular bed for a prolonged period of time increases the blood oxygen capacity and oxygen delivery to tissues with the resultant increase in body total oxygen taking-up.

Animals↗
PubMed1991

[The colloid osmotic pressure of blood. Physiology, measuring technique and pre-analytic factors of influence].

Since the fundamental work of Starling the central of colloid osmotic pressure for maintaining volume homoeostasis and for transcapillary fluid exchange has been well known. To treat an intravasal volume deficit colloidal plasma substitution solutions are able to secure a sufficient colloid osmotic pressure. The last one can be measured by oncometry. Therefore an individual therapy is possible. This review describes the physiologic function, measurement techniques and important influencing parameters and disturbing factors which may be taken into consideration when colloid osmotic pressure is determined.

Blood Proteins↗
PubMed1991

[Therapeutic approach in degenerative-dystrophic diseases of the hip joint in relation to the immunologic status].

In the process of study of the immunological status peculiarities of 202 patients with some degenerative-dystrophic diseases of hip joint has been revealed that the hyperimmune reactions to tissular antigens of the joint components (bone, cartilage, synovial membrane) are more often observed in case of non-specific arthritis, asephic necrosis of the head of the femur and dysplastic coxarthrosis. These were precisely the states with more frequent postoperative complications, provoking the process development, joint ankylosing or formation of ossificates. Preoperative immunocorrection therapy of 20 patients by means of a course of low-dose injections of plasma substitutes (polyglukine, hemodesis or reopolyglukine), individually selected by RIML and lymphocytotoxic test, allowed to arrest the lryperimmune manifestations. After reconstructive-restorative operations there was observed positive clinical and roentgenologic dynamics in the operated joint of the patients.

Antigen-Antibody Reactions↗
PubMed1991

[The dynamics of the immunological indices during the treatment of recurrent erysipelas with the new immunostimulant bemitil].

Bemitil, administered orally in a dose of 0.25-0.5 g a day for 5-7 days at the acute period of the relapse of erysipelas as an immunostimulant, enhanced the effectiveness of the basic therapy including antibiotics, anti-inflammatory and antiallergic drugs, vitamins, plasma-substituting fluids and saline solutions, as well as ultraviolet irradiation of the focus of lesion. Bemitil therapy was associated with an increase in the number of T-lymphocytes, normalization of the balance between the peripheral lymphocyte preparations, an increase of blood serum levels of IgA and IgM.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Characteristics of the development of respiratory insufficiency in the early postoperative period following surgery of cancer of the esophagus and the cardia].

Acute respiratory failure (ARF) in the earliest postoperative period after radical surgery for esophageal cancer is characterized by staged development. Its severity is determined by the degree of ventilation-perfusion disorders and the accompanying diffusion disturbances. The following factors are considered to be ARF-provoking: postaggressive circulation centralization, predominant administration of crystalloid plasma substitutes, persistence of hypoproteinemia in the earliest postoperative period, as well as extended lymph dissection involving cardiopulmonary plexus located in the area of bifurcation. The latter factor is the peculiarity of surgery caused by oncological considerations, while three former factors should be taken into account during management of patients in the intra- and postoperative periods.

Cardia↗