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At least 1,117 records · Page 62Linked to original sources
PubMed1994

A justification for high resolution hematocrit measurement.

The purpose of this study was to determine the feasibility of using a 6" digital caliper and a 20x viewing microscope to measure hematocrit (HCT) from microhematocrit tubes. The reliability and validity of the digital caliper technique (DC) was simultaneously compared with that of the conventional "turntable" style microhematocrit method (MC) and the Coulter Counter hematocrit (CC) for a comprehensive comparison of the three methods. The reliability of the three methods was assessed by computing the standard error of the measurement (SEm) on triplicate readings of human blood samples. The SEm for MC, CC, and DC methods were 0.3555, 0.3004, and 0.1491, respectively. Validity was assessed by comparing the average of the triplicate HCT readings for each method with HCT determined by densitometry. Average HCT values (+/- SE) for the MC, CC, DC, and densitometry methods were 42.3 +/- 3.2, 42.4 +/- 3.4, 43.1 +/- 3.4, 43.7 +/- 3.3, respectively. Only the DC HCT values were not different from the densitometry HCT (P > 0.05). The MC and CC values were significantly lower (P < 0.01). It is concluded that accurate, highly precise measurements of HCT are obtainable using the digital caliper. The significance for this is the increased ability to perform extremely accurate measurement of changes in plasma volume. With this information, research labs can reliably measure smaller changes in plasma than was previously possible with commercial procedures.

Adolescent↗
PubMed1993

[The use of perfluorocarbon emulsions for suppression of rejection reaction in kidney allotransplantation].

Successful solution of the problems of kidney transplantation is associated with further study of the pharmacological correction of the function of the kidneys. The article discusses the prospects of the use of perfluoran, a plasma substitute with a function of oxygen transport based on a perfluorocarbon emulsion, in the posttransplantation period for increasing the positive results of kidney transplantation. From the results of 24 dog experiments with allotransplantation of kidneys, a conclusion is drawn that the decrease of creatinine concentration in the blood with the use of perfluoran may be a consequence of the antiischemic properties of the emulsion. It is pointed out that thorough study of the condition of the parenchymatous organs in the body and the determination of the sequelae of the use of these blood substitutes are necessary.

Animals↗
PubMed1977

Comparability of pyrogen tests.

The results of the rabbit pyrogen test carried out in different but similarly equipped Institutes on 36 batches of plasma substitute are comparable. If extreme variations occur in the results of the test the cause is not likely to be found in the conditions and execution of the work, as is shown by testing material from the same bottle. When the material is taken from the same bottle the results obtained by the different Institutes are similar. One explanation of the non-comparable results seems to lie in the cleaning of the bottles. It is therefore essential that manufacturers utilize properly washed bottles. Another cause of non-comparable results seems to be linked with the time factor; as it is known from the literature, pyrogen can disappear during storage.

Animals↗
PubMed1996

Resuscitation from severe hemorrhage.

The potential to be successfully resuscitation from severe traumatic hemorrhagic shock is not only limited by the "golden 1 hr", but also by the "brass (or platinum) 10 mins" for combat casualties and civilian trauma victims with traumatic exsanguination. One research challenge is to determine how best to prevent cardiac arrest during severe hemorrhage, before control of bleeding is possible. Another research challenge is to determine the critical limits of, and optimal treatments for, protracted hemorrhagic hypotension, in order to prevent "delayed" multiple organ failure after hemostasis and all-out resuscitation. Animal research is shifting from the use of unrealistic, pressure-controlled, hemorrhagic shock models and partially realistic, volume-controlled hemorrhagic shock models to more realistic, uncontrolled hemorrhagic shock outcome models. Animal outcome models of combined trauma and shock are needed; a challenge is to find a humane and clinically realistic long-term method for analgesia that does not interfere with cardiovascular responses. Clinical potentials in need of research are shifting from normotensive to hypotensive (limited) fluid resuscitation with plasma substitutes. Topics include optimal temperature, fluid composition, analgesia, and pharmacotherapy. Hypotensive fluid resuscitation in uncontrolled hemorrhagic shock with the addition of moderate resuscitative (28 degrees to 32 degrees C) hypothermia looks promising in the laboratory. Regarding the composition of the resuscitation fluid, despite encouraging results with new preparations of stroma-free hemoglobin and hypertonic salt solutions with colloid, searches for the optimal combination of oxygen-carrying blood substitute, colloid, and electrolyte solution for limited fluid resuscitation with the smallest volume should continue. For titrating treatment of shock, blood lactate concentrations are of questionable value although metabolic acidemia seems helpful for prognostication. Development of devices for early noninvasive monitoring of multiple parameters in the field is indicated. Molecular research applies more to protracted hypovolemic shock followed by the systemic inflammatory response syndrome or septic shock, which were not the major topics of this discussion.

Animals↗
PubMed1979

[Intravascular persistence, tissue storage and excretion of hydroxyethyl starch (HAS)].

Hydroxyethyl starch is a derivative of amylopectin, the branched glycogen-like alpha-1,4-glucose polymer, the amylase hydrolysis of which is retarded by hydroxyethylation. If 70 to 90 per cent of the glucose polymer units contain hydroxyethyl groups, the intravascular persistence and urinary excretion of hydroxyethyl starch of a molecular weight of 435,000 is similar to that of Dextran 70. Hydroxyethyl starch and Dextran 70 are stored briefly in reticuloendothelial and hepatic cells, and cause swelling and vacuolation of renal tubules with little alteration of renal function. Elimination of hydroxyethyl starch from sites of tissue storage is much faster than elimination of the non-metabolized polymers acacia and polyvinylpyrrolidone. The distribution and excretion kinetics of hydroxyethyl starch are thus appropriate for a plasma substitute.

Animals↗
PubMed1997

[Septic shock in suppurative diseases of the face and neck].

A total of 283 patients with odontogenic sepsis, in 66 of these complicated with septic shock, were observed in 1983-1995. A program for rapid assessment of the main clinical laboratory parameters is proposed for differentiating the phases of shock development. Combined use of hemoperfusion and extracorporeal perfusion oxygenation of the blood with preliminary or simultaneous intraarterial infusion of plasma substitutes possessing hemodynamic effects is pathogenetically justified in septic shock.

Combined Modality Therapy↗
PubMed1997

[Treatment of undeveloped external intestinal fistulas].

135 patients with undeveloped intestinal fistulas (116-85.9%-males, and 19-14.1%-females) were followed up by the authors. The patients underwent surgery for acute appendicitis-17 (12.6%), traumatic injuries of abdominal organs-78 (57.8%), acute intestinal obstruction-33 (24.4%), inflammatory processes of the uterus and adnexites-7 (5.2%). Small bowel fistulas were observed in 88 (65.2%) of patients, large bowel fistulas-in 47 (34.8%). The optimal mode of treatment for the fistula seems the obturation of fistula duct by means of catheter of Petzer of Foley. It is guite necessary to perform a simultaneous broad exploration of abscesses of anterior abdominal wall and their sanatation by the method of flowing-aspiration therapy by N.N. Kanshin. For elimination of endotoxicosis the ultraviolet irradiation of autologous blood was used as well as intravenous laser irradiation of blood, hemosorption, plasmapheresis, infusions of plasma and plasma substitutional solutions. The patients were given 2-3 antibiotics of a broad spectrum of action, one of which being obligatory introduced intravenously. From 135 patients 104 (77.0%) underwent surgery. The method of choice in small bowel fistulas the authors suggest intraabdominal resection of the bowel, and in large bowel fistulas-resection of 3/4 by the method of A.V. Melnikov. 17 patients (17.3%) died after the surgery.

Adult↗
PubMedDate not supplied

[A case of disseminated intravascular coagulation--a paraneoplastic manifestation of a borderline ovarian tumor].

A 24-year-old-woman was admitted because of disseminated intravascular coagulation (DIC), menometrorrhagia and galactorrhea. The investigations performed showed a right adnexal tumor after the equilibration of DIC with plasma substitution, we performed a right adnexectomy with limited excision of peritoneal. The pathologic examination showed a focus of endometriosis on the right ovary who had a polycystic look and a right adnexal fibromyxoma (premalignant lesion). The post operative evolution was good, with the loss of entire onco-hemato-endocrinologic picture. We describe the interrelation between DIC (paraneoplastic syndrome), menometrorrhagia and galactorrhea, the pathologic hypothesis and the treatment of DIC.

Adult↗
PubMed1998

[Excess mortality in critically ill patients after treatment with human albumin].

According to the results of a systematic review of randomized clinical studies administration of human albumin to critically ill patients is associated with excess mortality, compared with withholding albumin or administration of crystalloid fluids. The study appears to be well done. Also, there are various explanatory pathophysiological mechanisms supporting the association. However, a favourable effect of albumin in certain patient groups cannot be excluded. Alternatives to albumin are available in most clinical situations, but unfortunately, they are not completely without drawbacks. The use of albumin has to be limited; it might only be abolished when a better effect of other fluids, such as synthetic solutions, is demonstrated.

Albumins↗
PubMed1976

[Postural reactions of the circulatory system in patients with extrapulmonary tuberculosis].

The main cause of occurrence of postural reactions in patients with extrapulmonary tuberculosis is a deficit of blood circulatory volume as well as cerebrospinal disturbances and "harmful" peculiarities of the operative posture. An increase of the circulatory volume by infusion of 0.5-1.0 litres of plasma substituting substances prior to patient's being rendered the operative posture liquidates, to a great extent, postural reactions of the circulatory system.

Blood Circulation↗
PubMed1978

Plasma ACTH and cortisol profiles in Addisonian patients receiving conventional substitution therapy.

Plasma ACTH and cortisol profiles were studied over 24 h in five Addisonian patients maintained in good health by conventional gluco- and mineralocorticoid treatment. Patients received their usual treatment (15--30 mg cortisol daily) in divided doses at 08.00 and 16.00 hours. Plasma cortisol concentrations differed from those of control subjects in being higher from 08.00 hours-noon and 17.00-18.00 hours and were unmeasurable (less than 20 nmol/l) during the period of active cortisol secretion (03.00-08.00 hours) observed in normal subjects. Peak plasma ACTH levels (618- greater than 1600 ng/l) occurred at 08.00-09.00 hours in the Addisonian patients and were much greater than those seen in control subjects (60-220 ng/l). Despite this, plasma ACTH fell promptly within 3 h of the morning dose to less than 100 ng/l and levels were indistinguishable from those seen in normal subjects over the period 12.00-02.00 hours. These results show that there are substantial differences between treated Addisonian and control subjects in respect of plasma cortisol and ACTH concentrations. The findings may lead to a better understanding of ACTH-cortisol relationships in disease states, including congenital adrenal hyperplasia where control of excessive ACTH secretion is clinically desirable.

Addison Disease↗