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At least 163 records · Page 9Linked to original sources
PubMed1993

Intraarterial thrombolysis of lower extremity occlusions: prospective, randomized comparison of forced periodic infusion and conventional slow continuous infusion.

A prospective randomized controlled trial compared forced infusion (FI) of urokinase (UK) with conventional slow continuous infusion (CI) in 25 patients with 25 acutely ischemic lower limbs. Demographics, ischemia categories, and infusion rates and doses were similar for both groups. A preliminary single-pass bolus of UK was injected into the thrombus in all patients with a pulsed-spray technique, and heparin was administered. UK was then infused with a CI pump (n = 13) or a prototype pulsed-spray pump (n = 12). The primary end point was patency, defined as at least 95% thrombolysis by volume, with brisk antegrade flow occurring within 4 hours. Eleven of the 12 patients (92%) who underwent FI and nine of the 13 (70%) who underwent CI had patency within 4 hours. However, 10 patients who underwent FI and nine who underwent CI had residual thrombi prolonging infusion. No significant differences between the two groups were apparent in speed of lysis, initial success rates, complication rates, or 30-day clinical outcome. Lytic therapy, however, was completed within 24 hours in 18 of 23 (78%) successfully treated patients (P = .01).

Aged↗
PubMed1987

Subcutaneous infusion of bleomycin--a practical alternative to intravenous infusion.

The phase specificity and short half-life of bleomycin make it likely that it would be more effective when administered by continuous infusion. This is supported by studies using cell lines, as well as by animal studies and clinical experience in humans. This study was conducted to compare the pharmacokinetics of intravenous (IV) and subcutaneous infusions of bleomycin. The serum concentrations of bleomycin were measured using a sensitive and specific radioimmunoassay. The results demonstrate similar plasma concentrations and area under the curve for both routes. The subcutaneous infusions were well tolerated, without local discomfort or excoriation. Subcutaneous infusion of bleomycin may thus offer a practical alternative to IV infusions and can be administered to patients who are ambulatory and out of hospital.

Bleomycin↗
PubMed2007

Twenty-four hour intra-arterial infusion of 5-fluorouracil, cisplatin, and leucovorin is more effective than 6-hour infusion for advanced hepatocellular carcinoma.

AIM: To evaluate the time dependence of intra-arterial 5-fluorouracil (5-FU) therapy for advanced hepatocellular carcinoma (aHCC). METHODS: Thirty-seven adult Japanese patients who had aHCC and liver cirrhosis were treated with combined intra-arterial 5-FU, cisplatin (CDDP), and leucovorin (LV). The Japan Integrated Staging score (JIS score) of each patient was 3 or more. The patients were divided into two groups, after which the 15 patients in group S were treated with 6-h infusion chemotherapy (LV at 12 mg/h, CDDP at 10 mg/h, and 5-FU at 250 mg/m2 per 4 h) and the 22 patients in group L were treated with 24-h infusion chemotherapy (LV at 12 mg/h, CDDP at 10 mg/h, and 5-FU at 250 mg/ m2 per 22 h). Continuous infusion chemotherapy was performed via the proper hepatic artery every 5 d for 4 wk using an implanted drug reservoir. RESULTS: The percentages of patients with a partial response after 4 wk of chemotherapy were 6.7% in group S and 31.8% in group L. The survival of group L was significantly better than that of group S, with the median survival time being 496 d in group L and 226 d in group S (P < 0.05). CONCLUSION: Continuous 24-h intra-arterial infusion is more effective for aHCC and can markedly prolong survival time as compared to 6-h infusion.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

[Infusion MR arteriography during hepatic arterial infusion chemotherapy: evaluation of clinical usefulness].

PURPOSE: We developed a new method of infusion MR arteriography (IMRA) via an implantable port system using an infusion pump for the evaluation of drug distribution during hepatic arterial infusion chemotherapy. The purposes of this study were to optimize the method and evaluate its clinical usefulness. MATERIALS AND METHODS: We used 3D-T1 TFE as the most suitable sequence for IMRA according to the results of a phantom model experiment. We examined 33 cases of liver cancer that had been treated by arterial infusion chemotherapy via the port system. The following investigations were performed: degree of tumor enhancement, intra- and extrahepatic perfusion abnormality, and related toxicity. The evaluation of images was performed separately by two radiologists. RESULTS: IMRA provided good images of contrast enhancement, to reveal the perfusion patterns. The treatment response rate in the tumor group with well enhancement was higher than that of the group with poor enhancement (p < 0.0001). Extrahepatic perfusion was well visualized and was correlated with toxicity (p < 0.0001). CONCLUSION: IMRA is a useful method to evaluate drug perfusion for the optimization of arterial infusion chemotherapy.

Adult↗
PubMed1989

Clinical trial of continuous infusion verapamil, bolus vinblastine, and continuous infusion VP-16 in drug-resistant pediatric tumors.

We optimized the modulation of drug resistance by the irreversible augmentation of cytotoxicity of coincubating vinblastine (VNB) with VP-16 and the reversible increase in cytotoxicity of coincubation of verapamil (VPL) with VNB and VP-16. VPL was administered as a loading dose (i.v.) (0.15 mg/kg) and then administered as a constant infusion (0.005 mg/kg) over 6 days. 24 h after verapamil, VNB 2 mg/m2 IVP was administered and followed 1 h later by a 5-day simultaneous continuous infusion of VP-16 (200 mg/m2/day) to seven pediatric patients (11 courses) with refractory malignancies. The mean age at treatment was 7.5 +/- 5.3 years, mean prior anthracycline dose (303 +/- 210 mg/m2) with a range of 0-606 mg/m2. Toxicity was limited to cardiac and hematological. The median nadir of the WBC was 900 at 14.5 +/- 0.5 days and platelet count 32,000 at 15.5 +/- 0.8 days. There were two episodes of bacterial sepsis both of which responded to i.v. antibiotics. Five of 11 courses resulted in first-degree block and one course in second-degree block. At Hour 120 of the VPL infusion the PR interval was 0.18 +/- 0.01 versus 0.13 +/- 0.01 at Hour 0 (P less than 0.0004). The ejection fraction by two-dimensional echocardiogram was not significantly different at Hour 0, 24, or 120 of the infusion (60.6 +/- 2.7 versus 52.7 +/- 5.1 versus 51.8 +/- 5.0%). The cardiac index was also not significantly different at Hour 0, 24, or 120 (4.39 +/- 0.2 versus 4.21 +/- 0.6 versus 3.91 +/- 0.5 liters/min/m2). The 15-min VPL level was 1954.5 +/- 391/ng/ml and steady state levels at Hour 24 and 120 of the infusion were 468.1 +/- 59 and 422.8 +/- 52 ng/ml, respectively. Two of 11 treatment courses resulted in hypotension secondary to inordinately high 24-h levels of VPL (1233 and 1263 ng/ml). These two episodes required inotropic support but did not require the discontinuation of VPL. There were 8 of 11 partial responses, the majority of which consisted of peripheral cytoreduction of leukemic blasts and one M-2A response in AML. The levels of VPL achieved in this study have been shown to augment the in vitro cytotoxicity of vinblastine and VP-16 to resistant cell lines. Further clinical studies are needed to determined the maximal-tolerated dose of VPL in a Phase I study and to examine its efficacy in selected relapsed pediatric patients.

Adolescent↗
PubMed1982

[Carbohydrate infusion in internal diseases. A comparative study in metabolically healthy, liver diseased and diabetic patients. VI. Infusions of a glucose/xylitol mixture (1:1 ratio) over a 48-hour period].

By central venous catheterization, 6 control persons, 7 patients with liver cirrhosis and 6 patients with diabetes mellitus were infused for 48 h with a 20% (w/v) mixture of glucose/xylitol (1:1). The infusion 48 h with a 20% (w/v) mixture of glucose/xylitol (1:1). The infusion rate of 0.125 g monosaccharide/kg/h could be maintained with minor deviations. There were no significant changes in blood glucose levels using this infusion regimen. Lactate levels, however, did increase constantly during the whole infusion period. In the liver group as well as in the diabetic group we could measure values between 1.5 and 3.9 mmol/l. Triglycerides increased solely in the diabetic group. Uric acid concentrations were elevated in all 3 groups. Clinically significant side effects were not observed.

Blood Glucose↗
PubMed1982

[Carbohydrate infusions in internal diseases. A comparative study in metabolically normal subjects, patients with liver diseases and diabetics. V. Infusion of a glucose-sorbitol mixture (ratio 1:1) for 48 hours].

Three groups (6 patients with liver cirrhosis, 6 patients with diabetes mellitus, 6 controls) have been infused for 48 h with a 20% (w/v) glucose/sorbitol-solution (1:1). The only group where the infusion rate of 0,25 g carbohydrates/kg/h could not be reached was the control group with 0,232 g carbohydrates/kg/h. We could not see any significant changes in blood glucose levels during the total infusion period. Sorbitol levels dropped very slowly after the end of the infusion, a time when sorbitol was still excreted in the urine. The concentration of triglycerides was steadily increasing. Besides there were no further changes compared to equicaloric glucose or glucose/fructose infusions.

Diabetes Mellitus↗
PubMed1996

[The effect of continuous epidural infusion of combination of buprenorphine and bupivacaine for postoperative pain relief using a portable 0.5 ml.h-1 type infuser with patient control module].

Using a portable 0.5 ml.h-1 type infuser with Patient Control Module (Baxter infuser BB+ PCM), we compared patients receiving continuous epidural infusion with patients using self controlled analgesia system for postoperative analgesia after upper abdominal surgery. Twenty-one patients were randomized into three groups: group I (n = 7) received 20 micrograms.h-1 of buprenorphine (Bu) with additional 20 micrograms of Bu; group II (n = 7) 20 micrograms.h-1 of Bu plus 1 mg.h-1 of bupivacaine (Bup) with additional 20 micrograms of Bu plus 1 mg of Bup; group III (n = 7) 20 micrograms.h-1 of Bu plus 2 mg.h-1 of Bup with additional 20 micrograms of Bu plus 2 mg of Bup. In all three groups, patients received supplemental Bu 0.1 mg intramuscularly as needed. During 48-hours postoperatively, we evaluated verbal descriptor pain scale, sedative scale, visual analogue scale, supplemental doses of Bu, and side effects. Total doses of Bu during the first 12 hours were significantly larger than those during other 12-hour period in all the groups (P < 0.05). In each period during the 12 to 48-hours after operation, the percentage of the patients who needed no supplemental Bu was 71.4-100%, which is higher than during the 0 to 12-hours (47.7%). There was no significant difference in verbal descriptor pain scale, sedative scale, visual analogue scale, and the incidence of side-effect among the three groups. Continuous epidural infusion with Bu using a portable 0.5 ml.h-1 type infuser with patient control module was effective for alleviating postoperative pain except in the first 12-hour period. However, addition of Bup to Bu did not improve the quality of postoperative epidural analgesia.

Aged↗
PubMed1997

Continuous infusion of 5-fluorouracil and low dose cisplatin infusion for the treatment of advanced and recurrent gastric adenocarcinoma.

BACKGROUND: Several chemotherapy studies have suggested that continuous infusion of 5-fluorouracil (5-FU) is more effective than bolus 5-FU. In addition, 5-FU and cis-Diamminedichloroplatinum-II (cisplatin) in combination have been shown to have synergistic cytotoxicity against several human neoplasms. In this study, the authors evaluated the efficacy and toxicity of continuous infusion of 5-FU and low dose cisplatin infusion (FP therapy) in the treatment of advanced and recurrent gastric adenocarcinoma. The relationship between the response to FP therapy and several factors was also examined. METHODS: A total of 26 patients fulfilling standard eligibility criteria were enrolled in the trial. FP therapy consisted of 5-FU (350 mg/m2/day every day by continuous infusion) and cisplatin (7.5 mg/m2/day in 100 mL of normal saline infused over 1 hour on Days 1-5 every week) for 4 weeks. RESULTS: A complete response was observed in 2 cases and a partial response in 11 cases, for an overall response rate of 50%. Patients with good performance status (PS) (0-1) and differentiated histologic type showed higher response rates (50.0% and 63.6%, respectively) than patients with poor PS (2 or 3) and undifferentiated histologic type (28.6% and 35.3%, respectively), although there were no significant differences. Patients with low serum levels of immunosuppressive acidic protein (IAP) showed a significantly higher response rate (71.4%) than those with high IAP levels (0%). Toxic effects included leukopenia, thrombocytopenia, nausea, and vomiting; these were not life-threatening and did not require treatment interruption. CONCLUSIONS: FP therapy is a promising regimen for patients with advanced and recurrent gastric adenocarcinoma. Serum levels of IAP may predict chemosensitivity.

Adenocarcinoma↗
PubMed2001

Epinephrine, norepinephrine and dopamine infusions decrease propofol concentrations during continuous propofol infusion in an ovine model.

OBJECTIVE: To determine the effects of exogenous ramped infusions of epinephrine, norepinephrine and dopamine on arterial and effluent brain blood concentrations of propofol under steady state intravenous anesthesia. DESIGN: Prospective, randomized animal study. SETTING: University research laboratory. SUBJECTS: Five adult female merino sheep. INTERVENTIONS: Induction (5 mg/kg) and continuous infusion of propofol (15 mg/min) with controlled mechanical ventilation to maintain PaCO2 40 mmHg. After 1 h of continuous anesthesia, each animal randomly received ramped infusions of epinephrine, norepinephrine (10, 20, 40 microg/min) and dopamine (10, 20, 40 microg x kg x min) in 3 x 5 min intervals followed by a 30-min washout period. MEASUREMENTS: Arterial and sagittal sinus whole blood for determination of propofol concentrations using high-pressure liquid chromatography. Cardiac output using a thermodilution method. Level of consciousness using an observational scale. MAIN RESULTS: All three drugs significantly and transiently increased cardiac output in a dose-dependent fashion to a maximum of 146-169% of baseline. Baseline arterial and sagittal sinus propofol concentrations were not statistically different prior to catecholamine infusions. All three drugs significantly reduced mean arterial propofol concentrations (95 % CI, p < 0.05): epinephrine to 41.8% of baseline (11.4-72), norepinephrine to 63 % (27-99) and dopamine to 52.9 % (18.5-87.3). There were parallel reductions of concentrations in sagittal sinus blood leaving the brain. The lowest blood concentrations were associated with emergence from anesthesia. Arterial concentrations were inversely related to the simultaneously determined cardiac output (r2 = 0.74, p < 0.0001). Comparison of the data with the predictions of a previously developed recirculatory model of propofol disposition in sheep showed the data were consistent with a mechanism based on increased first pass dilution and clearance of propofol secondary to the increased cardiac output. CONCLUSIONS: Catecholamines produced circulatory changes that reversed propofol anesthesia. These observations have potential clinical implications for the use of propofol in hyperdynamic circulatory conditions, either induced by exogenous catecholamine infusions or pathological states.

Anesthetics, Intravenous↗
PubMed2003

Septal infusions of glucose or pyruvate, but not fructose, produce avoidance deficits when co-infused with the GABA agonist muscimol.

Although glucose typically enhances memory or reverses memory deficits, glucose can also produce memory deficits when co-infused with the gamma-aminobutyric acid (GABA) agonist muscimol into the medial septum (Parent & Gold, 1997; Parent, Laurey, Wilkniss, & Gold, 1997). To date the mechanisms underlying the memory-impairing interaction between GABA and glucose remain unknown. Here we investigate whether this effect is the result of hyperosmolar conditions or may involve glucose metabolism. Male Sprague-Dawley rats were given one-trial inhibitory avoidance training after receiving septal infusions of vehicle (phosphate-buffered saline, 0.5 microl), the GABA(A) agonist muscimol (3 nmol), glucose (16.5, 33, or 66 nmol), fructose (33 nmol), pyruvate (33 nmol), or a solution containing muscimol combined with glucose, fructose, or pyruvate. Retention performance was tested 48 h later. Infusions of glucose, pyruvate, fructose, or muscimol alone did not affect retention performance. However, co-infusions of all doses of glucose (16.5, 33, or 66 nmol) or the glycolytic end product pyruvate with muscimol impaired retention performance. Co-infusions of fructose with muscimol did not affect retention performance. These results suggest that the memory-impairing interaction between glucose and muscimol does not result from hyperosmolar conditions, because equiosmolar concentrations of fructose do not mimic the effects of glucose and the memory deficits do not vary as a function of glucose concentration. The finding that pyruvate mimicked the effects of glucose and impaired memory when combined with muscimol suggests that glucose metabolism may be involved in the memory-impairing interaction between glucose and GABA(A) receptors in the medial septum.

Animals↗
PubMed1995

Inter-individual variation in half-life of infused recombinant factor VIII is related to pre-infusion von Willebrand factor antigen levels.

In an attempt to explain the substantial inter-individual variability in half-life of infused factor VIII (FVIII) among haemophilia A patients, we studied the correlation of pre-infusion von Willebrand factor antigen (vWFAg) levels and the half-life of a recombinant-DNA-derived FVIII (r-VIII SQ. Pharmacia, Sweden). Intra-individual variation in half-life was small (range of variation 0-2.1 h) in 12 severely affected haemophiliacs who received two doses of FVIII concentrate. In contrast, inter-individual variation in half-life was large (range of half-lives 6-28.8 h). A strong correlation between half-life and pre-infusion vWFAg levels was present (r = 0.87, P = 0.0003). We conclude that the half-life of infused recombinant FVIII is related to pre-infusion vWFAg levels in severely affected haemophilia A patients.

Adult↗
PubMedDate not supplied

Cerebrovascular response to infused 5-hydroxytryptamine in the baboon. Part 1. 5-Hydroxytryptamine infusion.

Cerebral blood flow was measured in 17 baboons before and during infusion of 5-hydroxytryptamine (5-HT) into the internal carotid artery. The mean values for total cerebral blood flow, grey matter flow, and white matter flow before 5-HT infusion were 40.8, 59.2, and 12.7 ml/min/100 gm of tissue, respectively. There was no significant alteration in total blood flow or flow through grey matter when 5-HT was infused at dosages ranging from 0.5 to 10.0 microng/kg/min. A small but significant decrease in white matter blood flow was recorded when 5-HT was infused at a rate exceeding 2.5 microng/kg/min. The study indicates that in vivo, with the xenon clearance method, intra-arterial infusion of 5-HT does not significantly alter cerebral blood flow.

Animals↗
PubMed1993

Comparison of intrathecal fentanyl infusion with intrathecal morphine infusion or bolus for postoperative pain relief after hip arthroplasty.

The purpose of this study was to compare an intrathecal fentanyl infusion with intrathecal morphine infusion or bolus for postoperative pain relief after hip arthroplasty. Sixty patients scheduled to undergo hip joint replacement were studied. A 28-gauge (n = 12) or a 22-gauge (n = 48) spinal catheter was introduced through the L3-4 interspace, 3-4 cm into the subarachnoid space. Spinal anesthesia was induced with 2 mL of plain 0.5% bupivacaine; additional bupivacaine was given in 0.5-mL increments, as required. Patients were given in a random and double-blind fashion either 0.5 mL of saline as a single bolus, followed by an infusion of 120 micrograms of fentanyl in 24 h (Group I, n = 20), 0.5 mL of saline, followed by an infusion of 200 micrograms of morphine in 24 h (Group II, n = 20), or 200 micrograms of morphine as a single bolus, followed by an infusion of 3 mL of saline in 24 h (Group III, n = 20) through the intrathecal catheter. In Group I, supplementary intramuscular (IM) opioid was required more often (46 doses) than in Group II (18 doses) in 24 h (P < 0.01). The number of patients given IM administered opioid was larger in Group I (18 patients) than in Group II (8 patients) (P < 0.01). The IM opioid was requested sooner in Group I (18 patients, mean 480 min) after the intrathecal injection than in Group III (13 patients, mean 786 min) (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2003

[The temperature measurement of infusion fluid by infrared thermometer is useful for safety in infusion therapy].

BACKGROUND: The measurement of infusion fluid temperature is important for patients' thermoregulatory management. However, we usually estimate the temperature by touching and feeling the surface of the infusion bag. Accordingly, there is increasing demand for more quantitative method to measure infusion fluid temperature. METHODS: In the operating room we evaluated the accuracy and precision of the infrared thermometer (Genius) for the measurement of infusion fluid temperature compared with the thermistor. RESULTS: The fluid temperature measured by Genius is accurate with sufficient precision compared with that measured by thermistor. CONCLUSIONS: The temperature measurement of infusion fluid by infrared thermometer is clinically helpful and useful for patients' safety.

Consumer Product Safety↗
PubMed2004

[Phacoemulsification of cataracts after pars plana vitrectomy (comparison of phacoemulsification with pars plana infusion and without pars plana infusion)].

PURPOSE: To compare peroperative complications of standard phaco technique and phaco with pars plana infusion performed for cataract after pars plana vitrectomy. METHOD: This prospective study randomly divided group of 64 patients with cataract after PPV into group A (standard phaco, 38 patients) and group B (phaco with par olana infusion, 26 patients). The study verifies the rate of peroperative complications such as deep anterior chamber, diaphragma movement miosis, and zonular dehiscention in these two groups. RESULTS: Peroperative complications had slightly higher rate in group B (with infusion). No specific complication in group A (standard phaco) was found. CONCLUSION: Standard phaco technic without par plana infusion has at least the same level of safety as phaco with pars plana infusion.

Humans↗
PubMed1986

Infusion of amino acids decreases the hyperglycaemic effect of per- and postoperative glucose infusion: an experimental study in the rabbit.

The effects on blood glucose concentration of 10% glucose with amino acid solution at low (18%) and high (25%) concentration of branched chain amino acids were studied, two days after laparotomy in fasted rabbits. During the whole study period, saline infusion was associated with normoglycaemia. Among the other infusion combinations peroperative infusion of amino acid solution high in branched chain amino acids with 10% glucose was the least hyperglycaemic. An amino acid solution low in branched chain amino acids with 10% glucose had the lowest hyperglycaemic effect 24 hours postoperatively. After 48 hours an infusion of 10% glucose produced the weakest hyperglycaemia. In preoperatively and 24 hours postoperatively 10% glucose was more hyperglycaemic than 10% glucose with the two amino acid solutions. After 24 and 48 hours, infusion of 10% glucose with amino acids high in branched chain amino acids was more hyperglycaemic than 10% glucose with amino acids low in branched chain amino acids.

Amino Acids↗
PubMed1986

[Double channel chemotherapy with intra-arterial infusion of DDP and concurrent intra-venous infusion of sodium thiosulfate (STS) in bladder cancer].

Ten patients with bladder cancer were treated with double channel chemotherapy which included intra-arterial infusion of DDP and concurrent intra-venous infusion of STS, a neutralizing agent against DDP. The method allows the administration of a relatively high dose of DDP to localized malignant tumors by protection from systemic cytotoxicity of DDP by STS. DDP in a dose of 100-150 mg/m2 of body surface was infused either to the internal iliac artery at a portion close to the superior vesical artery or to the aortic bifurcation by the Seldinger technique over 30 minutes, and infusion of 20 g STS to the peripheral vein was simultaneously started and continued for 2-3 hours. One patient achieved a complete response and 2 patients achieved a partial response. The response rate was 30%. Histopathologically, 4 out of 8 patients showed an effect of 2 grades or more by Oboshi-Shimosato's criteria. Invasive or hypervascular tumors seem to be more responsive to the present treatment than superficial or hypovascular ones. Side effects were relatively mild inspite of a large dose of DDP. It should be noted that concurrent STS infusion efficiently counteracts the renal toxicity of DDP.

Adult↗