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  • Articles: DFG German National Licenses  (2)
  • Carbromal  (1)
  • Ketone body ratio, in brain-dead patients  (1)
  • 1
    ISSN: 1432-1440
    Keywords: Haemoperfusion ; Carbromal ; Diazepam ; Phenobarbital ; Hämoperfusion ; Carbromal ; Diazepam ; Phenobarbital
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In der vorliegenden Arbeit werden die Adsorptionseigenschaften von 6 verschiedenen Materialien, die bei der Hämoperfusion eingesetzt werden in vitro geprüft: Amberlite XAD-2 und XAD-4, Haemocol, Collodium verkapselte Aktivkohle, Collodium verkapselte und Albumin beschichtete Aktivkohle und Aktivkohle-Hohlfaser. Carbromal wird am schnellsten eliminiert von Amberlite XAD-2 und XAD-4, ebenso Diazepam. Beim Vergleich der verschiedenen Kohlepräparate werden Carbromal und Diazepam am schnellsten von Haemocol aus der Lösung entfernt, Phenobarbital von Aktivkohle-Hohlfaser, wenn man eine 5-stündige Perfusion zu Grunde legt. Die gerinnungsphysiologischen und klinisch-chemischen Untersuchungen mit Hilfe von heparinisiertem Frischblut lassen schwerwiegende Nebenwirkungen erkennen. Die Abnahme der Thrombozyten ist am ausgeprägtesten bei Amberlite XAD-2 und XAD-4, sie ist aber auch bei den Kohlepräparationen nachweisbar: Nach 5stündiger Hämoperfusion ist ihre Zahl auf bis zu 10% des Ausgangswertes abgefallen. Die Hämolyse ist besonders stark bei Amberlite XAD-2 und XAD-4, sowie Haemocol. Die je nach Giftstoff unterschiedlich große Adsorption der geprüften Materialien und ihre verschieden stark ausgeprägten Nebenwirkungen erfordern nach unseren Ergebnissen einen der individuellen Situation des Patienten angepaßten Einsatz.
    Notes: Summary The properties of six adsorbents for Haemoperfusion were investigated in vitro: Amberlite XAD-2; Amberlite XAD-4; Haemocol; collodion coated charcoal; albumine-collodion encapsulated charcoal and activated carbon fibers. Carbromal and diazepam are most quickly removed from aqueous solutions by Amberlite XAD-2 and XAD-4. Of the charcoal containing materials, Haemocol eliminates most rapidly carbromal and diazepam; while activated carbon fibers remove phenobarbital faster. When heparinized blood is perfused, a remarkable reduction in platelet count is observed. The drop is most pronounced with Amberlite XAD-2 and XAD-4, but even when using charcoal preparations the platelet depletion can reach 10% of the original number over 5 hours. Haemolysis is most pronounced with Amberlite XAD-2, XAD-4 and Haemocol. As the efficiency of the adsorbents towards the various drugs differ and as their adverse effects also vary, the decision for a particular material will have to be made according to the individual case.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2277
    Keywords: Liver graft viability ; Ketone body ratio, in brain-dead patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hepatic energy metabolism was assessed by measuring the blood ketone body ratio (KBR), that is, the ratio of acetoacetate to β-hydroxybutyrate in the arterial blood, in 31 brain-dead patients in an intensive care unit (ICU) in Japan and in 25 donors just before procurement of the liver for transplantation in Germany. In the study in Japan, 7 of the 12 brain-dead patients treated with highdose catecholamine showed significantly decreased KBRs, revealing the detrimental effect of catecholamine on livermmetabolism. In contrast, 8 of the 9 untreated patients with blood pressure below 80 mm Hg showed almost normal KBRs. In the 25 donors in Germany, KBR was maintained within the normal range. Based upon conventional criteria, 21 livers were selected for use and the other 4 were discarded. Nineteen of the grafts were able to normalize KBR within 24 h after reperfusion, while 2 failed to function and required a second transplantation. It was suggested that a KBR in the normal range in donors is a prerequisite to immediate recovery of metabolic function of the liver graft after transplantation, and that hypotensive donors as a potential source of liver grafts may warrant further study.
    Type of Medium: Electronic Resource
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