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  • Artikel: DFG Deutsche Nationallizenzen  (3)
  • Dopamine  (1)
  • Haemofiltration  (1)
  • Lung injury  (1)
  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Intensive care medicine 16 (1990), S. 363-371 
    ISSN: 1432-1238
    Schlagwort(e): Intensive care ; Radionuclides ; Lung injury
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Conclusion Three isotopic methods of estimating alveolar-capillary membrane permeability have been described. The first, radiolabelled HSA, is crude, and appears to have no clinical applications. Pulmonary99mTc-DTPA clearance studies are relatively easy to perform, but suffer from their high sensitivity and variations in technique from centre to centre. The double isotopic measurement of PAI has only been adopted by a few centres, but may offer reliable assessment of the pulmonary endothelial permeability which is probably an early marker of acute lung injury. None of these techniques has proved predictive of outcome in ARDS. However, trials where alveolar-capillary membrane permeability is assessed before clinical evidence of lung injury is apparent have yet to be conducted. Thus at present, methods of assessing alveolar-capillary membrane permeability, particularly capillary endothelial integrity, may prove to be more useful in monitoring new therapeutic interventions in lung injury, rather predicting outcome.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Intensive care medicine 19 (1993), S. 290-293 
    ISSN: 1432-1238
    Schlagwort(e): Acute renal failure ; Cardio-pulmonary bypass ; Haemofiltration
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective To study the impact of continuous veno-venous haemofiltration on survival in patients with acute renal failure (ARF) following cardio-pulmonary bypass (CPB) surgery. Design A retrospective study of all patients requiring haemofiltration after CPB over a 2 year period. Setting A 20 bedded, adult cardothoracic intensive care unit in a postgraduate teaching hospital. Patients 35 patients (26 male, age range 24–74 years) required haemofiltration (2.7% of the total number of patients undergoing CPB). Main results Cardiovascular failure post CPB was the commonest causes of ARF (n=16). Indications for haemofiltration were ureamia (21), oligo-anuria (11), volume overload (2) and hyperkalaemia (1). Mean time from CPB to the initiation of haemofiltration was 8 days (range 0–15 days). Mean urea was 30 mmol/l and creatinine 362 μmol/l immediately prior to treatment. Urea was well-controlled in all patients, although 2 needed haemodiafiltration. Twenty-six patients died during their admission to the ICU (74% mortality). A further 3 patients died during their hospital admission, following discharge from ICU. Outcome was particularly poor in patients with cardiovascular failure following CPB (16 cases, 0 survivors). Survivors tended to commence filtration earlier (mean of 4 vs 7 days for non-survivors) and required treatment for a mean period of 8 days (range 1–26 days). Survival was determined by the number of failed organ systems at the start of haemofiltration. Thus, 100% of patients with single system failure survived, compared to only 10% with 3 or more system failure. Conclusions Despite the theoretical advantages of haemofiltration and the effective control of uraemia the mortality associated with ARF following CPB remains high and is probably determined by the number of failed organs systems.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1432-1238
    Schlagwort(e): Key words Cardiopulmonary bypass ; Gastrointestinal permeability ; Dopexamine ; Dopamine
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: To compare the effects of dopexamine and dopamine on the mucosal permeability of the gastrointestinal tract (GIT). Design: Prospective, randomised clinical trial. Setting: Intensive care unit of a postgraduate teaching hospital, London, England. Patients: Thirty patients undergoing elective surgery involving cardiopulmonary bypass, performed by a single surgeon. Interventions: Patients were randomly assigned to receive either dopexamine 2.0 μg/kg per min or dopamine 2.5 μg/kg per min for the duration of the study period. Measurements and main results: Hemodynamic parameters and gastric intramucosal pH (pHi) were measured at intervals throughout the study. GIT permeability was measured once, post-operatively, using the ratio of absorbed lactulose to L-rhamnose. The groups were similar with respect to demographics, pre- and post-operative risk factors. The lactulose/rhamnose ratio was (mean ± SEM) 0.44 ± 0.10 in the dopexamine group vs 0.65 ± 0.08 in that receiving dopamine (p 〈 0.05). The dopexamine group had a significantly higher oxygen delivery preoperatively (479.5 ± 32.0 ml/min per m2 vs 344.4 ± 23.9 ml/min per m2 for dopamine, p 〈 0.01), but no other significant differences emerged between the groups. Conclusions: Compared to dopamine, dopexamine reduces GIT permeability following surgery involving cardiopulmonary bypass. The mechanism of this effect remains unclear.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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