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  • 1995-1999  (6)
  • 1996  (6)
  • Platelet function  (4)
  • Coagulation  (2)
  • Endothelium  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Influence of different volume therapies on platelet function in the critically ill (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1075-1081 
    Details
    ISSN: 1432-1238
    Keywords: Key words Critically ill ; Sepsis ; Trauma ; Volume therapy ; Platelet function ; Aggregometry ; Hydroxyethyl starch solution ; Albumin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Both albumin and synthetic colloids such as hydroxyethyl starch (HES) solution are used to optimize hemodynamics in the critically ill. The influence of different long-term infusion regimes on platelet function was studied. Design: Prospective, randomized study. Setting: Clinical investigation on a university hospital surgical intensive care unit. Patients: Twenty-eight consecutive trauma patients (injury severity score〉15 points) and 28 consecutive nontraumatized surgical patients with sepsis. Interventions: The patients received either 20% human albumin (HA trauma, n=14; HA sepsis, n=14) or 10% low-molecular-weight HES solution HES 200/0.5 (HES trauma, n=14; HES sepsis; n=14) for 5 days to maintain central venous pressure and/or pulmonary capillary wedge pressure between 12 and 16 mmHg. Measurements and results: Platelet function was assessed by aggregometry (=turbidimetric technique) using adenosine diphosphate 2.0 μmol/l, collagen 4 μl/ml, and epinephrine 25 μmol/l as inductors. Arterial blood was sampled on the day of admission or the day of diagnosis of sepsis (=baseline value) and over the next 5 days. Standard coagulation parameters (antithrombin III, fibrinogen, partial thromboplastin time) were also measured. Total use of HES by the 5th day totalled 4870±990 ml in the trauma and 3260±790 ml in the sepsis patients (HA trauma: 1850±380 ml; HA sepsis: 1790±400 ml). Maximum platelet aggregation decreased significantly during the first 2–3 days after baseline in all groups. At the end of the investigation period, platelet aggregation variables had recovered and reached (or even exceeded) baseline values. Within the entire investigation period, the course of platelet aggregation variables did not differ significantly between HA and HES-treated patients irrespective of whether they were trauma or sepsis patients. Conclusions: Alterations in hemostasis may occur for several reasons in the critically ill. Human albumin is the preferred first-line volume therapy in patients at risk for coagulation disorders. With respect to platelet function, volume replacement with (lower-priced) low-molecular-weight HES solutions can be recommended in this situation without any risk.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01699231
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Influence of different volume therapies on platelet function in the critically ill (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1075-1081 
    Details
    ISSN: 1432-1238
    Keywords: Critically ill ; Sepsis ; Trauma ; Volume therapy ; Platelet function ; Aggregometry ; Hydroxyethyl starch solution ; Albumin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Both albumin and synthetic colloids such as hydroxyethyl starch (HES) solution are used to optimize hemodynamics in the critically ill. The influence of different long-term infusion regimes on platelet function was studied. Design Prospective, randomized study. Setting Clinical investigation on a university hospital surgical intensive care unit. Patients Twenty-eight consecutive trauma patients (injury severity score〉15 points) and 28 consecutive nontraumatized surgical patients with sepsis. Interventions The patients received either 20% human albumin (HA trauma,n=14; HA sepsis,n=14) or 10% low-molecular-weight HES solution HES 200/0.5 (HES trauma,n=14; HES sepsis;n=14) for 5 days to maintain central venous pressure and/or pulmonary capillary wedge pressure between 12 and 16 mmHg. Measurements and results Platelet function was assessed by aggregometry (=turbidimetric technique) using adenosine diphosphate 2.0 μmol/l, collagen 4 μl/ml, and epinephrine 25 μmol/l as inductors. Arterial blood was sampled on the day of admission or the day of diagnosis of sepsis (=baseline value) and over the next 5 days. Standard coagulation parameters (antithrombin III, fibrinogen, partial thromboplastin time) were also measured. Total use of HES by the 5th day totalled 4870±990 ml in the trauma and 3260±790 ml in the sepsis patients (HA trauma: 1850±380 ml; HA sepsis: 1790±400 ml). Maximum platelet aggregation decreased significantly during the first 2–3 days after baseline in all groups. At the end of the investigation period, platelet aggregation variables had recovered and reached (or even exceeded) baseline values. Within the entire investigation period, the course of platelet aggregation variables did not differ significantly between HA and HES-treated patients irrespective of whether they were trauma or sepsis patients. Conclusions Alterations in hemostasis may occur for several reasons in the critically ill. Human albumin is the preferred first-line volume therapy in patients at risk for coagulation disorders. With respect to platelet function, volume replacement with (lower-priced) low-molecular-weight HES solutions can be recommended in this situation without any risk.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01699231
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    The effects of pentoxifylline on circulating adhesion molecules in critically ill patients with acute renal failure treated by continuous veno-venous hemofiltration (1996)
    Springer
    Intensive care medicine 22 (1996), S. 305-311 
    Details
    ISSN: 1432-1238
    Keywords: Key words Continuous hemofiltration ; Renal failure ; Inflammatory response ; Soluble adhesion molecules ; Endothelial leukocyte adhesion molecules [sELAM-1] ; Vascular cell adhesion molecule-1 [sVCAM-1] ; Intercellular adhesion molecule-1 [sICAM-1] ; Granule membrane protein 140 [sGMP-140] ; Neutrophils ; Endothelium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Circulating adhesion molecules appear to be excellent markers of endothelial activation in critically ill patients. Pentoxifylline (PTX) may limit sequelae of inflammation and subsequent endothelial activation by various mechanisms. The influence of PTX on the plasma levels of soluble adhesion molecules in critically ill patients undergoing continuous veno-venous hemofiltration (CVVH) was studied. Design: Prospective, randomized, blinded study. Setting: Clinical investigation in the surgical intensive care unit of a university hospital. Patients and participants: Fourteen consecutive patients suffering from acute renal failure (ARF) with postoperative complications who received continuous pentoxifylline (CVVH-PTX) i.v. were compared with 14 patients with ARF who did not receive PTX (CVVH control group). Interventions: Pump-driven CVVH was carried out with a blood flow ranging from 120 to 150 ml/min. All patients received fentanyl and midazolam continuously and were on mechanical ventilation. PTX (300 mg) was given as a loading dose, followed by continuous infusion of 1.2 mg/kg per h for the next 5 days. Measurements and results: From arterial blood samples, plasma levels of soluble adhesion molecules (endothelial leukocyte adhesion molecules [sELAM-1], and intercellular adhesion molecule-1 [sICAM-1], vascular cell adhesion molecule-1 [sVCAM-1], and P-selectin granule membrane protein [sGMP-140] were measured using enzyme-linked immuno-sorbent assays (ELISA). Measurements were carried out before the start of CVVH to establish baseline values and continued during the next 5 days. Main results: Eleven of the CVVH-PTX patients and 8 of the CVVH control patients survived during the investigation period. In the CVVH-PTX patients 2.4±0.3 g/day of PTX was given. At baseline, plasma levels of sELAM-1, sICAM-1, and sVCAM-1 were markedly higher than normal in both groups. In the CVVH control patients, all measured soluble adhesion molecules increased further during the study period (sELAM-1 from 90±22 to 134±30 ng/ml; sICAM-1 from 958±173 to 1460±209 ng/ml; sVCAM-1 from 1100±188 to 1804 ng/ml; sGM-140 from 499±102 to 688±121 ng/ml) (p〈0.05), whereas in the PTX-treated CVVH patients, plasma levels of all soluble adhesion molecules remained almost unchanged. The PaO2/FIO2 increased in the PTX-treated patients (from 209±67 to 282±58 mmHg) and remained almost unchanged in the CVVH control patients. Conclusion: Leukocyte/endothelial interactions play an important role in the inflammatory process. Circulating adhesion molecules may serve as markers of the extent of inflammation. Continuous i.v. administration of PTX was successful in blunting the increase of soluble adhesion molecules in critically ill patients undergoing CVVH. Whether these effects result from improved circulation at the microcirculatory level or from (direct or indirect) beneficial effects on endothelial cells warrants further controlled studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700451
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Does long-term continuous administration of pentoxifylline affect platelet function in the critically ill patient? (1996)
    Springer
    Intensive care medicine 22 (1996), S. 644-650 
    Details
    ISSN: 1432-1238
    Keywords: Key words Pentoxifylline ; Critically ill ; Sepsis ; Trauma ; Inflammation ; Coagulation ; Platelet function ; Aggregometry ; Collagen ; Epinephrine ; Adenosine diphosphate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: The methylxanthine derivative pentoxifylline (PTX) is one of those promising substances which are under current investigation to modify or limit inflammatory response. Antiaggregation activity has also been described that may contribute to the beneficial effects of this substance. Long-term effects on platelet function have not been elucidated yet. Design: Prospective, randomized study. Setting: Clinical investigation on a surgical intensive care unit of a university hospital. Patients: 26 trauma patients and 26 patients suffering from sepsis secondary to major operations were consecutively studied. Interventions: The patients prospectively received either 1.5 mg/kg per h pentoxifylline continuously for 5 days (after a loading dose of 600 mg) (trauma-PTX, n=13; sepsis-PTX, n=13) or saline solution as placebo (trauma-control; n=13; sepsis-control, n=13). Measurements: On the day of admission (trauma patients) or day of the diagnosis of sepsis and at 12:00 p.m. during the next 5 days, platelet aggregation induced by adenosine diphosphate (ADP 2.0 μmol/l), collagen (4 μl/ml), and epinephrine (25 μmol/l) was determined by a turbidimetric method from arterial blood samples. Standard coagulation screen was also monitored. Main results: In untreated trauma and sepsis patients, maximum platelet aggregation induced by all three agonists decreased during the first few days after inclusion in the study [trauma: ADP–17.1±8.0 rel% (% change from baseline); sepsis: ADP –26.1±5.6 rel%]. In due course, maximum platelet aggregation recovered, reaching the baseline value or even exceeding it (trauma patients). In the PTX-treated patients, platelet aggregation was significantly less impaired (sepsis group: ADP –4.4±3.3 rel%) or even increased beyond baseline values in the first few days of the study (trauma group: ADP 16.1±8.0 rel%). Fibrinogen plasma levels were lower in the non-treated control groups (p〈0.05) than in the PTX groups. Conclusions: Continuous infusion of PTX for 5 days did not impair platelet function in critically ill patients. In both trauma and sepsis patients, the usual deterioration in platelet function was even attenuated, which may be due to the effects of PTX on cytokine release (e.g., reduction in tumor necrosis factor and interleukin-1), improvement in microcirculation, or additional fibrinolytic effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709740
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Does long-term continous administration of pentoxifylline affect platelet function in the critically ill patient? (1996)
    Springer
    Intensive care medicine 22 (1996), S. 644-650 
    Details
    ISSN: 1432-1238
    Keywords: Pentoxifylline ; Critically ill ; Sepsis ; Trauma ; Inflammation ; Coagulation ; Platelet function ; Aggregometry ; Collagen ; Epinephrine ; Adenosine diphosphate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective The methylxanthine derivative pentoxifylline (PTX) is one of those promising substances which are under current investigation to modify or limit inflammatory response. Antiaggregation activity has also been described that may contribute to the beneficial effects of this substance. Long-term effects on platelet function have not been elucidated yet. Design Prospective, randomized study. Setting Clinical investigation on a surgical intensive care unit of a university hospital. Patients 26 trauma patients and 26 patients suffering from sepsis secondary to major operations were consecutively studied. Interventions The patients prospectively received either 1.5 mg/kg per h pentoxifylline continuously for 5 days (after a loading dose of 600 mg) (trauma-PTX,n=13; sepsis-PTX,n=13) or saline solution as placebo (trauma-control;n=13; sepsis-control,n=13). Measurements On the day of admission (trauma patients) or day of the diagnosis of sepsis and at 12:00 p.m. during the next 5 days, platelet aggregation induced by adenosine diphosphate (ADP 2.0 μmol/l), collagen (4 μl/ml), and epinephrine (25 μmol/l) was determined by a turbidimetric method from arterial blood samples. Standard coagulation screen was also monitored. Main results In untreated trauma and sepsis patients, maximum platelet aggregation induced by all three agonists decreased during the first few days after inclusion in the study [trauma: ADP −17.1±8.0 rel% (% change from baseline); sepsis: ADP −26.1±5.6 rel%]. In due course, maximum platelet aggregation recovered, reaching the baseline value or even exceeding it (trauma patients). In the PTX-treated patients, platelet aggregation was significantly less impaired (sepsis group: ADP −4.4±3.3 rel%) or even increased beyond baseline values in the first few days of the study (trauma group: ADP 16.1±8.0 rel%). Fibrinogen plasma levels were lower in the non-treated control groups (p〈0.05) than in the PTX groups. Conclusions Continuous infusion of PTX for 5 days did not impair platelet function in critically ill patients. In both trauma and sepsis patients, the usual deterioration in platelet function was even attenuated, which may be due to the effects of PTX on cytokine release (e.g., reduction in tumor necrosis factor and interleukin-1), improvement in microcirculation, or additional fibrinolytic effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709740
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    The effects of pentoxifylline on circulating adhesion molecules in critically ill patients with acute renal failure treated by continuous veno-venous hemofiltration (1996)
    Springer
    Intensive care medicine 22 (1996), S. 305-311 
    Details
    ISSN: 1432-1238
    Keywords: Continuous hemofiltration ; Renal failure Inflammatory response ; Soluble adhesion molecules ; Endothelial leukocyte adhesion molecules [sELAM-1] ; Vascular cell adhesion molecule-1 [sVCAM-1] ; Intercellular adhesion molecule-1 [sICAM-1] ; Granule membrane protein 140 [sGMP-140] ; Neutrophils ; Endothelium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Circulating adhesion molecules appear to be excellent markers of endothelial activation in critically ill patients. Pentoxifylline (PTX) may limit sequelae of inflammation and subsequent endothelial activation by various mechanisms. The influence of PTX on the plasma levels of soluble adhesion molecules in critically ill patients undergoing continuous veno-venous hemofiltration (CVVH) was studied. Design Prospective, randomized, blinded study. Setting Clinical investigation in the surgical intensive care unit of a university hospital. Patients and participants Fourteen consecutive patients suffering from acute renal failure (ARF) with postoperative complications who received continuous pentoxifylline (CVVH-PTX) i.v. were compared with 14 patients with ARF who did not receive PTX (CVVH control group). Interventions Pump-driven CVVH was carried out with a blood flow ranging from 120 to 150 ml/min. All patients received fentanyl and midazolam continuously and were on mechanical ventilation. PTX (300 mg) was given as a loading dose, followed by continuous infusion of 1.2 mg/kg per h for the next 5 days. Measurements and results From arterial blood samples, plasma levels of soluble adhesion molecules (endothelial leukocyte adhesion molecules [sELAM-1], and intercellular adhesion molecule-1 [sICAM-1], vascular cell adhesion molecule-1 [sVCAM-1], and P-selectin granule membrane protein [sGMP-140] were measured using enzyme-linked immuno-sorbent assays (ELISA). Measurements were carried out before the start of CVVH to establish baseline values and continued during the next 5 days. Main results Eleven of the CVVH-PTX patients and 8 of the CVVH control patients survived during the investigation period. In the CVVH-PTX patients 2.4±0.3 g/day of PTX was given. At baseline, plasma levels of sELAM-1, sICAM-1, and sVCAM-1 were markedly higher than normal in both groups. In the CVVH control patients, all measured soluble adhesion molecules increased further during the study period (sELAM-1 from 90±22 to 134±30 ng/ml; sICAM-1 from 958±173 to 1460±209 ng/ml; sVCAM-1 from 1100±188 to 1804 ng/ml; sGM-140 from 499±102 to 688±121 ng/ml) (p〈0.05), whereas in the PTX-treated CVVH patients, plasma levels of all soluble adhesion molecules remained almost unchanged. The PaO2/FIO2 increased in the PTX-treated patients (from 209±67 to 282±58 mmHg) and remained almost unchanged in the CVVH control patients. Conclusion Leukocyte/endothelial interactions play an important role in the inflammatory process. Circulating adhesion molecules may serve as markers of the extent of inflammation. Continuous i.v. administration of PTX was successful in blunting the increase of soluble adhesion molecules in critically ill patients undergoing CVVH. Whether these effects result from improved circulation at the microcirculatory level or from (direct or indirect) beneficial effects on endothelial cells warrants further controlled studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700451
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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