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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 327 (1970), S. 999-1002 
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 327 (1970), S. 1017-1022 
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Kreislaufparameter Pulsfrequenz und arterieller Blutdruck (Quotient = Schockindex) ermöglichen, zusammen mit der Bestimmung des zentralen Venendruckes, durch Hypovolämie bedingte Formen der Kreislaufinsuffizienz zu erfassen. Die Blutvolumenbestimmung mittels Isotopenverdünnungsverfahren ist zeitraubend und bei bestehender relativer bzw. absoluter Hypovolämie von beschränkter Aussagekraft. Jede Kreislaufinsuffizienz führt zu pathologischen Veränderungen der Blutrheologie. Beim präoperativen Volumenersatz sollte dabei durch Anwendung erythrocytenfreier Lösung jede weitere Beeinträchtigung der Fließeigenschaften des Blutes vermieden werden.
    Notes: Summary The circulation parameters, pulse rate and arterial blood pressure (quotient = shock index), together with the determination of central venous pressure, allow to recognise forms of circulatory insufficiency due to hypovolaemia. Blood volume estimation by the isotope dilution method is time-consuming and of limited value in the presence of relative or absolute hypovolaemia. Any circulatory insufficiency leads to pathological changes in blood rheology. In preoperative volume replacement, therefore, any further impairment of the blood's rheological properties should be avoided by the use of a solution free of erythrocytes.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 337 (1974), S. 157-164 
    ISSN: 1435-2451
    Keywords: Sympatho-Adrenergic Reaction ; Microcirculation ; Hemodilution ; Sympathico-adrenerge Reaktion ; Mikrozirkulation ; Hemodilution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Volumenverlust und Trauma lösen eine Stimulation des sympathischen Systems aus, welche zur Constriction prd- und postcapilldrer Gefäßabschnitte der adrenerginnervierten Organe führt. Die hieraus resultierende Verminderung der Strömungsgeschwindigkeit bewirkt einen steilen Anstieg der Blutviscositdt, vor allem im Bereich der postcapillären Venolen. Vasoconstriction und gestörtes EigenflieBverhalten des Blutes führen zur Dissoziation der Capillardurchströmung und damit zu einer inadäquaten Versorgung des Gewebes. Als Folge von Gewebshypoxie und -acidose resultieren transcapilläre Flüssigkeitsverluste, wodurch die Mikrozirkulationsstörung noch weiter verstärkt wird. Der erste Schritt der kausalen Schocktherapie mull in der i.v. Infusion von Kolloidlösungen bestehen, wodurch die Fließeigenschaften des Blutes verbessert, die Volumenverluste ausgeglichen und die sympathische Stimulation unterbrochen werden können.
    Notes: Summary Hypovolemia and trauma are associated with increased autonomic nervous activity and thus with vasoconstriction in splanchnic organs, kidney and skin. Due to low flow and viscosity changes of the blood, the microcirculatory flow becomes unevenly distributed while transcapillary transport is reduced, resulting in tissue hypoxia, hidden acidosis and increased fluid loss. The re-distribution of macro. and microcirculatory flow can be treated successfully with initial volume replacement with colloidal solutions.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 157 (1972), S. 267-269 
    ISSN: 1433-8580
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 157 (1972), S. 174-176 
    ISSN: 1433-8580
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1433-8580
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 267 (1970), S. 433-445 
    ISSN: 1432-1912
    Keywords: Gelatine ; Dextran 60 ; Hypotension ; Histamine Release
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a series of 133 dogs, 10–20 ml/kg arterial blood were removed and replaced by rapid intravenous infusion of an equivalent volume of various plasma substitutes. Following the infusion of gelatine solutions, an acute fall in arterial blood pressure was observed, but not following the infusion of equal quantities of Dextran 60 or of 0.9% NaCl solution. Measurement of the blood histamine levels as well as the fact that the circulatory effects could be modified by the previous administration of anti-histaminic drugs indicate that the hypotension observed following the rapid infusion of gelatine solutions is due to the release of histamine. Since histamine liberation has also been shown in preliminary studies in man, rapid infusions of gelatine solutions should be avoided in clinical practice, or patients receiving them should be pre-treated with anti-histaminic drugs.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 157 (1972), S. 269-271 
    ISSN: 1433-8580
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 159 (1973), S. 141-151 
    ISSN: 1433-8580
    Keywords: Uptake ; Reproducible state of shock ; Reservoir technique ; Mortality rate ; Uptake ; Reproduzierbares Schockstadium ; Reservoirtechnik ; Mortalitätsrate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 60 mischrassige Hunde wurden in Pentobarbitalnarkose bis zu einem arteriellen Mitteldruck von 40 mm Hg entblutet. Mittels Reservoirtechnik wurde dieser Druck während 3 Std konstant gehalten; anschließend erfolgte die Reinfusion des Reservoirblutes. Die extrem differierenden blutchemischen Parameter ließen erkennen, daß trotz identischer Versuchsbedingungen bei den Tieren kein vergleichbares Schockstadium erzielt worden war. Homogene Kollektive mit signifikant unterschiedlichen Schockstadien ergaben sich dagegen, nachdem die Tiere auf Grund ihres uptake-Volumens (9, 23, 41% des maximalen Reservoirvolumens) gruppiert wurden. Die Größe des uptake korreliert in diesen Gruppen direkt mit der Mortalitätsrate. Das uptake-Volumen spiegelt die individuelle sympathico-adrenerge Reaktivität bzw. das Ausmaß der schockbedingten Gewebsveränderungen wider.
    Notes: Summary 60 mongrel dogs anaesthetized with pentobarbital have been subjected to arterial bleeding until mean arterial pressure reached 40 mm Hg; this value was maintained by means of the reservoir technique over a 3 hrs period, after which the reservoir volume has been reinfused. Extreme variation of electrolyte, acid base and enzyme changes observed after the hypotensive period in arterial blood indicate that comparable degrees of shock have not been achieved inspite identical experimental procedure. Homogenous and significantly different groups of animals at the end of the hypotensive period, however, resulted from grouping the animals according to their uptake volume (9, 23, 41% of maximum reservoir volume). The uptake volume correlates directly to the mortality rate. The magnitude of uptake reflects the individually different sympatho-adrenergic reactivity, the degree of shock induced tissue damage respectively.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1433-8580
    Keywords: Hemorrhagic shock ; Hemodilution ; Hemorheology ; Microcirculation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The keyproblem of hemorrhagic shock consists in decreased tissue nutrition and tissue drainage from metabolites with subsequent hypoxic cellular damage. In two groups of 50 dogs the effect of whole blood (n = 30) versus hemodilution with dextran-60 (n = 20) was evaluated from central hemodynamics, capillary blood flow and transcapillary exchange from tissue to blood in skeletal muscle by use of a double isotope technique. Following a period of hemorrhagic hypotension either all the shed blood or dextran-60 were infused. Hemodilution with dextran produced a decrease in hematocrit to 20%, lowered effeciently blood viscosity and TPR and increased cardiac output to 160% of control. Capillary blood flow and exchange were nearly doubled as compared to the control level. Retransfusion of blood caused only transient normalization with rapid deterioration in central and peripheral hemodynamics, together with an increase in blood viscosity. The viscosity depressant effect of hemodilution is discussed as key factor causing the better immediate response to dextran infusion in hemorrhagic shock.
    Type of Medium: Electronic Resource
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