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  • Cardio-pulmonary bypass  (1)
  • Iron overload  (1)
  • Lung injury  (1)
  • Procollagen peptides  (1)
  • 1
    ISSN: 1432-1238
    Keywords: Intensive care ; Radionuclides ; Lung injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Septicaemia ; Bleomycin-detectable iron ; Non-haem iron ; Iron overload
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To assess plasma iron status in critically ill patients with septic shock. Design: Observational, prospective study. Setting: Adult intensive care units in teaching and tertiary referral hospitals. Patients and participants: Fifteen adult patients with established septic shock. Normal control subjects (n = 10) were also investigated. Data from patients and controls were compared with previously published iron values in critical care patients. Measurements and results: The indices investigated and correlated with clinical scores of illness severity included bleomycin-detectable iron, non-haem iron; transferrin and its percentage iron saturation, and the iron binding (anti-oxidant) activity of transferrin. Bleomycin-detectable iron was not present in the plasma of patients with septic shock whilst the plasma transferrin remained unsaturated with iron. One patient in multi-organ failure displayed bleomycin-detectable iron in plasma (1.16 μmol/l) and had 100 % iron-saturation of transferrin. The plasma non-haem iron levels (7.84 ± 1.82 μmol/l) were the lowest of all critical care patient groups studied by us. The plasma transferrin levels were also low but resulted in a near normal percentage saturation of transferrin with iron (34.6 ± 6.5 %). The scores of clinical severity correlated with changes in plasma iron chemistry. Conclusions: Patients with septic shock rarely have iron saturated transferrin in their plasma leading to the presence of bleomycin-detectable iron.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 18 (1992), S. 290-292 
    ISSN: 1432-1238
    Keywords: Procollagen peptides ; Cardiopulmonary bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Type III procollagen N-peptides (PIIINPs) are believed to be released in stoichiometric amounts as type III collagen molecules are secreted from cells. We hypothesized that if the human lung actively produces type III collagen a detectable transpulmonary gradient in PIIINPs would exist in normal individuals that might be altered following a pulmonary insult. PIIINPs were therefore measured by radioimmunoassay in serum taken simultaneously from the pulmonary artery (PA) and left ventricle/aorta (LV) in 11 patients undergoing routine cardiac catheterisation. Mean PIIINP levels±SEM in LV were 66.8±5.4 μg·ml−1 and 59.9±4.1 μg·ml−1 in PA (p〈0.04). In 6 patients, repeat measurements taken 4 h after cardiopulmonary bypass revealed a significant fall in PA values to 43.8±2.6 μg·ml−1 (p〈0.001) and abolition of the transpulmonary gradient. These results suggest the adult human lung actively synthesis type III collagen and that, in the short term, cardiopulmonary bypass inhibits this process.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 19 (1993), S. 290-293 
    ISSN: 1432-1238
    Keywords: Acute renal failure ; Cardio-pulmonary bypass ; Haemofiltration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
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