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  • 1
    Electronic Resource
    Electronic Resource
    The use of radionuclide techniques in the assessment of alveolar-capillary membrane permeability on the intensive care unit (1990)
    Springer
    Intensive care medicine 16 (1990), S. 363-371 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF01735173
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Blood lactate and mixed venous-arterial PCO2 gradient as indices of poor peripheral perfusion following cardiopulmonary bypass surgry (1991)
    Springer
    Intensive care medicine 17 (1991), S. 320-324 
    Details
    ISSN: 1432-1238
    Keywords: Blood lactate ; Acid base balance ; Cardiopulmonary bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Conventional indices of tissue perfusion after surgery involving cardiopulmonary bypass (CPB) may not accurately reflect disordered cell metabolism. Venous hypercarbia leading to an increased veno-arterial difference in CO2 tensions (V-aCO2 gradient) has been shown to reflect critical reductions in systemic and pulmonary blood flow that occur during cardiorespiratory arrest and septic shock. We therefore measured plasma lactate levels and V-aCO2 gradients in 10 patients (mean age 57.2 years) following CPB and compared them with conventional indices of tissue perfusion. Plasma lactate levels, cardiac index (CI) and oxygen uptake $$(\dot VO_2 )$$ all increased significantly (p〈0.05 vs baseline levels) up to 3h following surgery. Oxygen delivery $$(\dot DO_2 )$$ did not change. Plasma lactate levels correlated significantly with CI (r=0.47,p〈0.01). V-aCO2 fell significantly with time (p〈0.01 vs baseline). There was an inverse relationship between V-aCO2 and cardiac index and V-aCO2 and lactate (r=−0.37,p〈0.05;r=−0.3,p〈0.05 respectively). We conclude that blood lactate, CI and $$\dot VO_2 $$ increase progressively following CPB. An increase in lactate was associated with a decrease in V-aCO2. An increase in V-aCO2 was not therefore associated with evidence of inadequate tissue perfusion as indicated by an increased blood lactate concentration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716189
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Transpulmonary gradient of type III procollagen peptides: Acute effects of cardio-pulmonary bypass (1992)
    Springer
    Intensive care medicine 18 (1992), S. 290-292 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF01706477
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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