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  • 1
    Electronic Resource
    Electronic Resource
    Immunologie bei Schwerverletzten (1997)
    Springer
    Der Chirurg 68 (1997), S. 1066-1070 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Traum ; Immunology ; Cytokines ; SIRS ; MOF. ; Schlüsselwörter: Trauma ; Immunologie ; Cyokine ; SIRS ; MOF.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Der klinische Verlauf bei polytraumatisierten Patienten wird durch das häufige Auftreten schwerwiegender immunologischer Komplikationen beeinträchtigt. Die Immunantwort auf schweres Trauma kann durch die vermehrte Freisetzung proinflammatorischer Mediatoren über das „systemic inflammatory response syndrome (SIRS)“ zum Mehrorganversagen [„multisystem organ failure (MOF)“] führen, welches mit einer Letalität von bis zu 80 % behaftet ist. Charakteristisch für die Entwicklung des Multiorganversagens ist das Auftreten des „remote organ failure (ROF)“, eine Fehlfunktion von Organen, die durch das eigentliche Trauma keinen direkten Schaden erlitten haben. Diese Arbeit gibt einen kurzen Überblick über die neueren Entwicklungen auf dem Gebiet der tierexperimentell-immunologischen Traumaforschung und geht eingehend auf den aktuellen Stand der klinisch-immunologischen Traumaforschung ein. Insbesondere wird die Bedeutung der sog. pro- und antiinflammatorischen Cytokine bei der Entstehung von SIRS, MOF und ROF erörtert. Trotz der vielen Fortschritte auf dem Gebiet der klinischen Immunologie und der vielfältigen Informationen über die Trauma-induzierten Immunfunktionsstörungen müssen jedoch noch viele offene Fragen gelöst werden, bevor die immunologischen Veränderungen nach schwerem Trauma durch immunmodulatorische Therapieansätze nachhaltig positiv beeinflußt werden können.
    Notes: Summary. Immunologial complications frequently occur during the clinical course in patients with multiple injuries. The increased release of pro-inflammatory mediators during the immunological response to trauma may lead to the systemic inflammatory response syndrome (SIRS) and furthermore, to multisystem organ failure (MOF), which is associated with a mortality of up to 80%. The development of multiple organ failure following major trauma is associated with remote organ failure, the dysfunction of organs which were not initially affected by the traum. This manuscript reviews recent data in experimental trauma research and offers a more detailed evaluation of the immunological findings in trauma patients. In particular, the role of pro- and anti-inflammatory cytokines in the development or SIRS, MOF and ROF is discussed. Despite the enormous progress in clinical immunology and the available data on trauma-induced immune dysfunction, a large number of questions still remain to be answered before the immunological alterations following severe trauma can be beneficially influenced by immunomodulatory therapeutic efforts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050324
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Effect of hemofiltration on hemodynamics and systemic concentrations of anaphylatoxins and cytokines in human sepsis (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1360-1367 
    Details
    ISSN: 1432-1238
    Keywords: Key words Hemofiltration ; Cytokines ; Anaphylatoxins ; Hemodynamics ; Sepsis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To determine whether hemofiltration (HF) can eliminate cytokines and complement components and alter systemic hemodynamics in patients with severe sepsis. Design: Prospective observation study. Setting: Surgical intensive care unit of a university hospital. Patients: 16 patients with severe sepsis. Interventions: Continuous zero-balanced HF without dialysis (ultrafiltrate rate 2 l/h) was performed in addition to pulmonary artery catheterization, arterial cannulation, and standard intensive care treatment. Measurements and main results: Plasma and ultrafiltrate concentrations of cytokines (the interleukins IL-1β, IL-6, IL-8, and tumor necrosis factor α) and of complement components (C3adesArg, C5adesArg) were measured after starting HF (t0) and 4 h (t4) and 12 h later (t12). Hemodynamic variables including mean arterial pressure (MAP), mean central venous pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, and cardiac output were serially determined. During HF, cytokine plasma concentrations remained constant. However, C3adesArg and C5adesArg plasma concentrations showed a significant decline during 12-h HF (C3adesArg: t0=676.9±99.7 ng/ml vs t12=467.8±71, p〈0.01; C5adesArg: 26.6±4.7 ng/ml vs 17.6±6.2, p〈0.01). HF resulted in a significant increase over time in systemic vascular resistance (SVR) and MAP (SVR at t0: 669±85 dyne·s/cm5 vs SVR at t12: 864±75, p〈0.01; MAP at t0: 69.9±3.5 mmHg vs MAP at t12: 82.2±3.7, p〈0.01). Conclusions: HF effectively eliminated the anaphylatoxins C3adesArg and C5adesArg during sepsis. There was also a significant rise in SVR and MAP during high volume HF. Therefore, HF may represent a new modality for removal of anaphylatoxins and may, thereby, deserve clinical testing in patients with severe sepsis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709552
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Effect of hemofiltration on hemodynamics and systemic concentrations of anaphylatoxins and cytokines in human sepsis (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1360-1367 
    Details
    ISSN: 1432-1238
    Keywords: Hemofiltration ; Cytokines ; Anaphylatoxins ; hemodynamics ; Sepsis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To determine whether hemofiltration (HF) can eliminate cytokines and complement components and alter systemic hemodynamics in patients with severe sepsis. Design Prospective observation study. Setting Surgical intensive care unit of a university hospital. Patients 16 patients with severe sepsis. Interventions Continuous zero-balanced HF without dialysis (ultrafiltrate rate 21/h) was performed in addition to pulmonary artery catheterization, arterial cannulation, and standard intensive care treatment. Measurements and main results Plasma and ultrafiltrate concentrations of cytokines (the interleukins IL-1β, IL-6, IL-8, and tumor necrosis factor α) and of complement components (C3adesArg, C5adesArg) were measured after starting HF (t0) and 4 h (t4) and 12 h later (t12). Hemodynamic variables including mean arterial pressure (MAP), mean central venous pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, and cardiac output were serially determined. During HF, cytokine plasma concentrations remained constant. However, C3adesArg and C5adesArg plasma concentrations showed a significant decline during 12-h HF (C3adesArg: t0=676.9±99.7 ng/ml vs t12=467.8±71,p〈0.01; C5adesArg: 26.6±4.7 ng/ml vs 17.6±6.2,p〈0.01). HF resulted in a significant increase over time in systemic vascular resistance (SVR) and MAP (SVR at t0: 669±85 dyne·s/cm5 vs SVR at t12: 864±75,p〈0.01; MAP at t0: 69.9±3.5 mmHg vs MAP at t12: 82.2±3.7,p〈0.01). Conclusions HF effectively eliminated the anaphylatoxins C3adesArg and C5adesArg during sepsis. There was also a significant rise in SVR and MAP during high volume HF. Therefore, HF may represent a new modality for removal of anaphylatoxins and may, thereby, deserve clinical testing in patients with severe sepsis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709552
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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