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  • 1
    Digitale Medien
    Digitale Medien
    Buchbesprechung (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 1078-1078 
    Details
    ISSN: 1432-1440
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01711921
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  • 2
    Digitale Medien
    Digitale Medien
    Zur Prophylaxe akuter Schleimhauterosionen im Rattenmagen mit Vitamin A (1975)
    Springer
    Research in experimental medicine 165 (1975), S. 199-203 
    Details
    ISSN: 1433-8580
    Schlagwort(e): hypoxic stress ; stressulcer ; Vitamin A protective effect ; Hypoxie-Stress ; Stressulcus ; Vitamin A-Schutzeffekt
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Die protektive Wirkung von Vitamin A gegenüber stressinduzierten Ulcerationen der Magenschleimhaut wurde im Hypoxie-Stress der Ratte untersucht. Die Zahl der akuten Schleimhauterosionen im Hauptmagen der Tiere wurde durch vor oder zu Stressbeginn intramuskulär verabreichte Vitamin A-Gaben von 125 000 – 500 000 E/kg KG signifikant vermindert. Eine geringere Dosierung oder die Verabreichung 2 Stunden nach Stressbeginn beeinflußte die Entstehung von akuten Schleimhauterosionen nicht mehr.
    Notizen: Summary The protective effect of Vitamin A against stress-induced ulcerations of the gastric mucosa was investigated by the hypoxic stress model of the rat. The incidence of acute mucosal erosions in the main stomach was significantly reduced by intramuscular application of 125 000 – 500 000 U Vitamin A/kg body weight prior to or immediately after the onset of stress. A dosage smaller than that or an application 2 hours after the onset of stress had no influence on the development of the acute mucosal erosions.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01971378
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  • 3
    Digitale Medien
    Digitale Medien
    Tumor necrosis factor measurement and use of different anticoagulants: Possible interference in plasma samples and supernatants from endotoxin-stimulated monocytes (1997)
    Springer
    Inflammation research 46 (1997), S. 342-347 
    Details
    ISSN: 1420-908X
    Schlagwort(e): Key words: Anticoagulants — Interleukins — Tumor necrosis factor assay
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Objective and Design: Unfractionated heparin is frequently used as an anticoagulant during blood sampling and in cell culture experiments. In the present study we investigated whether heparin and other anticoagulants (citrate and EDTA) interfered with measurements of plasma tumor necrosis factor alpha (TNFα) concentrations or with TNFα release from endotoxin-stimulated monocytes.¶Material and Methods: TNFα was measured by a WEHI 164 bioassay in the plasma of 16 septic patients anticoagulated with heparin, citrate, or EDTA. Anticoagulants were incubated with the bioassay cell line and cell lysis was monitored. To exclude falsely low TNFα concentrations, anticoagulants were incubated in increasing amounts with human recombinant TNFα/saline solution, and rTNFα recovery was measured either with the WEHI 164 bioassay or an ELISA test. Further, anticoagulants were incubated with monocytes isolated from healthy volunteers and stimulated with endotoxin. Supernatants were analyzed for TNFα with both test systems.¶Results: No biologically active TNFα was detected in the plasma with heparin anticoagulation, whereas with citrate, reproducible, TNFα-induced cytotoxicity was detectable in blood samples of 13 of the 16 patients. Anticoagulation with EDTA resulted in fairly high, variable and poorly reproducible TNFα values. Only EDTA produced falsely high values by unspecific lysis of WEHI cells. Only heparin at a concentration of 20 I.U./ml or more was found to produce falsely low values by interaction with the TNFα bioassay, but also with the ELISA test. In monocyte culture experiments, heparin significantly attenuated the stimulatory effect of endotoxin on TNFα release already at the lowest concentration tested (25 I.U./ml).¶Conclusions: Heparin and EDTA may have significant adverse effects on TNFα measurement when used for blood sampling. Citrate does not interfere with the TNFα bioassay or ELISA, and seems, therefore, to be the anticoagulant of choice. Due to intrinsic interactions with various cell systems (including the WEHI cell and monocytes), one should be careful in using heparin in cell culture studies in which effects of TNFα or of endotoxin are being studied.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s000110050199
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  • 4
    Digitale Medien
    Digitale Medien
    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
    Schlagwort(e): Key words Hemofiltration ; Cytokines ; Anaphylatoxins ; Hemodynamics ; Sepsis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: 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.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01709552
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  • 5
    Digitale Medien
    Digitale Medien
    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
    Schlagwort(e): Hemofiltration ; Cytokines ; Anaphylatoxins ; hemodynamics ; Sepsis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: 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.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01709552
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  • 6
    Digitale Medien
    Digitale Medien
    Incidence and mortality of severe sepsis in surgical intensive care patients: the influence of patient gender on disease process and outcome (2000)
    Springer
    Intensive care medicine 26 (2000), S. 167-172 
    Details
    ISSN: 1432-1238
    Schlagwort(e): Key words Severe sepsis ; Septic shock ; Gender ; Clinical study ; Intensive care therapy ; Mortality
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: Laboratory studies demonstrated significant detrimental effects of male sex-steroids (testosterone) on immune functions following hemorrhagic shock and soft-tissue trauma. Moreover, better survival of female mice subjected to severe sepsis was observed when compared to male animals. The aims of the present study were to evaluate whether or not gender differences regarding incidence and mortality of severe sepsis do exist in surgical intensive care patients and to elucidate the influence of patient age on incidence and mortality of severe sepsis/septic shock.¶Design: Data base review of prospectively collected data from surgical intensive care patients.¶Setting: Surgical intensive care unit of the department of surgery of a university hospital.¶Patients: Prospectively collected data of 4218 intensive care patients (2709 male, 1509 female).¶Results: Significantly fewer female patients were referred to the intensive care unit (6.6 % vs 10.8 % of all patients; P 〈 0.05) leading to a significantly smaller proportion of female intensive care patients (35.8 % vs 64.2 %). No gender differences regarding number of failing organs or surgical procedure (exception vascular surgery) were observed in patients with and without severe sepsis/septic shock, indicating that the patients studied are comparable regarding general health prior to admission to SICU. Among all female patients referred to SICU only 7.6 % developed severe sepsis/septic shock, while 10.4 % of all male patients suffered from severe sepsis or septic shock (P 〈 0.05). This gender difference results from a significantly lower incidence of severe sepsis/septic shock in female patients between 60 and 79 years. No gender difference regarding mortality rates of severe sepsis/septic shock was observed (men 64.9 %, women 65.5 %).¶Conclusions: Our results indicate a significantly smaller number of female patients requiring intensive care as well as a significantly lower incidence of severe sepsis/septic shock in female intensive care patients. Mortality from severe sepsis/septic shock, however, is not affected by gender.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001340050041
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  • 7
    Digitale Medien
    Digitale Medien
    Septic shock and multiple organ failure: Treatment with haemofiltration? (1991)
    Springer
    Intensive care medicine 17 (1991), S. 372-373 
    Details
    ISSN: 1432-1238
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01716201
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  • 8
    Digitale Medien
    Digitale Medien
    303. Mehrfachorganversagen bei polytraumatisierten Patienten (1982)
    Springer
    Langenbeck's archives of surgery 358 (1982), S. 578-578 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Polytrauma ; Multiple organ failure ; Sepsis ; Traumatic shock ; Polytrauma ; Vielfach-Organversagen ; traumatischer Schock ; Sepsis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Eine Analyse von 375 Polytraumatisierten aus 4 Jahren ergab in 8 % ein isoliertes, in 6,7 ein multiples Organversagen. Das IOV betraf überwiegend die Lunge (27/30), beim MOV war grundsätzlich die Lunge der Ausgangsort. Die Letalität stieg mit der Zahl der befallenen Organe: Lunge allein: 37 %, Lunge und Leber 70 %. Ein Vierfach-Organversagen überlebten 2 von 6. Schock und Sepsis waren die prädisponierenden Faktoren. Bei ihrer Verhütung sowie ausreichender frühzeitiger Beatmung muß auch die Prophylaxe ansetzen.
    Notizen: Summary The analysis of 375 polytraumatized patients during 4-year period showed in 8 % a single (SOF) and in 6.7 % a consecutive multiple organ failure (MOF). The SOF concerned the lung in 27 of 30 cases; in MOF the lung was the first organ concerned in all cases, followed by the liver. Mortality rose with the number of organs involved: lung alone 37 %, lung and liver 70 %. A quadruple failure was only survived by 2 of 6. Traumatic shock and sepsis were predisposing factors; their prevention was the main prophylaxis of MOF, together with sufficient and early respirator treatment.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01272049
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  • 9
    Digitale Medien
    Digitale Medien
    252. Vergleichende Untersuchungen von Dopamin und Dobutamin bei chirurgischen Intensivpatienten (1986)
    Springer
    Langenbeck's archives of surgery 369 (1986), S. 780-781 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Dopamine ; Dobutamine ; Hemodynamic changes ; Renal changes ; Dopamin ; Dobutamin ; Haemodynamische Unterschiede ; Renale Unterschiede
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Intraindividuell wurde an 10 Patienten nach Ersatz der infrarenalen Bauchaorta Dopamin I mit 3μg · kg−1 · min−1 und Dopamin II 6 μg · kg−1 min−1 mit Dobutamin I 4 μg · kg−1 · min−1 und Dobutamin II 8 μg · kg−1 · min−1 auf ihre unterschiedliche Beeinflußung der cardialen und renalen Parameter untersucht. Signifikante haemodynamische Unterschiede ergaben sich in der Senkung des rechten Vorhofdrucks und linksventriculären Füllungsdrucks unter Dobutamin II im Vergleich zu einer Steigerung bei Dopamin II. Die Urin- und Natriumausscheidung war in beiden Gruppen bei Dopamin signifikant höher. Beim chirurgischen Intensivpatient ohne kardiale Vorerkrankung genügt zur Kreislaufsteigerung Dopamin.
    Notizen: Summary Following replacement of the infrarenal abdominal aortic segment, ten patients were given dopamine (Dop) and dobutamine (Dob) at two different dosages: Dop I (3 μg · kg−1 · min−1), Dop II (6 pμg · kg−1 · min−1), Dob I (4 μg · kgt−1 · min−1), and Dob II (8 μg · kg−1 · min−1). The changes in hemodynamic and renal parameters were studed in each individual patient. Significant differences were shown only in the reduction of right atrial pressure and left ventricular filling pressure during Dob. II application, compared to an increase which occurred with Dop. II. The output of urine and sodium was significantly higher in both groups after dopamine. In the surgical intensive care patient without cardiac disease, adequate circulation can be obtained with dopamine alone.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01274571
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  • 10
    Digitale Medien
    Digitale Medien
    270. Ursachen und Prognose des respiratorischen Versagens bei chirurgischen Intensivpatienten (1985)
    Springer
    Langenbeck's archives of surgery 366 (1985), S. 675-675 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Respiratory failure ; Prognosis ; Surgical intensive care ; Respiratorisches Versagen ; Ursachen and Prognose ; Chirurgische Intensivpatienten
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung 316 nach allgemeinchirurgischen Eingriffen maschinell beatmete Patienten wurden prospektiv untersucht. Als Ursache des Lungenversagens überwiegt zunächst die postoperative respiratorische Insuffizienz (75% der Patienten), nach der ersten Woche dominieren mit 60% schwere Infektionen, spater die zentral-/schwächebedingte Hypoventilation. 154 Patienten wurden langzeitbeatmet (〉24 h) mit einer Letalität von 25,9%. Prognostisch relevant waren nicht das Patientenalter oder die Beatmungsdauer sondern die Art des operativen Eingriffs, das AusmaB der primären Gasaustauschstörung (PaO2/FiO2) and die Entwicklung einer schweren Infektion wahrend der Beatmung.
    Notizen: Summary Patients who required mechanical ventilation after general surgery (n=316) were studied prospectively. The main cause of primary postoperative respiratory failure was lung dysfunction (75%): after the first week, severe infection was dominant (60%) and, later, hypoventilation caused by central or general weakness. There was a mortality of 25.9% in 154 patients who were under artificial respiration for longer than 24 h. Factors of prognostic relevance were the type of operative procedure, the extent of primary lung dysfunction (PaO2/FiO2) and the development of severe infection during mechanical ventilation.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01836868
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