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  • 1
    Electronic Resource
    Electronic Resource
    Global tissue oxygenation during normovolaemic haemodilution in young children (1997)
    Oxford, UK : Blackwell Science Ltd
    Pediatric anesthesia 7 (1997), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sixteen patients (1–8 years) scheduled for major general surgery were chosen for the study. They were divided into two groups according to the replacement solution used for haemodilution (HD); whether 6% middle molecular weight hydroxyethyl starch (HES) or 6% dextran 60 (DEX). After induction of general anaesthesia and pulmonary artery catheterization, a precalculated amount of autologous blood was withdrawn while the patient's autologous blood was simultaneously replaced by either HES or DEX. Autologous blood was retransfused at a minimum haematocrit (Hct.) of 17% or at the end of surgery. The following parameters were measured and/or calculated before and after HD, every 20 min intraoperatively and hourly for 6 h postoperatively: heart rate (HR), mean arterial pressure (MAP), Cardiac index (CI), Hct., arterial and mixed venous oxygen content (CaO2, CvO2) and arterio-venous difference of oxygen content (avDO2), oxygen delivery index (DO2I), oxygen consumption index (VO2I). The cardiovascular system remained stable. There was no significant difference as regards SvO2, despite a significant decrease in CaO2 to 10.8 and 10.0 ml·dl−1 (median values) due to reduction of haemoglobin concentration in the HES and DEX groups respectively. In spite of the low hct. values during surgery DO2I remained in normal range (median value 602 and 710 ml·min−1·m−2) in HEX and DEX group respectively. There was no significant change in VO2I after haemodilution (median value 212 and 243 ml.min−1·m−2) in either group. No statistically significant difference was noticed between either groups regarding: CaO2, CvO2, DO2I, VO2I, and no side effects of the colloids were observed. Isovolaemic haemodilution (Hct. approx;17%) is well tolerated by young children undergoing major elective surgery; global tissue oxygenation was preserved throughout the procedure and both solutions used for haemodilution were equally effective.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.1997.d01-69.x
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  • 2
    Electronic Resource
    Electronic Resource
    Cigarette smoke elicits leukocyte adhesion to endothelium in hamsters: Inhibition by CuZn-SOD
    Amsterdam : Elsevier
    Free Radical Biology and Medicine 14 (1993), S. 573-581 
    Details
    ISSN: 0891-5849
    Keywords: Animal model ; Cigarette smoke ; Free radicals ; Hamster ; Intravital microscopy ; Leukocyte/endothelium interaction ; Microcirculation ; Superoxide dismutase ; Tobacco
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0891-5849(93)90138-K
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  • 3
    Electronic Resource
    Electronic Resource
    Open chest and open pericardium affect the distribution of myocardial blood flow in the right ventricle (1990)
    Springer
    Basic research in cardiology 85 (1990), S. 508-518 
    Details
    ISSN: 1435-1803
    Keywords: myocardialblood flow ; rightventricle ; pericardium ; microspheres ; dog
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have investigated the effects of open chest and open pericardium on the distribution of myocardial blood flow assessed with the radioactive microsphere technique (15 μm). Five dogs with intact thorax served as controls (group I) and six dogs were studied after a right-sided thoracotomy and pericardiotomy (group II). Global myocardial blood flow (mean±S.D.) was 0.73±0.17 ml·min−1·g−1 in group I and 1.22±0.09 ml·min−1·g−1 in group II (p〈0.05). Analysis of transmural blood flow distribution revealed that flow was 44% higher in the right and 60% higher in the left ventricular endocardial layers in the open-chest animals, whereas epicardial flow increased by 105% and 90%, respectively. As a result of the preferential blood flow to the epicardial layers of the right ventricle, the endo/epi ratio was reduced from 1.30±0.26 in group I to 0.86±0.11 in the open-chest group (p〈0.05). Left ventricular endo/epi ratio was 1.27±0.16 and 1.06±0.11 (n.s.), respectively. External work and diastolic filling pressure of the right ventricle did not differ between the two groups and therefore cannot account for the redistribution of myocardial blood flow. It is concluded that the distribution of myocardial blood flow, particularly in the RV, is severely disturbed by thoracotomy and pericardiotomy. This is an important aspect for the planning and evaluation of studies under open-chest/open-pericardium conditions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01931496
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  • 4
    Electronic Resource
    Electronic Resource
    Initiale Durchblutungsreaktionen abdomineller Organe im Endotoxinschock (1966)
    Springer
    Langenbeck's archives of surgery 316 (1966), S. 659-664 
    Details
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02433698
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  • 5
    Electronic Resource
    Electronic Resource
    Die Beeinflußbarkeit der Darmdurchblutung durch hyperosmolare Lösungen (1968)
    Springer
    Langenbeck's archives of surgery 322 (1968), S. 1186-1191 
    Details
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Nach Infusion hyperosmolarer Lösungen fand sich beim Hund ein markanter Anstieg der Mesenterialdurchblutung und des Herz-Zeitvolumens. Die stärkste Durchblutungssteigerung wurde sowohl bei normaler als auch bei reduzierter Mesenterialdurchblutung (Hämorrhagie, Vasopressin und PLV2-Injektion) nach Infusion der hyperonkotisch-hypertonischen Lösung von 10% niedermolekularem Dextran und 20% Sorbit beobachtet. Diese Lösungen sind zur Behandlung der postoperativen Darmatonie bei Patienten geeignet.
    Notes: Summary A marked increase of mesenteric blood flow and cardiac output was observed after intravenous administration of hyperosmolar solutions. The optimal effect in normal as well as in reduced mesenteric blood flow (after hemorrhage or injection of pitressin and PLV2) was obtained after infusion of a hyperoncotic-hypertonic solution of 10% low molecular weight dextran and 20% sorbitol. This solution was found effective in the treatment of postoperative intestinal atonia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02454026
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  • 6
    Electronic Resource
    Electronic Resource
    Experimentelle Chirurgie und klinisch-experimentelle Untersuchungen zum Noteingriff (1970)
    Springer
    Langenbeck's archives of surgery 327 (1970), S. 999-1002 
    Details
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01259179
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  • 7
    Electronic Resource
    Electronic Resource
    121. Kreislauf vor Noteingriffen (1970)
    Springer
    Langenbeck's archives of surgery 327 (1970), S. 1017-1022 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF01259184
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  • 8
    Electronic Resource
    Electronic Resource
    20. Hämodynamik des Schocks (1974)
    Springer
    Langenbeck's archives of surgery 337 (1974), S. 157-164 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF01278652
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  • 9
    Electronic Resource
    Electronic Resource
    194. Hämodilution (1978)
    Springer
    Langenbeck's archives of surgery 347 (1978), S. 677-678 
    Details
    ISSN: 1435-2451
    Keywords: Surgery elective ; Autologous blood ; Blood, saving ; Transfusion, risks ; Elektive Chirurgic ; autologes Blut ; Einsparung ; Transfusionsrisiken
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Hämodilution (HD) wird durch Blutentzug und simultanen isovolämischen Ersatz durch langwirksame Kolloide induziert. Bei intraoperativem Blutverlust sind als Folge der HD die Erythrocytenverluste geringer. Das entzogene, autologe Blut wird während oder am Ende des chirurgischen Eingriffes retransfundiert. Hauptziel der präoperativen HD ist, den irreversiblen Verlust von Erythrocyten möglichst gering zu halten. Durch these Methode kann in der elektiven Chirurgie bei zahlreichen Patienten auf die Transfusion von Spenderblut verzichtet werden. Der Film demonstriert die physiologischen Mechanismen, welche die Adaption an den reduzierten Hämatokrit erlauben; die Indikationen, Kontraindikationen und Vorteile dieses Alternativverfahrens zur Bluttransfusion werden dargestellt.
    Notes: Summary Gradual removal and simultaneous replacement of blood with equal volumes of long-lasting colloids result in hemodilution. Consequently blood lost during operation contains fewer red cells. The autologous blood removed is retransfused in reverse order during and after surgery. The principal aim of preoperative hemodilution is to keep the irreversible loss of autologous red cells down to the lowest possible level. By this method, the transfusion of donor blood can be avoided in numerous patients undergoing elective surgery. The film illustrates the physiologic mechanisms that permit adaptation to the intentional reduction in hematocrit and outlines the indications, contraindications, and advantages of this principle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01579487
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  • 10
    Electronic Resource
    Electronic Resource
    Problems of massive blood transfusions patient adapted measures? (1978)
    Springer
    Langenbeck's archives of surgery 346 (1978), S. 1-9 
    Details
    ISSN: 1435-2451
    Keywords: Blood transfusion ; Blood storage ; Autotransfusion ; Blood filter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01261765
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