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  • 1
    Electronic Resource
    Electronic Resource
    A new side effect of inhaled nitric oxide in neonates and infants with pulmonary hypertension: functional impairment of the neutrophil respiratory burst (1996)
    Springer
    Intensive care medicine 22 (1996), S. 252-258 
    Details
    ISSN: 1432-1238
    Keywords: Key words Inhaled nitric oxide ; Pulmonary hypertension ; Respiratory burst of neutrophils
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Introduction: Inhaled nitric oxide (NO) may be beneficial in the treatment of pulmonary hypertension, both of the newborn and in the adult respiratory distress syndrome. Up to now, serious systemic side effects have not been reported. Objective: The effect of inhaled NO on superoxide anion production by neutrophils. Design: Prospective study of a consecutive series of 15 neonates and infants. Setting: Neonatal and paediatric ICUs with a total of 17 beds (university hospital). Measurements and results: Superoxide anion production was determined by a flow cytometric method using dihydrorhodamine 123 (DHR) as an oxidative probe after the priming of neutrophils with N-formyl-methionyl-leucyl-phenylalanine (fMLP) or with Escherichia coli. The generated fluorescence was expressed as relative fluorescence intensity (RFI). Inhalation of NO for more than 24 h reduced the superoxide anion production by neutrophils stimulated with E. coli to below baseline values before NO inhalation (mRFI=158±25 vs 222±24; P=0.03). This decrease was more pronounced after more than 72 h (mRFI=133±17). At this time, superoxide anion production by fMLP-stimulated neutrophils was also decreased (mRFI=40±3, vs 57±5; P=0.03). The reduced capacity of superoxide production persisted throughout therapy with NO and lasted up to more than 4 days after the end of NO inhalation. Conclusion: The results suggest that inhalation of NO in patients with pulmonary hypertension causes reduced superoxide anion production by neutrophils stimulated with E. coli or with fMLP. To determine the clinical importance of this systemic side effect with respect to bacterial infections, a randomized controlled study is necessary.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712246
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    A new side effect of inhaled nitric oxide in neonates and infants with pulmonary hypertension: Functional impairment of the neutrophil respiratory burst (1996)
    Springer
    Intensive care medicine 22 (1996), S. 252-258 
    Details
    ISSN: 1432-1238
    Keywords: Inhaled nitric oxide ; Pulmonary hypertension ; Respiratory burst of neutrophils
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Introduction Inhaled nitric oxide (NO) may be beneficial in the treatment of pulmonary hypertension, both of the newborn and in the adult respiratory distress syndrome. Up to now, serious systemic side effects have not been reported. Objective The effect of inhaled NO on superoxide anion production by neutrophils. Design Prospective study of a consecutive series of 15 neonates and infants. Setting Neonatal and paediatric ICUs with a total of 17 beds (university hospital). Measurements and results Superoxide anion production was determined by a flow cytometric method using dihydrorhodamine 123 (DHR) as an oxidative probe after the priming of neutrophils withN-formyl-methionyl-leucylphenylalanine (fMLP) or withEscherichia coli. The generated fluorescence was expressed as relative fluorescence intensity (RFI). Inhalation of NO for more than 24 h reduced the superoxide anion production by neutrophils stimulated withE. coli to below baseline values before NO inhalation (mRFI=158±25 vs 222±24;P=0.03). This decrease was more pronounced after more than 72 h (mRFI=133±17). At this time, superoxide anion production by fMLP-stimulated neutrophils was also decreased (mRFI=40±3, vs 57±5;P=0.03). The reduced capacity of superoxide production persisted throughout therapy with NO and lasted up to more than 4 days after the end of NO inhalation. Conclusion The results suggest that inhalation of NO in patients with pulmonary hypertension causes reduced superoxide anion production by neutrophils stimulated withE. coli or with fMLP. To determine the clinical importance of this systemic side effect with respect to bacterial infections, a randomized controlled study is necessary.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712246
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Granulocyte colony-stimulating factor receptor expression on neutrophils of term and preterm neonates with and without signs of infection (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 497-500 
    Details
    ISSN: 1432-1076
    Keywords: Key words Granulocyte colony-stimulating factor receptor ; Flow cytometry ; Neonates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neutrophils are an essential component of the human host defence system against infection. Recombinant human granulocyte colony-stimulating factor induces neutrophilia and enhances effector functions of mature neutrophils. Since the biological effects of granulocyte colony-stimulating factor (G-CSF) are mediated by its receptor, we investigated the expression of G-CSF receptor on the surface of neutrophils of term and preterm neonates (n = 22) with and without signs of infection and of healthy adults (n = 13) by flow cytometry. In healthy adults, the percentage of neutrophils expressing G-CSF receptor was higher compared to cord blood of term and preterm neonates (87% vs 53%, P 〈 0.05). Between 2 and 32 h of life, neonates with signs of infection showed lower values of G-CSF receptor expression compared to neonates without signs of infection (32% vs 54%, P 〈 0.05). No correlation was detectable between expression of G-CSF receptor and gestational age. Conclusion Expression of granulocyte colony-stimulating factor receptor on neutrophils is lower than in adults. This may adversely affect granulopoiesis and neutrophil function during the neonatal period. Moreover, granulocyte colony-stimulating factor receptor expression seems to be down-regulated during neonatal infection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051129
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Anaemia, thrombocytopenia and coagulopathy due to occult diffuse infantile haemangiomatosis of spleen and pancreas (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 379-383 
    Details
    ISSN: 1432-1076
    Keywords: Key words Antithrombin III ; Coagulation ; Haemangiomatosis ; Kasabach-Merrit syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diffuse infantile haemangiomatosis of the spleen is a very rare lesion. Large haemangiomas may cause trapping of platelets and coagulation disorders known as Kasabach-Merrit syndrome. We here report the case of an infant with splenic and pancreatic haemangiomatosis presenting with life-threatening thrombocytopenia, anaemia and intravascular coagulation. Diagnosis was hampered by reactive erythroblastosis and non-conclusive radiological findings. While treatment with corticosteroids was ineffective, administration of antithrombin III improved coagulation parameters. After splenectomy the child recovered promptly and has remained free of disease for 3 years to date. Conclusion Occult visceral haemangiomatosis without visible cutaneous haemangiomas should be included in the differential diagnosis of thrombocytopenia, anaemia and consumption coagulopathy. Antithrombin III treatment may be considered to overcome bleeding problems in patients with Kasabach-Merrit syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051096
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Meningokokkensepsis und Purpura fulminans Erfolgreiche Lysetherapie mit rekombinantem Gewebeplasminogenaktivator (1999)
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 1010-1013 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Meningokokkensepsis ; Purpura fulminans ; Fibrinolyse ; Gewebeplasminogenaktivator ; Key words Meningococcemia ; Purpura fulminans ; Fibrinolysis ; Tissue plasminogen activator
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A case of a 16 years old young man with meningococcemia, septic shock and purpura fulminans is presented. The clinical course was complicated by ischemia of both lower legs and feet as well as both cheeks. After successful restoration of circulation, the lower legs remained ischemic and loss was imminent. Therefore, fibrinolytic therapy with recombinant tissue plasminogen activator (rt-PA) was started: Both lower legs and feet could be preserved. All of the toes of the right foot, however, had to be amputated. Discussion: Fibrinolytic therapy with rt-PA should be considered as a therapeutic option in patients with meningococcemia and purpura fulminans with imminent loss of extremities. Optimal perfusion pressure and control of coagulation seems to be a prerequisite for successful fibrinolytic therapy. Care should be taken to avoid complications, especially intracerebral hemorrhage.
    Notes: Zusammenfassung Berichtet wird über den Krankheitsverlauf eines 16jährigen Jugendlichen, der akut an einer Meningokokkensepsis mit septischem Schock und Purpura fulminans erkrankte. Nach Stabilisierung des Herz-Kreislauf- Systems blieben die Wangen sowie die Unterschenkel und Füße beidseits ischämisch, so daß mit einem Verlust beider Unterschenkel und Füße gerechnet werden mußte. In dieser Situation wurde eine Fibrinolyse mit rekombinantem Gewebeplasminogenaktivator (rt-PA) durchgeführt: Beide Unterschenkel und Füße konnten erhalten werden, jedoch mußten alle Zehen des rechten Fußes amputiert werden. Diskussion: Bei Meningokokkensepsis mit Purpura fulminans erscheint eine Fibrinolyse bei ischämischen Extremitäten sinnvoll. Diese sollte allerdings u.E. erst nach Stabilisierung des Herz-Kreislauf-Systems und der Gerinnung erfolgen, da ansonsten weder der Effekt der Lyse noch mögliche Komplikationen, insbesondere Blutungen in das Zentralnervensystem, richtig erkannt werden können.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050532
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    Paper (German National Licenses)
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