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  • 1
    Electronic Resource
    Electronic Resource
    Increased oxygen consumption after cardiac surgery is associated with the inflammatory response to endotoxemia (1996)
    Springer
    Intensive care medicine 22 (1996), S. 294-300 
    Details
    ISSN: 1432-1238
    Keywords: Oxygen consumption ; Endotoxemia ; Tumor necrosis factor ; Interleukin-6 ; Hypermetabolism ; Post-perfusion syndrome ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective The aim of this study was to determine whether the increase in post-operative oxygen consumption (ΔVO2) in cardiac surgery patients in related to endotoxemia and subsequent cytokine release and whether ΔVO2 can be used as a parameter of post-perfusion syndrome. Design Prospective study. Setting Operating room and intensive care unit of a university hospital. Patients Twenty-one consecutive male patients undergoing elective coronary artery bypass surgery without major organ dysfunction and not receiving corticosteroids. Measurements and results Plasma levels of endotoxin, tumor necrosis factor (TNF) and interleukin-6 (IL-6) were measured before, during and for 18 h after cardiac surgery. Oxygen consumption, haemodynamics, the use of IV fluids and dopamine, body temperature and the time of extubation were also measured. Measurements from patients with high ΔVO2 (≥median value of the entire group) were compared with measurements from patients with low ΔVO2 (〈median). Patients with high ΔVO2 had higher levels of circulating endotoxin (P=0.004), TNF (P=0.04) and IL-6 (P=0.009) received more IV fluids and dopamine while in the ICU, and were extubated later than patients with low ΔVO2. Several hours after ΔVO2 the patient's body temperature rose, Forward stepwise regression analysis showed that circulating endotoxin and TNF explained 50% of the variability of ΔVO2. Conclusions This study demonstrates that patients with high post operative oxygen comsumption after elective cardiac surgery have higher circulating levels of endotoxin, TNF and IL-6 and also have more symptoms of post-perfusion syndrome. Early detection of high VO2 might be used as a clinical signal to improve circulation in order to meet the high oxygen demand of inflammation. In addition, continuous measurement of VO2 provides us with a clinical parameter of inflammation in interventional studies aiming at a reduction of endotoxemia or circulating cytokines.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700449
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  • 2
    Electronic Resource
    Electronic Resource
    Oxygen consumption after cardiopulmonary bypass — implications o of different measuring methods (1993)
    Springer
    Intensive care medicine 19 (1993), S. 105-110 
    Details
    ISSN: 1432-1238
    Keywords: Oxygen consumption ; Cardiopulmonary bypass ; Pulmonary gas exchange ; Energy metabolism ; Physiological monitoring ; Intra-pulmonary oxygen consumption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To determine whether intra-pulmonary oxygen consumption or whole body oxygen consumption is the main determinant of the hypermetabolic response after cardiopulmonary bypass. Secondly, which method of measuring oxygen consumption best quantifies this hyperdynamic response. Design We measured oxygen consumption by analysing respiratory gas (VO2-gas), carbon dioxide excretion (VCO2), and respiratory exchange ratio (RER = VCO2/VO2), and calculated oxygen consumption using the Fick-method (VO2-Fick) and intra-pulmonary oxygen consumption (VO2-gas — VO2-Fick) in patients at fixed times before and after elective cardiac surgery. Next, comparisons were made between methods and also between measurements at different times before and after bypass. Setting University hospital Patients 10 elective cardiac surgical patients Interventions None Measurements and results VO2-gas, VCO2 and RER were measured with an open circuit indirect calorimeter VO2-Fick was calculated: VO2-Fick=cardiac indexx(arterial — mixed venous oxygen content). Intrapulmonary oxygen consumption was calculated as the difference between VO2-gas and VO2-Fick. Both VO2-gas and VO2-Fick were about 20% higher after bypass than after induction of anaesthesia. Absolute values of VO2-gas were about 30% higher than VO2-Fick. Intra-pulmonary oxygen consumption accounted for 32% of whole body oxygen consumption after induction of anaesthesia and did not increase after bypass. Conclusion Whole body oxygen consumption and not intra-pulmonary oxygen consumption is the main determinant of the hypermetabolic response after bypass. Increased intra-pulmonary oxygen consumption is not related to bypass. VO2-gas best quantifies this hypermetabolic response directly after bypass, and not VO2-Fick, VCO2 or intra-pulmonary oxygen consumption, since VO2-Fick excludes intra-pulmonary oxygen consumption and VCO2 does not reflect metabolism directly after bypass.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01708371
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  • 3
    Electronic Resource
    Electronic Resource
    Activation of plasma systems and blood cells by endotoxin in rabbits (1991)
    Springer
    Inflammation 15 (1991), S. 81-90 
    Details
    ISSN: 1573-2576
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endotoxin plays an important role in the pathogenesis of septicaemia by activation of cellular and plasmatic systems. This study was performed to investigate the effects of infusion of endotoxin in rabbits by measuring the activation of cellular and plasma systems. Endotoxin was infused at a rate of 1 mg/kg body wt for 10 min, which caused death of all rabbits within 72 h. Endotoxin induced early leukopenia and thrombopenia, increased plasma levels ofβ-glucuronidase and leukotriene B4 (LTB4), and decreased complement total hemolytic activity (CH50) and tissue plasminogen activator (t-PA) activity. These observations correlate with the cellular and plasma changes that have been documented in severely ill endotoxemic patients. Therefore, we conclude that this endotoxin model in rabbits is a valuable tool for investigation of pathophysiology and treatment of endotoxic shock.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00917503
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  • 4
    Electronic Resource
    Electronic Resource
    Methylprednisolone prophylaxis protects against endotoxin-induced death in rabbits (1991)
    Springer
    Inflammation 15 (1991), S. 91-101 
    Details
    ISSN: 1573-2576
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endotoxemia in patients can lead to sepsis and shock by activation of cellular and plasmatic systems. Corticosteroids are described to have a beneficial effect on these phenomena. In this study of controlled endotoxic shock, we investigated the protective effects of prophylactic corticosteroid treatment against activation of cellular and plasmatic systems. In this respect, a low-dose methylprednisolone (1 mg/kg body wt) treatment was compared with that of a high-dose methylprednisolone (40 mg/kg body wt) treatment. Endotoxin infusion induced death of all rabbits, which was associated with leukopenia, thrombopenia, increased levels ofβ-glucuronidase, and leukotriene B4 (LTB4) and decreased levels of complement total hemolytic activity (CH50) and tissue plasminogen activator (t-PA) activity. Both methylprednisolone regimens prevented death of the rabbits after endotoxin infusion, which correlated with a significant decrease of the granulocyte release productβ-glucuronidase (P 〈 0.01). The early leukopenia and thrombopenia were not prevented; however, both cell numbers returned more rapidly to baseline values than in the placebo group (P 〈 0.01,P 〈 0.05). The LTB4 and CH50 concentration and t-PA activity did not differ significantly between the treated and placebo groups. These results indicate that although methylprednisolone has no inhibitory effect on the activation of the complement, arachidonic acid, and fibrinolytic systems, it protected the animals from the deleterious effects of endotoxin shock by inhibition of leukocyte activation. In this regard a low dosage of methylprednisolone is equally effective as the most often recommended high dose.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00917504
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  • 5
    Electronic Resource
    Electronic Resource
    Fabrication and characterization of an asymmetric polyurethane membrane for use as a wound dressing (1992)
    New York, NY [u.a.] : Wiley-Blackwell
    Journal of Applied Biomaterials 3 (1992), S. 287-303 
    Details
    ISSN: 1045-4861
    Keywords: Chemistry ; Polymer and Materials Science
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine , Technology
    Notes: To prevent wound dehydration and bacterial penetration, a wound dressing should be occlusive, but on the other hand it should also be permeable for wound exudate to prevent bullae formation. To meet these requirements a new type of polyurethane wound dressing which consists of a microporous top layer (pore size 〈 0.7 μm) supported by a sublayer with a highly porous sponge-like structure containing micropores (pore size 〈10 μm) as well as macropores (pore size: 50-100 μm) was designed. The pores of both layers are interconnected and form a continuous structure in the membrane. Membranes according to this design were prepared either by means of a two-step or by means of a one-step casting process. Both fabrication methods are based on phase inversion techniques. Asymmetric polyurethane Biomer® membranes prepared by the two-step casting process were tested in vivo as full thickness skin substitutes using guinea pigs. Neither wound dehydration nor infections were observed while the drainage capacity of the wound dressing was effective in preventing bullae formation. Furthermore the wound dressing remained firmly adhered to the wound surface during the whole process of wound healing. In contrast to all other commercial wound dressings currently available the polyurethane wound dressing applied on excised clean wounds did not need to be replaced during healing but could be left on the wound until full regeneration of the skin had taken place after which it was spontaneously repelled. © 1992 John Wiley & Sons, Inc.
    Additional Material: 12 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/jab.770030408
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  • 6
    Electronic Resource
    Electronic Resource
    Biodegradability and tissue reaction of random copolymers of L-leucine, L-aspartic acid, and L-aspartic acid esters (1977)
    Hoboken, NJ : Wiley-Blackwell
    Journal of Biomedical Materials Research 11 (1977), S. 405-422 
    Details
    ISSN: 0021-9304
    Keywords: Chemistry ; Polymer and Materials Science
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine , Technology
    Notes: A series of copoly(α-amino acids) with varying percentages of hydrophilic (l-aspartic acid) and hydrophobic monomers (l-leucine, β-methyl-l-aspartate, and β-benzyl-l-aspartate) were implanted subcutaneously in rats and the macroscopic degradation behavior was studied. Three groups of materials (A, B, C) with different ranges of hydrophilicity were distinguished: A) hydrophobic materials showed no degradation after 12 weeks; B) more hydrophilic materials revealed a gradual reduction in size of the samples, but were still present after 12 weeks; and C) hydrophilic copolymers disappeared within 24 hr.The tissue reactions caused by the materials of group A resembled that of silicone rubber, whereas those of group B showed a more cellular reaction.
    Additional Material: 6 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/jbm.820110308
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  • 7
    Electronic Resource
    Electronic Resource
    Interaction of fibroblasts and polymer surfaces: relationship between surface free energy and fibroblast spreading (1983)
    Hoboken, NJ : Wiley-Blackwell
    Journal of Biomedical Materials Research 17 (1983), S. 807-817 
    Details
    ISSN: 0021-9304
    Keywords: Chemistry ; Polymer and Materials Science
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine , Technology
    Notes: Cell spreading and cell division rates of a transformed line of mouse lung fibroblasts were studied on various polymer surfaces in the presence of serum proteins. The bare polymer surfaces, as well as the protein-coated surfaces, were characterized by their polar (γsp) and dispersion (γsd) surface free energies. Cell spreading appeared to be dependent on the polar surface free energy. Cell spreading is low when the γsp of the bare surface is lower than 5 erg cm-2; marked spreading occurs when γsp is higher than 15 erg cm-2. A similar relationship was found between cell spreading and polarity of the protein-coated surfaces, although less pronounced than for the bare surfaces. Cell spreading appeared independent of the dispersion surface free energy. Cell division rate was the same on all surfaces tested.
    Additional Material: 6 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/jbm.820170508
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