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  • 1
    ISSN: 1432-1238
    Schlagwort(e): Key words Traumatic shock ; Cardiac tamponade ; Metabolic acidosis ; Methamphetamine intoxication ; Hyperammonemia ; Hyperuricemia
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A case of a 38-year-old male with traumatic shock complicated by methamphetamine intoxication is presented. The patient was involved in an assault which resulted in cardiac tamponade and right ventricular outflow laceration. Pericardiocentesis was immediately performed. However, profound metabolic acidosis greatly in excess of that expected from the short duration of the shock was revealed by arterial blood gas analysis. Another cause of the metabolic acidosis was suspected. The patient subsequently admitted to intravenous use of methamphetamine. Following hemodynamic and metabolic stabilization by continuous pericardial drainage and intravenous administration of sodium bicarbonate, the patient underwent cardiac surgery. His postoperative course was uneventful. There is a substantial association between methamphetamine users and traumatic accidents. In such cases, early identification of drug use is important. Marked metabolic acidosis, which conflicts with the diagnosed cause of shock, may be a clinical clue to methamphetamine intoxication.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Intensive care medicine 22 (1996), S. 1169-1175 
    ISSN: 1432-1238
    Schlagwort(e): Key words Macrophage inflammatory protein-1alpha (MIP-1α) ; Interleukin-8 (IL-8) ; Sepsis ; Disseminated intravascular Coagulation (DIC)
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Structured Abstract   Objective: To determine the significance of the C–C chemokine MIP-1α and the C–X–C chemokine IL-8 in sepsis. Design: Prospective study. Setting: Clinical investigation, emergency department and general intensive care unit of university hospital. Patients and participants: 38 septic patients and 5 healthy volunteers were studied. Sepsis was diagnosed following the criteria formulated by ACCP/SCCM. Interventions: 10–20 ml of blood was drawn from each patient at the time of initial diagnosis of sepsis. Measurements and results: MIP-1α and IL-8 were determined by sandwich ELISA. Both chemokines were undetectable in the healthy volunteers. In sepsis, serum MIP-1α was detected in 45% of the patients and IL-8 was detected in 84%. The levels of MIP-1α, but not of IL-8, correlated with CRP, IL-6 and TNFα levels. Complications, including various organ failures and mortality, showed no correlation with serum MIP-1α levels. In contrast, we found increased levels of serum IL-8 in patients with disseminated intravascular coagulation (DIC) (p〈0.05), central nervous system (CNS) dysfunction (p〈0.05), renal failure (p〈0.01) and the mortality rates were higher in the IL-8 detectable group than in the IL-8 undetectable group (50% vs 0%, p〈0.05). Conclusions: The production of MIP-1α and IL-8 was increased in sepsis. Furthermore, an initially detectable level of circulating IL-8, but not MIP-1α, predicted a high mortality in sepsis diagnosed according to the ACCP/SCCM criteria.
    Notizen: Abstract  We studied blood MIP-1α and IL-8 in 38 septic patients and 5 healthy volunteers. Both chemokines were undetectable in the healthy volunteers. In sepsis, serum MIP-1α was detected in 45% of the patients and IL-8 in 84%. The levels of MIP-1α, but not of IL-8, correlated with CRP, IL-6 and TNFα levels. Complications, including various organ failures and mortality, showed no correlation with serum MIP-1α levels. In contrast, we found increased levels of serum IL-8 in septic patients with disseminated intravascular coagulation, central nervous system (CNS) dysfunction or renal failure, and the mortality rate was higher in the IL-8-detectable group than in the IL-8 undetectable group (50% vs 0%, p〈0.05). In conclusion, the production of both MIP-1α and IL-8 was increased and initially detectable levels of circulating IL-8 predicted high mortality in sepsis.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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