Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Jan 2002
Clinical TrialMeasurement of blood and plasma coagulation time using free oscillating rheometry.
An assay based on free oscillating rheometry to measure the activity of coagulation factors is described. The method can be used in blood and plasma and is particularly suitable for screening and monitoring coagulation disturbances in point-of-care testing (POCT) in environments where quick analysis with minimal preanalytical work is needed. In this study the endpoint as clotting onset time (COT) is determined by a deviation from initial viscoelastic properties of an oscillating sample. ⋯ COT was shown to give a dose-dependent response to added thrombin and to be resistant to high concentrations of corn trypsin inhibitor, indicating measurement of the tissue-factor-dependent pathway of coagulation activation. COT in recalcified blood and plasma covariated with prothrombin time (PT) according to Owren, and activated partial thromboplastin time (aPTT). The technique and instrument used proved to be quick and easy to handle, and suitable for POCT as well as for examinations in the laboratory.
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Cytokines and leukocyte adhesion molecules are activated and found in increased concentrations in bacterial infection. The purpose of this study was to investigate whether some of these new serum markers could be feasible as a single on-admission test to predict acute appendicitis (AA). ⋯ ROC analysis confirmed that IL-6 showed the best trend in the diagnosis of AA. However, the diagnosis of AA was not greatly improved by any of the new serum markers as single on-admission tests.
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Scand. J. Clin. Lab. Invest. · Jan 2002
Intratracheal pulmonary ventilation keeps tracheal tubes clean without impairing mucociliary transport.
Intratracheal pulmonary ventilation (ITPV) is a form of tracheal gas insufflation through a reverse thrust catheter that facilitates expiration and enhances CO2 removal. Tracheas of sheep mechanically ventilated for 3 days with gas delivered through the reverse-thrust catheter remained free of secretions, without suctioning. It was hypothesized that: 1) The expiratory flow from the lungs, combined with continuous cephalad flow from the reverse-thrust catheter keeps endotracheal tubes clean; and 2) tracheal mucus velocity is not impaired by ITPV. ⋯ The enhanced expiratory flow during ITPV expels secretions from the endotracheal tube through entraining of mucus at the tip of the endotracheal tube. Tracheal mucus velocity is not influenced by ITPV.
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Scand. J. Clin. Lab. Invest. · Jan 2002
Comparative StudyCorrelation between blood glucose concentration and glucose concentration in subcutaneous adipose tissue evaluated with microdialysis during intensive care.
Hyper- as well as hypoglycemia may be detrimental for brain energy metabolism and even a moderate increase in blood glucose concentration can affect outcome adversely. During physiological conditions, glucose concentration obtained from microdialysis of subcutaneous adipose tissue adequately reflects plasma glucose concentration. This study examines whether this correlation is also obtained during intensive care in patients with severe injuries. ⋯ The correlation between blood glucose concentration and glucose concentration in subcutaneous adipose tissue was not as good during intensive care as in normal humans. The poor correlation during the first 6 h probably reflects a stress reaction (and possibly local vasoconstriction). Microdialysis of subcutaneous adipose tissue permits frequent bedside analyses of the biochemical composition of the extracellular fluid and may be of value during routine intensive care provided the methodological limitations are recognized.
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Scand. J. Clin. Lab. Invest. · Jan 2002
Comparative StudyBlood coagulation and fibrinolysis in acute ischaemic and haemorrhagic (intracerebral and subarachnoid haemorrhage) stroke: does decreased plasmin inhibitor indicate increased fibrinolysis in subarachnoid haemorrhage compared to other types of stroke?
Ischaemic and haemorrhagic stroke may cause haemostatic abnormalities, apart from concomitant brain damage. In this study, some blood coagulation and fibrinolysis parameters were investigated in 30 patients with ischaemic stroke (atherothrombotic) and 30 with haemorrhagic (20 with intracerebral and 10 with subarachnoid haemorrhage) stroke. The following parameters were determined within the first 24h after stroke: prothrombin time (PT%). activated partial thromboplastin time (aPTT). fibrinogen, activity of FVII, antithrombin. plasmin inhibitor (PI) and fibrin D-dimer. ⋯ With the exception of this difference, there were no other differences between ischaemic stroke and the two types of haemorrhagic stroke. This could indicate that haemostatic abnormalities are a consequence of brain damage rather than primary haemostatic activation during thrombosis and/or bleeding in the acute phase of stroke. A decrease in the plasmin inhibitor could suggest excessive fibrinolysis in subarachnoid haemorrhage.