Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Dec 1988
Comparative StudyElevated levels of plasma hyaluronan in septicaemia.
Hyaluronan (hyaluronic acid) is normally rapidly cleared from the circulation by the endothelial cells in the liver sinuoids, which make up part of the reticulo-endothelial system (RES). An impaired RES function in severe infection and sepsis might therefore lead to elevated hyaluronan plasma levels. Thus, plasma concentrations of hyaluronan were analysed in 44 patients with severe infection at onset of disease and twice during the following 2-3 days. ⋯ Septic shock, and especially fatal septic shock, thus appears to be associated with elevated plasma hyaluronan concentrations. Possible mechanisms might be an increased release of the polysaccharide from the interstitial space to the bloodstream, or a decreased rate of clearance by liver endothelial cells. This question demands further study.
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Scand. J. Clin. Lab. Invest. · Nov 1988
Intravenous 133Xe clearance in preterm neonates with respiratory distress. Internal validation of CBF infinity as a measure of global cerebral blood flow.
An intravenous 133Xe clearance technique is described, giving very low values of global cerebral blood flow (CBF infinity) in mechanically ventilated, preterm infants. External monitoring of the chest is used to estimate the arterial input function to the brain, with a modified correction to allow for increased recirculation due to right-to-left shunting. ⋯ Fifteen-minute clearance data gave better precision than 8-min data. The modified chest curve correction was partly effective in a case of extreme right-to-left shunting.
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Scand. J. Clin. Lab. Invest. · Oct 1985
Interstitial fluid volume, plasma volume and transcapillary colloid osmotic gradient in patients with hepatic cirrhosis and fluid retention.
Colloid osmotic pressure in plasma (IIp) and in subcutaneous interstitial fluid (IIi) (wick technique), plasma volume (PV) and interstitial fluid volume (IFV) were measured in 12 patients with hepatic cirrhosis and fluid retention. The value of IIp (mean +/- SD) was 21.4 +/- 4.2 mmHg (28.6 +/- 3.4 mmHg in normal subjects (p less than 0.01)), mean IIi was 8.6 +/- 2.2 mmHg (15.8 +/- 2.7 mmHg in normal subjects (p less than 0.01)) and mean transcapillary colloid osmotic gradient (IIp-IIi) was 12.7 +/- 3.8 mmHg compared to 12.8 +/- 2.7 mmHg in normal subjects (p greater than 0.1). ⋯ The reduction in IIi can partly be explained by simple dilution and partly by a decrease in interstitial protein mass. The wash-down of interstitial proteins in non-splanchnic tissues reduces the tendency to oedema and hypovolaemia.
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Scand. J. Clin. Lab. Invest. · May 1985
Comparative Study Clinical Trial Controlled Clinical TrialDextran 70 versus donor plasma as colloid in open-heart surgery under extreme haemodilution.
Dextran 70 and donor plasma were compared as colloid in the priming solution during heart-lung perfusion in open-heart surgery. The patients underwent surgery for coronary artery or aortic valve disease. One group of nine patients had plasma in the priming solution, while ten patients received dextran 70. ⋯ Preoperatively the mean values of the colloid osmotic pressure of plasma were 24.2 mmHg and 25.5 mmHg in the plasma and dextran group, respectively. Corresponding figures 45 min after start of perfusion were 13.9 mmHg and 16.9 mmHg, respectively, significantly higher in the dextran group than in the plasma group. The colloid osmotic pressure exerted by dextran was about 9 mmHg during heart-lung perfusion and about 4 mmHg 18 h later.(ABSTRACT TRUNCATED AT 250 WORDS)
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Scand. J. Clin. Lab. Invest. · Dec 1982
Relationship of red-cell 2,3-diphosphoglycerate with anaemia, hypoxaemia and acid-base status in patients with cirrhosis of the liver.
The red-cell 2,3-diphosphoglycerate (DPG) concentration is determined in 60 patients with hepatic cirrhosis, in 33 with iron deficiency anaemia and in 86 healthy subjects. In all cases, the erythrocyte volume fraction and the haemoglobin concentration are simultaneously measured, while the cirrhotic patients undergo, at the same time, analyses of the arterial pH, pO2 and pCO2 and of the levels of inorganic phosphate, bicarbonate and lactate in their venous blood. ⋯ Anaemia, hypoxaemia and acid-base disturbances are disorders frequently associated with cirrhosis of the liver. In the present study we deduce that alkalosis, and therefore the plasma pH level, is the most important factor causing the increased DPG concentration in patients with liver cirrhosis for any level of haemoglobin, with respect to other subjects with anaemia.