Progress in clinical and biological research
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Prog. Clin. Biol. Res. · Jan 1987
Comparative StudyFluid resuscitation in canine traumatic-hemorrhagic shock: long-term comparison of hydroxyethyl starch vs. Ringer's lactate.
In 16 anesthetized foxhounds a traumatic-hemorrhagic shock was performed. Following shock the dogs were randomized to treatment with autologous blood and either hydroxyethyl starch (HES, 450/0.5) or Ringer's lactate (RL). The animals were monitored for 24 h after treatment. ⋯ Albumin extravasation, on the other hand, was more pronounced (p less than 0.01) in the RL-group and, moreover, albumin redelivery by lymph was decreased (p less than 0.05). On the basis of this study, both fluid modalities appear to be equally effective in resuscitation from traumatic-hemorrhagic shock without interfering with pulmonary function and ARDS. The importance that the tissue albumin accumulation ranks for final outcome from shock, however, requires further investigation.
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Prog. Clin. Biol. Res. · Jan 1987
Comparative Study Clinical Trial Controlled Clinical TrialAdenosine: a clinical experience and comparison with verapamil for the termination of supraventricular tachycardias.
The efficacy and side-effects of adenosine for treatment of supraventricular arrhythmias were compared to verapamil therapy in patients presenting to the emergency room. Clinical variables and the time interval from the initiation of treatment to the termination of the supraventricular tachycardia, as well as the time from the initial effective dose of medication to the termination of supraventricular tachycardia were compared for adenosine and verapamil. Adenosine was given to a total of 44 patients, 16 patients in the electrophysiology laboratory, and 28 patients in the emergency room for evaluation and termination of their tachycardia. ⋯ There was no significant difference between the two groups with respect to clinical variables. Adenosine converted 18 of 18 episodes of supraventricular tachycardia in 14 patients 24.6 +/- 9.6 seconds from the administration of the effective dose (0.104 +/- 0.024 mg/kg) and a mean of 4.4 +/- 2.0 minutes from the initiation of therapy. Verapamil converted 29 of 32 episodes of supraventricular tachycardia in 20 patients, 10.9 +/- 7 minutes from the administration of the effective dose, and a mean of 16.8 +/- 20 minutes from the initiation of therapy using a mean of 8.4 +/- 3.4 mg of IV verapamil.(ABSTRACT TRUNCATED AT 400 WORDS)
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Clinical correlations of the plasma chromogenic Limulus assay were evaluated in 520 septic episodes to assess the diagnostic utility of the assay in a university hospital setting. Otherwise unselected patients undergoing blood culture were studied. An association of plasma Limulus activity with gram negative bacteremia and focal infections was found (p less than .001 and p less than .01, respectively). ⋯ Abnormal neutrophil parameters were unassociated with positive assays in any group. The sensitivity and specificity of the test for a condition known to cause endotoxemia--either gram negative infection or major intestinal disease--were low, 21% and 93% respectively. However, the predictive value of a positive test was 79%, indicating utility for the assay.