Infusionstherapie und Transfusionsmedizin
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Infusionsther Transfusionsmed · May 2000
Arificial Oxygen Carriers as Red Blood Cell Substitutes - Perfluorocarbons and Cell-Free Hemoglobin.
Forthcoming shortfall of blood products and persisting concerns about viral transmission and immunosuppressive side effects of allogeneic blood transfusion have reinforced the studies with alternative oxygen carriers in the last years. Modern perfluorochemicals and cell-free hemoglobin solutions can be applied without prior cross-matching and are now available as stable formulations with long shelf life. Both groups of oxygen carriers have shown their effectivity and tolerability in numerous animal studies. ⋯ Future studies must show if these modern oxygen carriers are able to improve outcome of patients with impaired perfusion and organ oxygenation. Copyright 2000 S. Karger GmbH, Freiburg
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Infusionsther Transfusionsmed · Jun 1996
Review[Iron homeostasis in preoperative autologous blood donation].
The role of iron metabolism, the value and the limits of oral as well as intravenous iron substitution in preoperative autologous blood donation are discussed according to the literature. ⋯ At the moment intravenous iron medication in autologous blood donation should be restricted to well-established exceptional cases. The use of intravenous iron combined with erythropoietin seems to be justified to avoid ineffective erythropoieses and to achieve a dose reduction of recombinant erythropoietin. Since there are nearly no risks and a possible efficacy cannot be totally excluded, oral iron supplementation may be applied to patients who tolerate it well. Real iron deficiency has to be treated with iron application. Further clinical studies have to be done for a final validation of the efficacy of iron substitution in non iron deficient preoperative autologous blood donors.
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Infusionsther Transfusionsmed · Apr 1996
[Morphologic and functional changes in thrombocytes after deep freezing with DMSO].
During the past decade much work has been carried out towards establishing the optimum method for cryopreservation of platelets. Among the various cryoprotectants dimethyl sulfoxide (DMSO) has been shown to be the most effective. This report describes ultrastructural and functional changes of platelets during the deep-freezing process with DMSO. ⋯ Although cryopreserved platelets are characterized by hemostatic effects in vivo, it seems conceivable that these effects could be improved by further development of platelet-freezing techniques.
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Infusionsther Transfusionsmed · Apr 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of two solutions with different glucose concentrations for infusion therapy during laparotomies in infants.
Comparison of two commercially available solutions for intraoperative infusion therapy during laparotomies in infants using a standardized anesthetic technique (combination of general anesthesia with a caudal block). ⋯ Solutions containing 5.5% glucose infused with 8 ml/kg/h caused in both age groups of infants intolerable hyperglycemias. In young infants, also a solution containing 2.5% glucose infused at a rate of 8 ml/kg/h leads to hyperglycemia, while in older children this amount of glucose is tolerated. It is recommended that for abdominal surgery in young infants glucose and fluid substitution is separated, in order to infuse glucose at an even lower rate. Still, blood glucose levels have to be monitored closely.
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Infusionsther Transfusionsmed · Apr 1996
Case Reports[Use of plasmapheresis in a 62-year-old patient with severe infection].
The elimination of cytotoxic substances from blood as part of sepsis treatment has been controversely discussed so far. The following case report demonstrates the advantages and disadvantages of this therapy strategy. ⋯ The temporary improvement during plasmapheresis suggests that the patient might have profited from plasmapheresis-related optimized oxygen delivery, controlled diuresis and decrease of oxygen consumption. In addition we hypothesized that elimination of high-molecular cytokines and toxines contributed to the improvement under plasmapheresis. Using plasmapheresis one has to consider the high costs, risk of infection, and the unexplained mode of action to the mediatory process. Therefore we cannot recommend this treatment in general. Further controlled studies should investigate the therapeutic benefits of plasmapheresis in patients with severe sepsis.