Infusionstherapie und Transfusionsmedizin
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Infusionsther Transfusionsmed · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialEffects of hypertonic saline hydroxyethyl starch solution on collagen-induced platelet aggregation and ATP secretion.
The purpose of this study was to investigate the effect of hypertonic (NaCl 7.5%) hydroxyethyl starch (HES 6%, molecular weight 200,000) (HHES) as used for small-volume resuscitation on global coagulation parameters and platelet function. ⋯ The changes in global coagulation parameters can be explained by dilutional effects of the infused solution. The hyperosmolar saline compound of the HHES solution obviously contributes to the slowing down of platelet aggregation. Osmotic stress and membrane pleating may aggravate HES-induced changes in membrane fluidity and microviscosity and thus explain this impaired interaction. The increase in ATP release suggests a change in receptor-second messenger interaction for delta granule release.
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Infusionsther Transfusionsmed · Aug 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of 2 6% middle-molecular hydroxyethyl starch solutions on elimination kinetics and flow characteristics of blood in volunteers].
Investigation of the influence of C2/C6 occupation ratio of 2 different 6% hydroxyethyl starch (HES) solutions on elimination kinetics and blood fluidity. ⋯ The infusion of HES 200/0.62 leads to a significantly longer prevalence in comparison to HES 200/0.5, in combination with clearly larger degradation products in the plasma; this fact causes a more marked dilutional effect, but also a more marked increase in the plasma viscosity up to 24 h after the end of infusion. In the discussion on haemodilution therapy in patients with arterial occlusive disease the employment of HES which induces an increase in plasma viscosity is thought to be a disadvantage.
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Infusionsther Transfusionsmed · Aug 1994
[Intracranial hemorrhage and hemostasis. Monitoring patients after intracranial hemorrhage by determination and follow-up of activation products of blood coagulation].
The aim of the study was to improve the detection of small hemorrhages with minimal symptoms and of unruptured aneurysms after a subdural and subarachnoid bleeding by the control of the intravascular hemostatic system. ⋯ The results of the recent study indicated that immunologically determined TAT, FPA, protein C, factor XIII and AT III activities might serve to improve management in patients with intracranial bleeding events. In view of these parameters the evaluation of risks for a rebleeding is improved. A decrease of the plasma factor XIII activity under 40% associated with a latent clotting activity induced by a thrombin generation caused a higher risk of rebleeding after an initial intracranial bleeding event. The necessity of substituting factor XIII in such cases should be elucidated to minimize risks of rebleeding.
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Infusionsther Transfusionsmed · Jun 1994
Randomized Controlled Trial Clinical TrialPerioperative glucose-insulin-potassium infusion in elective coronary surgery: minor benefit in connection with blood cardioplegia?
The goal of this study was to examine the metabolic and hemodynamic effects of a glucose-insulin-potassium infusion in elective coronary surgery, when blood cardioplegia was used for cardiac protection. ⋯ Perioperative GIK infusion entailed a slight decrease in the postoperative need for dopamine support, but was connected with a considerable risk of hypoglycemia.
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Infusionsther Transfusionsmed · Apr 1994
Randomized Controlled Trial Clinical Trial[Autotransfusion with leap-frog technique in patients with coronary heart disease and planned aortocoronary venous bypass].
The goal of the study is to test and control the quality of a special leap-frog technique which enables saving heterologous blood. ⋯ 40% of the cardiosurgical patients could be considered for autologous blood donation. Isovolemic hemodilution with HES 200/0.5 10% was a suitable and safe measure in preoperative blood sampling. Physical exercise should be performed before and after autologous blood donation. A reduced exercise tolerance suggests that autologous blood donation should be stopped.