Infusionstherapie und Transfusionsmedizin
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Infusionsther Transfusionsmed · Dec 1993
Comparative StudyModulation of pulmonary vascular resistance and edema formation by short-term infusion of a 10% fish oil emulsion.
The aim of this study was to investigate whether the pulmonary response to inflammatory stimulation, resulting in increased vascular resistance and permeability, could be attenuated by short-term infusion of triglycerides containing omega-3 fatty acids. With the concept of altering the composition of membrane phospholipids in such a manner that stimulation resulted in the release of less vasoconstrictive and permeability-enhancing metabolites of eicosapentaenoic acid instead of those of arachidonic acid (AA), the parenteral application of a lipid emulsion prepared from fish oil (Omegavenös) was tested in comparison with a soy oil preparation (Lipovenös). ⋯ The data demonstrate that omega-3 fatty acids seem to be incorporated into the phospholipid pool of the pulmonary tissue, even after short-term infusion (3 h) resulting in an attenuated pressure reaction and edema formation due to an altered spectrum of metabolites in the case of inflammatory stimulation.
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Transcranial Doppler sonography (TCD) has gained increasing relevance since its introduction by Aaslid in 1982. Basal cerebral arteries are insonated with a 2-MHz ultrasound beam. The backscattered ultrasound is analyzed by Fast-Fourier transformation and permits continuous and noninvasive determination of flow velocities (v) and pulsatility index (PI). ⋯ TCD is a fascinating monitoring device with many advantages. It can be useful for many patients and physicians, if its limitations and the clinical situation are kept in mind. Further studies have to define the role of TCD in neuroanaesthesia.
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Assessment of the level of cerebral function or of functional deficits, respectively, as in patients with acute cerebral lesions in coma, is the main purpose of cerebral monitoring. Although the clinical-neurological exploration of the patient with employment of scoring systems, such as the Glasgow Coma Scale, is the most comprehensive approach, it is of limited quantitative nature. ⋯ Recording of the intracranial pressure in comatose patients with severe head injury continues to play a central role in early recognition of fatal complications threatening the brain, such as an intracranial mass. Besides, assessment of the intracranial pressure is indispensable for selection of appropriate methods of treatment and adjustment of its necessary dose.
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Infusionsther Transfusionsmed · Oct 1993
Comparative Study[Comparative study of blood and infusion heaters at various flow-through rates].
Transfusions of refrigerator-temperature blood, particularly when given very quickly, may induce severe hypothermia. In Germany, blood warmers used to avoid this danger mainly operate with dry heat. ⋯ For routine transfusions and infusions the Biotest BW 385L is the most suitable warmer. If a massive transfusion is necessary, it is recommendable to use two or three Fenwal BW-5 or to apply other technologies.
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Infusionsther Transfusionsmed · Oct 1993
[Monitoring intraoperative processing of acoustic stimuli with auditory evoked potentials].
130 Patients undergoing elective intra-abdominal, gynaecological, urological or cardiac surgery were studied after institutional approval and informed consent. In all patients auditory-evoked potentials (AEP) were recorded in the awake state and during general anaesthesia. Latencies of the peaks V, Na, Pa, Nb and P1 were measured. ⋯ During anaesthesia with receptor-specific anaesthetics, the brainstem peak V as well as the mid-latency components remain nearly unchanged compared with AEP from awake patients. This indicates that auditory stimuli reach the primary auditory cortex and are processed at a primary cortical level. With increasing doses of fentanyl one can observe only a significant decrease of amplitudes for the late component P1.(ABSTRACT TRUNCATED AT 250 WORDS)