Infusionstherapie und klinische Ernährung
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Infusionsther Klin Ernahr · Apr 1987
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of the modification of blood, blood coagulation, cardiovascular circulation by 3% modified, fluid gelatins and 6% low-molecular weight hydroxyethyl starch].
A randomized, comparative study with 3% modified fluid gelatine and 6% low molecular hydroxyethylstarch has been made on 87 patients of an intensive care unit. Both plasma substitutes were well compatible to the patients. The erythrocyte sedimentation rate was accelerated significantly by both plasma substitutes. ⋯ The gelatine substitute showed a significant rise in blood pressure after end of infusion, the hydroxyethylstarch substitute did not. Both substitutes showed a rise in diuresis with a delay of 1 h. There were no differences between both solutions in the diuretic effect after infusion.
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Infusionsther Klin Ernahr · Oct 1986
[Intraoperative infusion therapy. Evaluation of the rate of administration and assessment of the effectiveness of infusion warmers].
A look at the efficiency of infusion warmers from the clinician's point of view must be based on the infusion rates usually necessary in the operating room. Therefore a retrospective evaluation of 1,510 anesthesia records was made in order to register the flow rate of every infusion. ⋯ Our past warming apparatus was found not very effective in this range under the standard conditions of a cold operating room with laminar air flow. A new in-line warmer, fast and easy to handle, proved superior in daily use.
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Infusionsther Klin Ernahr · Aug 1986
A concentrated mixture of amino acids and dipeptides for total parenteral nutrition.
Using a subhuman primate (baboon) we have investigated the utility of a 20% mixture of amino acids and dipeptides as the nitrogen source for total parental nutrition. The mixture, besides containing all 8 essential amino acids and a number of non-essential amino acids (glutamate, aspartate, arginine, histidine, serine, ornithine and alanine), contained 6 dipeptides (Gly-Ile, Gly-Leu, Gly-Val, Gly-Tyr, Gly-Gln, and Ala-Gln) and acetyl-cysteine. A week of total parenteral nutrition was preceded by one week of oral feeding. ⋯ This efficiency of dipeptide utilization persisted even when the infusion rate of the amino acid and dipeptide mixture was increased by 7-fold. There was no alteration in liver, kidney, and immune function during the parenteral period. The data indicate the efficacy and safety of the mixture of amino acids and dipeptides as the nitrogen source for parenteral nutrition.
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Infusionsther Klin Ernahr · Jun 1986
Randomized Controlled Trial Clinical Trial[Volume replacement with a new hydroxyethyl starch preparation (3 percent HES 200/0.5) in heart surgery].
In a randomized study including 55 patients undergoing elective aorto-coronary bypass surgery efficacy of a low concentrated hydroxyethylstarch (3% HES 200/0.5) was tested after extracorporeal circulation (ECC). All patients received 1,000 ml autologous washed erythrocytes (cell saver) and 400 ml fresh frozen plasma (FFP). ⋯ With regard to hemodynamic efficiency and the change in laboratory data no relevant differences between group I, II and III could be seen. EVLW-measurement demonstrated the lowest increase in lung water after infusion of HES; simultaneously pulmonary gas exchange was less compromised in comparison to the other infusion groups. 3% HES 200/0.5 solution can be considered as an effective volume substitute with short intravascular retention time, which seems to be of advantage in patients coming off extracorporeal circulation.
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Infusionsther Klin Ernahr · Feb 1986
[Reactions of critically ill patients to volume therapy with hydroxyethyl starch (6% HES 450/0.7)].
At 31 critically ill surgical patients who on clinical grounds required fluid therapy, hemodynamic and oxygen transport, responses were measured after volume expansion with 500 ml 6% HES 450/0,7. There were statistically significant increases in cardiac index (CI) from 3,5 +/- 2,1 to maximal values of 4,4 +/- 0,2 (l/min/m2) and in wedge pressure (WP) from 9,3 +/- 0,7 to maximal values of 13,6 +/- 0,8 (mm Hg) and a significant reduction of systemic vascular resistance index (SVRI) from 2018 +/- 128 to 1641 +/- 102 (dynsec/cm5 m2). There were also observed statistically significant maximal increases of left ventricular stroke work index (LVSWI) from 41 +/- 3,1 to 53 +/- 3,2 (gm/m2) of oxygen delivery (DO2) from 489 +/- 24 to 587 +/- 29 (ml/min/m2) and of oxygen consumption (VO2) from 111 +/- 6 to 130 +/- 7 (ml/min/m2) which took place at the time of the maximum CI-increase. Moreover MAP-, CI- and VO2-responses of patients were stratified according to clinical conditions like time of operation, age, prognosis, ARDS, sepsis, hyperdynamic- and blood volume status.