Infusionstherapie und klinische Ernährung
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Infusionsther Klin Ernahr · Feb 1986
[Indirect calorimetry in mechanically ventilated children. 3. Clinical use of a new measurement procedure].
After the new device for measurement of oxygen uptake (VO2) and carbon dioxide elimination (VCO2) was tested in a pneumatic lung model, we investigated its clinical practicability. First the level of VO2 and VCO2 in the early postoperative phase was determined. Secondly we examined alterations in gasexchange caused by various intensive care activities. ⋯ This device allows to quantify accurately oxygen consumption and carbon dioxide elimination in ventilated children. Furthermore, alterations in metabolism and cardiopulmonary variables caused by intensive care and therapeutic interventions can be examined continuously. It seems to be a valuable tool for metabolic and cardiopulmonary monitoring in critically ill children.
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Infusionsther Klin Ernahr · Aug 1984
[Effect of Nutriflex 48 on the plasma amino acid pattern in surgical intensive care patients with infection].
Nutriflex 48 (48 g amino acids and 1250 nonprotein kcal/l), containing 20% branched chain amino acids, was infused in a dose of 2000 ml per day over a period of 14 days to 8 surgical intensive care patients with sepsis and concomitant liver dysfunction. Cumulative nitrogen balance was negative on each day of investigation, as aspected in those patients. ⋯ These results seem to indicate that in septic patients a total parenteral nutrition with conventional amino acid solutions containing normal concentrations of branched chain amino acids, is possible. The results of the present study show that the necessity of parenteral nutrition in septic patients with highly branched chain amino acids can not be supported.
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Infusionsther Klin Ernahr · Jun 1981
Randomized Controlled Trial Clinical Trial[Effect of hydroxyethyl starch HES 450/0.7 and 5% human albumin on the colloid osmotic pressure and hemodynamic parameters in hypovolemic patients after major abdominal procedures].
In a randomized study 20 patients with hypovolemia following abdominal surgery for malignoma were treated with 500 ml HES 450/0.7 or human albumin 5% during the first 24 h after operation. COP and various blood- and hemodynamic parameters were measured immediately before and after infusion as well as 2, 4 and 6 h after infusion. After HES-infusion COP increased from 20.2 to about 22 mmHg and remained at a significantly higher level (p less than 0.01) for 6 h. ⋯ In the albumin-group CVP increased from the same starting level only to 4.2 cmH2O, and then dropped back to 3.2 cmH2O after 6 h (no significant difference to the starting level). The other blood- and hemodynamic parameters measured showed no significant differences between the two groups. The results show that a quick and reliable improvement of hypovolemia can be obtained in both groups immediately after infusion, but that the COP- and volume-stabilizing effects of HES-infusion are more distinct and remained for a significantly longer period of time than the effects of albumin 5%-infusion.
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Infusionsther Klin Ernahr · Jun 1981
Comparative Study[Parenteral nutrition in polytrauma - comparison between a fat-free and a fat-containing nutritional regime].
Two groups of patients with multiple injuries were treated with high-caloric parenteral nutrition over a period of 10 days. One group received amino acids (1 g/kg BW/day) and dextrose (2.0 x resting metabolic rate calories). ⋯ Nevertheless, in the lipid group more balanced blood-sugar levels were seen with smaller amounts of insulin to be needed. This suggests a beneficial effect on the carbohydrate metabolism.
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Donor blood should be selected properly before transfusion. Cross-matching has to be done in the laboratory by at least two established techniques. The importance of the bedside test and the controlled blood transfusion is pointed out.