Infusionstherapie (Basel, Switzerland)
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Severe septicemia is commonly a catabolic disease process with increased energy demands and enhanced protein degradation. Septic ICU-patients are on the one hand dependent on a sufficient substrate application; on the other hand, however, the organism's tolerance against exogenous substrate application is very often diminished in these patients because of varying organ insufficiencies. Because septicemia is not a uniform type of illness with predictable organ dysfunctions, it is not possible to give recommendations for a specific nutritional diet in septic patients. Nutritional management must be adapted individually according to the type and the degree of organ dysfunctions associated with septicemia.
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The success of transfusing platelet concentrates depends on a variety of factors; those factors are to a certain extent the subject of this paper. The quantity and quality of platelets transfused is discussed in relation to peripheral blood platelet concentration. The data obtained do not yet allow a final conclusion at present, so that further investigations are required.
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Randomized Controlled Trial Clinical Trial
[Effect of a 10% and 6% hydroxyethyl starch solution (molecular weight 200,000/0.62) in comparison with a 10% dextran solution (molecular weight 40,000) on flow properties of blood and tissue oxygen pressure in patients with intermittent claudication].
In a randomized, double-blind cross-over study in 10 patients with intermittent claudication, 2 concentrations (6% and 10%) of a hydroxyethyl starch (HES) solution of mean molecular weight 200,000 and of substitution degree 0.62 were compared to a 10% low-molecular-weight dextran solution of mean molecular weight 400,000. In addition to several hemorheological parameters, the behavior of the tissue oxygen pressure directly in the ischemic lower leg muscles of patients with chronic arterial occlusive vascular disease (stage IIb) was examined. 500 ml of the solutions described above were infused over a period of 30 min. Parameters such as tissue oxygen pressure and flow properties of blood were determined before infusion, immediately upon terminating infusion and 30, 60, 90, 120 and 180 min thereafter. ⋯ This behavior was less pronounced with the 6% solution. Measurement of the erythrocyte aggregation yielded an increase in values after infusion which was more significant for the 10% than for the 6% HES solution. The tissue oxygen pressure, as a measure of the tissue oxygen supply, remained more or less constant during hypervolemic hemodilution, despite reduced hematocrit values in the dextran group and in the 10% HES group.(ABSTRACT TRUNCATED AT 250 WORDS)
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In healthy volunteers, possible complications at the needle site were studied during short-term as well as continuous subcutaneous infusion of aqueous fluid with portable mini-pumps. Local complications, such as leakage of fluid, erythema, and bacterial contamination of the hypodermic needle were associated with the duration of the indwelling time, but not with the total volume delivered during every experiment. The hypodermic steel needle caused pain when the subcutaneous fat tissue layer was thin. These findings may have clinical relevance for the performance of continuous subcutaneous hormone infusion therapy (e.g. insulin-pump treatment of type-I diabetes mellitus).