Infusionstherapie und Transfusionsmedizin最新文献

{"title":"[Use of plasmapheresis in a 62-year-old patient with severe infection].","authors":"A Koepp,&nbsp;R Lampert","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The elimination of cytotoxic substances from blood as part of sepsis treatment has been controversely discussed so far. The following case report demonstrates the advantages and disadvantages of this therapy strategy.</p><p><strong>Case report: </strong>A 62-year-old male patient developed a paralytic ileus with wound dissection 3 days after elective sigma resection. A few hours after surgical revision he went into severe sepsis. A controlled ventilation was necessary as well as the use of catecholamines to maintain sufficient mean arterial pressure. Body temperature stayed between 39 and 40 degrees C (rectal). The patient's extremities and body showed severe marmorations due to the pathologic vasal alteration. A laparotomy one day after the operation revealed a massive generalized edema of the bowels without any evidence of insufficient anastomosis. The fulminant septic process could not be stopped with conservative treatment including continuous veno-venous hemofiltration. Under further deterioration of the pulmonary function (signs of beginning ARDS) and the generalized capillary leak syndrome we started plasmapheresis 2 days after operation in order to eliminate high-molecular cytokines. The plasmapheresis was done twice the following 2 days. Under this treatment the septic process was stopped. The pulmonary function and the circulation improved. The disturbed peripheral perfusion normalized. A laparotomy confirmed a significant decrease of the intestine wall edema. Unfortunately we could not repeat plasmapheresis. On the following days the patient worsened again and died 20 days later due to multiorgan failure.</p><p><strong>Discussion: </strong>The temporary improvement during plasmapheresis suggests that the patient might have profited from plasmapheresis-related optimized oxygen delivery, controlled diuresis and decrease of oxygen consumption. In addition we hypothesized that elimination of high-molecular cytokines and toxines contributed to the improvement under plasmapheresis. Using plasmapheresis one has to consider the high costs, risk of infection, and the unexplained mode of action to the mediatory process. Therefore we cannot recommend this treatment in general. Further controlled studies should investigate the therapeutic benefits of plasmapheresis in patients with severe sepsis.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"92-6"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19749072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Quality control of flow cytometry by means of fluorescent particles (\"beads\")].","authors":"H G Höffkes,&nbsp;G Schmidtke","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"115-6"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19750390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Monoclonal antibodies and immune marking].","authors":"H D Kleine,&nbsp;M Freund","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"109-10"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19750387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Morphologic and functional changes in thrombocytes after deep freezing with DMSO].","authors":"M Böck,&nbsp;L Greither,&nbsp;M U Heim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>During the past decade much work has been carried out towards establishing the optimum method for cryopreservation of platelets. Among the various cryoprotectants dimethyl sulfoxide (DMSO) has been shown to be the most effective. This report describes ultrastructural and functional changes of platelets during the deep-freezing process with DMSO.</p><p><strong>Materials and methods: </strong>Single-donor platelet concentrates were cryopreserved in liquid nitrogen by use of DMSO. Before, during and after the freezing process samples were taken for analysis of ultrastructure and platelet function.</p><p><strong>Results: </strong>While after isolation and addition of DMSO a normal ultrastructure of platelets could be observed, clear signs of beginning cell necrosis were detected after thawing and resuspension in autologous plasma. Fibrinogen-binding capacity and platelet aggregation were significantly diminished.</p><p><strong>Conclusions: </strong>Although cryopreserved platelets are characterized by hemostatic effects in vivo, it seems conceivable that these effects could be improved by further development of platelet-freezing techniques.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"76-9"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19749069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Flow cytometry and data analysis].","authors":"C T Nebe","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"111-3"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19750388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Quantitative flow cytometry: absolute cell count determination in whole blood and blood components].","authors":"H Radtke","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"114"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19750389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Plasma volume determination with ICG dye in changes of intravascular volume. Dye dilution method before and after autologous blood donation and after retransfusion in the human].","authors":"H Gehring,&nbsp;W Nahm,&nbsp;K F Klotz,&nbsp;O Zais,&nbsp;R Schreiber,&nbsp;P Schüren,&nbsp;P Schmucker","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The determination of the current intravascular plasma volume with the dye dilution method is of major interest in therapeutic intervention and scientific research. The use of the rapidly eliminated dye indocyanine green (ICG) allows to perform plasma volume measurements serially and to observe a time course. The following questions should be investigated in the present study: 1. Do the plasma volume (PV) values measured by the ICG method in this study agree with data of other authors with special respect to basic values for further clinical investigations, and 2. Do the measured differences coincide with the withdrawn and retransfused plasma volume?</p><p><strong>Design: </strong>Prospective study (on each 20 healthy female and male volunteers).</p><p><strong>Setting: </strong>Research laboratory of a university department of anesthesiology.</p><p><strong>Participants: </strong>Each 20 healthy female and male volunteers.</p><p><strong>Interventions: </strong>Measurement of PV with ICG both before and after withdrawal of 10% of blood volume and after retransfusion.</p><p><strong>Results: </strong>The plasma volume per body surface area (PV/BSA) was in the group of female volunteers 1639 +/- 198 and in male volunteers 1687 +/- 224 ml/m2 (mean +/- SD). The withdrawn amount of plasma volume (EPV) was 188 +/- 23 in the female group and 149 +/- 26 ml/m2 in the male group. Determined by the ICG method the difference for the withdrawal was in female volunteers 198 +/- 174 and in male volunteers 171 +/- 158 ml/m2 and for the retransfusion in the female group 190 +/- 169 and in the male group 142 +/- 154 ml/m2.</p><p><strong>Conclusions: </strong>The mean differences in plasma volume measured by the ICG method both before and after withdrawal and after retransfusion of autologous blood were in good agreement with the withdrawn amount of plasma volume. The large standard deviation has to be considered in clinical assessment of an individual measurement.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19749071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality control in the preanalytical phase of flow cytometry.","authors":"M Heins","doi":"10.1159/000223270","DOIUrl":"https://doi.org/10.1159/000223270","url":null,"abstract":"","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 2","pages":"107-8"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000223270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19750386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can blood group O red cells of donor origin acquire weak group A reactivity through serum A transferase of the recipient after bone marrow transplantation?","authors":"M G Wichmann,&nbsp;T Haferlach,&nbsp;M Suttorp,&nbsp;Y Zhang,&nbsp;J Neppert","doi":"10.1159/000223251","DOIUrl":"https://doi.org/10.1159/000223251","url":null,"abstract":"<p><strong>Background: </strong>Blood group A substance was detected on red cells of a patient who received a bone marrow transplant from a blood group O donor 3.5 years ago.</p><p><strong>Materials and methods: </strong>Peripheral blood was investigated by conventional serological techniques, fluorescence in situ hybridisation, and polymerase chain reaction.</p><p><strong>Results: </strong>All peripheral blood cells are of donor origin. Anti-A and not anti-A, B of blood group O individuals can be absorbed to the group O red cells of the patient.</p><p><strong>Conclusion: </strong>We suppose that the patient's residual serum A transferase attaches the appropriate sugar to substance H on the red cell membrane to form substance A.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"29-31"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000223251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19629570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Microbial safety of blood products].","authors":"P G Höher","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Septicemia caused by contaminated stored blood is a rare event, and the actual incidence is hard to determine due to a considerable variation of the different study protocols. This review is intended to give an overview of the pertinent literature considering causes, frequencies and kind of agents in contaminated blood products.</p><p><strong>Sources: </strong>English and German literature as well as own data.</p><p><strong>Selection criteria: </strong>Original and review articles relevant to the topic.</p><p><strong>Findings: </strong>The rate of septic episodes after transfusion of contaminated blood donations is approximately 0.3% (0.003-5%) of all blood transfusions. Contaminations of red cell preparations are predominantly caused by gram-negative bacteria, most often psychrophiles (Pseudomonas sp. Yersinia enterocolitica, Serratia). In platelet concentrates the prevailing bacterial organisms are represented by staphylococcal species. Bacterial contamination of blood and blood products may be generated in the process of blood collection and preparation of blood components. Materials and machinery used for blood processing may well serve as sources of contaminations. A considerable proportion of all contaminations must be attributed to transient, asymptomatic bacteremia of the donor. An additional predonation questionnaire addressing clinical symptoms associated with various pathological conditions (abdominal pain, tick-bites, malaria) has proven unpractical and may lead to a rejection rate of donors as high as 11%.</p><p><strong>Conclusions: </strong>In-process bacteriological surveillance, stringent control of technical and hygienic conditions, and the use of leukocyte filters can reduce the risk of bacteria transmission. In case of transfusion reactions due to suspected bacterial contamination, blood samples of the patient as well as of the transfused blood product and the transfusion equipment used must be secure for microbiological examination.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"42-58"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19630039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}