Infusionstherapie und Transfusionsmedizin最新文献

{"title":"[The revised PEDINFUS computer program for total and added parenteral nutrition in children].","authors":"J Kuchenbecker,&nbsp;L Urbina,&nbsp;M Müller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The computer program PEDINFUS, first described in 1991, has been fundamentally revised and further developed. The area of application has been considerably widened as additive parenteral nutrition has been included and the group of newborn and preterm infants has been taken into account. Consequently, the program can be used for children of all age groups. In addition, the program has a graphical user interface and can be used on several hardware platforms. The flexibility of the program has also been increased to a considerable degree. Now the nutrient amounts per kilogram per day, the limits of the laboratory values, the combination of enteral food and infusion solutions, and the already drawn-up infusion plans can be changed at liberty. Considerably more matters of clinical interest accompanying parenteral nutrition have been integrated in the program. Further plausibility controls have also been introduced to achieve greater certainty in the calculation of the infusion solutions. In consequence, the preconditions for ensuring and controlling the quality of infusion therapy regimens can be established on an improved level.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"35-40"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19630037","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":"The clinical application of two newly developed lipid emulsions (Solipid 20% S&E) in critically ill patients.","authors":"K Widhalm,&nbsp;S Kohl,&nbsp;A Hammerle","doi":"10.1159/000223248","DOIUrl":"https://doi.org/10.1159/000223248","url":null,"abstract":"<p><strong>Objective: </strong>The clinical compatibility of two newly developed lipid emulsions based on soy oil (20%) emulsified with egg lecithin (12 g/l) or soy lecithin (15 g/l) (Solipid 20% E&S) has been compared.</p><p><strong>Design: </strong>Double-blind prospective randomized study.</p><p><strong>Setting: </strong>Intensive care unit of a university hospital.</p><p><strong>Patients: </strong>20 patients (16 men, 4 women, age 20-59 years) were entered into the study.</p><p><strong>Interventions: </strong>One g of lipids/kg body weight per day was administered on day 1 and subsequently 2 g/kg/day on days 2-5. Blood was drawn once a day, lipids, lipoproteins, apoproteins and other routine clinical chemistry parameters were determined.</p><p><strong>Results: </strong>No significant increase of total triglycerides could be observed. Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoproteins A I and B usually remained below the reference ranges. Electrolytes, uric acid and glucose, blood cells, parameters of liver and kidney function, coagulation and protein metabolism did not show relevant changes; only the activity of gamma-GT in both groups--independent of the sort of lecithin--increased significantly.</p><p><strong>Conclusion: </strong>The results indicate adequate elimination of both tested lipid emulsions from the plasma at usual clinical conditions. Therefore Solipid 20% S&E can be used in critically ill patients.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000223248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19630041","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":"[Isovolemic hemodilution for avoiding homologous blood transfusions: effectiveness in large gynecologic interventions].","authors":"M Oberhauser,&nbsp;H J Bardenheuer,&nbsp;H Bernasconi,&nbsp;T Genz,&nbsp;U Kreimeier","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The practicability and efficiency of a standardized, preoperative isovolemic hemodilution was investigated during major gynecological operations (Wertheim's operation, etc.).</p><p><strong>Design: </strong>Prospective clinical trial with a historical control group.</p><p><strong>Setting: </strong>Operating room of a gynecological university hospital.</p><p><strong>Patients and interventions: </strong>Under general anesthesia hemodilution to a hemoglobin concentration of 9 g/dl was performed in 48 patients (mean age: 53 years). Shed blood volume amounted to 900 +/- 210 ml. Transfusion of autologous or homologous blood was provided when Hb concentration decreased beyond 7 g/dl intraoperatively.</p><p><strong>Results: </strong>Compared to a control group of 57 patients without hemodilution the total number of PRBC units transfused was significantly reduced. Moreover, in 65% of all patients the transfusion of homologous blood could completely be avoided perioperatively (control group: 21% of patients). Adverse effects did not occur.</p><p><strong>Conclusions: </strong>The data reflect that acute isovolemic hemodilution before major gynecological operations represents a safe, easy to handle and effective procedure to avoid transfusion of homologous blood up to a total blood loss of 1,300-1,400 ml.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"15-23"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19629568","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":"[Importance of introduction of PCR in blood banks].","authors":"L Gürtler","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19630038","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":"[Effect of administration of blood products on the course of tetanus antibody concentration in immuno-incompetent patients].","authors":"M Pietsch,&nbsp;S Töre,&nbsp;K H Schütt","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Collecting of data for immunoprophylaxis of tetanus in immunodeficient patients via administration of blood products.</p><p><strong>Design: </strong>Prospective single case studies.</p><p><strong>Setting: </strong>Clinical therapy in a department of hematology with continuous determination of tetanus antibody concentrations in patients' sera and administered blood products with an enzyme immunoassay.</p><p><strong>Patients: </strong>3 patients with acute myeloid leukemia (FAB classifications M1, M3, M4).</p><p><strong>Interventions: </strong>Regular administration of blood products due to clinical therapy.</p><p><strong>Results: </strong>After administration of about 4,000 IU tetanus antitoxin i.v., serum concentration is increasing by 1 IU/ml. Half life in serum amounts to 7 days. Protection lasts therefore up to 6 weeks.</p><p><strong>Conclusions: </strong>Immunodeficient patients may receive a medium-term effective protection against tetanus after selection of suitable blood products. This method is interesting also for prophylaxis of postoperative tetanus in immunocompetent patients.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"25-8"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19629569","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":"[Thrombocyte collection with the A3p program using the blood cell separator Haemonetics MCS 3p].","authors":"R Moog,&nbsp;N Müller","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"60"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19630040","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":"Intensification of donor interviewing procedures: a feasibility study.","authors":"D J van Rhenen,&nbsp;M H Molijn,&nbsp;J Gorgels,&nbsp;J M van der Linden,&nbsp;L K Ko","doi":"10.1159/000223252","DOIUrl":"https://doi.org/10.1159/000223252","url":null,"abstract":"<p><strong>Objective: </strong>To determine the feasibility and acceptability for the blood donor of an intensified blood donor interviewing procedure on high-risk factors for infectious diseases. To answer the question whether an intensified blood donor interviewing procedure would lead to an unacceptable loss of blood donors.</p><p><strong>Design: </strong>Feasibility study.</p><p><strong>Setting: </strong>Red Cross Bloodbank Rotterdam. DONORS: Study group of 240 first-time donors.</p><p><strong>Interventions: </strong>Intensified donor interviewing techniques by direct questioning and workload assessment.</p><p><strong>Results: </strong>Intensified interviewing was welcomed by 88-91% of first-time donors and rejected by 2-5%. On the question whether the intensified interviewing procedure should be the standard approach of the blood bank the answer was positive in 76-82% of first-time donors and negative in 11-14%. No blood donors indicated that this would be a reason to withdraw from blood donation. The workload for the blood bank physician increased by approximately 30%.</p><p><strong>Conclusion: </strong>The approach of intensified donor interviewing techniques in first-time donors is acceptable both to the donors and the blood bank workload.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"23 1","pages":"32-4"},"PeriodicalIF":0.0,"publicationDate":"1996-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000223252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19630036","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":"Feasibility and rate of leucocyte depletion with a single leucocyte depletion filter during massive transfusion.","authors":"A Rieger,&nbsp;M Saefkow,&nbsp;I Hass,&nbsp;C Spies,&nbsp;K Eyrich","doi":"10.1159/000223160","DOIUrl":"https://doi.org/10.1159/000223160","url":null,"abstract":"<p><strong>Background: </strong>The study examines the feasibility and rate of leucocyte depletion with a single leucocyte depletion filter in combination with the Level 1 heat exchanging infusion/transfusion device H-500/H-25i during massive transfusions.</p><p><strong>Materials and methods: </strong>LeukoGuard-6 filters (LG-6) were manufactured to fit the infusion sets of the Level 1 H-500/H-25i. This modified device was used intraoperatively in six patients with severe haemorrhage. Following determination of the white cell counts (WCC) in each buffy coat poor red cell concentrate prior to administration, WCC were then obtained from blood sampled directly distal to the filter after the first and after the last red cell concentrate was given. Leucocytes were determined in the Nageotte chamber and then calculated to determine leucocytes/250 ml (therapeutic unit). Parameters of feasibility (time for preparation of the system, the amount of transfused red cell concentrates, time interval of transfusions) were recorded.</p><p><strong>Results: </strong>The mean volume of red cell concentrates which were transfused and filtered by a single filter was 2,708 ml (S.D. +/- 797 ml) within a mean time interval of 42.5 min (S.D. +/- 26 min). With a mean WCC of 1.17 +/- 0.68 x 10(9) leucocytes/250 ml in the red cell concentrate prior to filtration the LG-6 achieved a log-3 reduction of leucocyte counts. During the transfusion the WCC distal to the filter increased on average by a factor of 3 (from 0.9 x 10(6) leucocytes/250 ml following the first blood unit to 2.7 x 10(6) leucocytes/250 ml following the last), but remained below 5 x 10(6).</p><p><strong>Conclusion: </strong>Modification of the Level 1 H-500/H-25i system by incorporating the LG-6 leucocyte depletion filter provides a significant reduction of the WCC in the transfused red cell concentrates during massive transfusion. The rate of leucocyte depletion by a single leucocyte depletion filter achieves low leucocyte counts which are documented to be of therapeutical value. As the significance of leucocyte-reduced blood products for patients with haemorrhagic shock following trauma or major surgery has still to be elucidated, the presented device may be useful in the performance of future studies related to this subject.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"22 6","pages":"355-9"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000223160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19569619","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":"[Effect of colloidal plasma substitutes on liberation of tumor necrosis factor-alpha (TNF-alpha) in human whole blood in vitro].","authors":"C Sirtl,&nbsp;G Salewsky,&nbsp;J Baier,&nbsp;S Lange,&nbsp;H Laubenthal,&nbsp;H A Neumann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the influence of colloidal plasma substitutes on human cytokine network, especially of tumor necrosis factor alpha (TNF-alpha), in vitro.</p><p><strong>Design: </strong>Heparinized whole blood samples from 8 healthy volunteers were divided and set on various concentrations of artificial colloidal plasma substitutes (native = 0 mg/ml; 5 mg/ml; 15 mg/ml). As colloids were used hydroxyethyl starch 200/0.5 (HES), dextran 60 (DX), urea-linked gelatin (GEL) and human albumin solution (HA). After incubation (24 h; 5% CO2; 37 degrees C; with and without concomitant stimulation of blood cells with phytohemagglutinin [PHA]) measurement of TNF-alpha release was performed via ELISA by the method described by Gallati. For the statistical evaluation a repeated measures analysis of variance was used.</p><p><strong>Results: </strong>Basic level of TNF-alpha was found between 226 and 273 pg/ml (0 mg of each colloid/ml), stimulation with PHA without any colloid increased the TNF-alpha level about fourfold (1,066-1,260 pg/ml; 0 mg of each colloid/ml). At 5 mg/ml and 15 mg/ml without PHA all 3 artificial colloids rose the level of TNF-alpha (up to 50%). Under concomitant stimulation each colloid induced additional TNF-alpha release in comparison to PHA alone. The changes elicited by DX and GEL were statistically significant (p < 0.001 and p = 0.005, respectively) in contrast to those induced by human albumin solution or HES.</p><p><strong>Conclusion: </strong>In relation to TNF-alpha plasma substitutes are not inert substances as perhaps suspected. The questions whether the observed effects exist in vivo how far other cytokines are influenced and the question about the clinical importance are subject of ongoing studies.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"22 6","pages":"332-8"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19569093","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":"Comparison of calculated and measured mixed venous oxygen saturation in critically ill patients.","authors":"G Cieslinski,&nbsp;T Konrad,&nbsp;H Klepzig","doi":"10.1159/000223157","DOIUrl":"https://doi.org/10.1159/000223157","url":null,"abstract":"<p><strong>Objective: </strong>According to the Fick principle the calculation of cardiac output and shunts is based on the exact determination of oxygen saturation. In this study an intraindividual comparison of two frequently applied methods was done.</p><p><strong>Design and setting: </strong>The calculated saturation by measuring partial oxygen pressure was compared with a gold standard, the reflectometrically measured saturation.</p><p><strong>Patients: </strong>75 patients of an intensive care unit in whom a Swan-Ganz catheter was introduced to answer clinical questions.</p><p><strong>Results: </strong>Overall, most calculated values were higher than the measured ones, the mean difference was 5.9% (+/- 8.03%), ranging from -10.4 to +37%. In lower saturations (< 65%) the difference between both estimated values was larger than in the range above 65%.</p><p><strong>Conclusions: </strong>Especially when handling with lower oxygen saturations, calculation of saturation with an automatic gas analyzer leads to overestimated values. The Fick principle can only be applied for hemodynamic calculations when oxygen saturation can be determined by an easy and correct method.</p>","PeriodicalId":13632,"journal":{"name":"Infusionstherapie und Transfusionsmedizin","volume":"22 6","pages":"340-3"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000223157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19569616","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}