ISSN:1660-3796    

DOI:10.1159/000222685

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

ISSN:1660-3796    

DOI:10.1159/000222686

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

ISSN:1660-3796    

DOI:10.1159/000222687

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

摘要:

Auf der Basis einer Literaturrecherche wird der gegenwärtige Stand des Wissens über die möglichen Ursachen des durch Tryptophan ausgelösten Eosinophilie-Myalgie-Syndroms dargestellt. Die anfangs begünstigte Hypothese, dieses Syndrom könne durch Metabolite infolge eines bei einzelnen Personen veränderten Tryptophanstoffwechsels ausgelöst werden, hat keine Wahrscheinlichkeit für sich. In der Zwischenzeit hat es sich herausgestellt, daß durch Verfahrensänderungen bei einem der Hersteller von Tryptophan bestimmte Chargen von L-Tryptophan Verunreinigungen enthalten. Soweit es sich zurückverfolgen läßt, haben nur solche tryptophanhaltigen Präparate ein Eosinophilie-Myalgie-Syndrom ausgelöst, die das Produkt dieses einen Herstellers mit den Verunreinigungen enthalten. Ob diese Verunreinigungen selbst die eigentliche Ursache für das Syndrom sind, oder ob sie nur Marker sind, bleibt zu ermitteln. Ein Tiermodell, das zur Klärung dieser Frage führen könnte, ist inzwischen entwickelt worden. Mit HPLC ist es heute möglich, diese Verunreinigungen festzustellen und entsprechende Chargen zu eliminieren. Bei Anwendung dieser Vorsichtsmaßnahmen besteht kein Grund auf lebensverlängernde oder lebensrettende künstlîche Ernährung mit notwendigerweise Tryptophan enthaltenden Díätpräparaten oder Inf

ISSN:1660-3796    

DOI:10.1159/000222688

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

ISSN:1660-3796    

DOI:10.1159/000222764

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

摘要:

Anaesthesiology and transfusion medicine are presented as two specialities in medicine which have many common interests and mutual bonds. They both are young developments with similar historical stages during the last centuries and fulminant final progresses within the last decades. In a state of the art review transfusion medicine is described as a new speciality whose complexity, its nowadays accepted facets, the goals and topics are clearley understood. The anaesthesiologist as the clinician with the greatest proximity to blood transfusion should know about transfusion medicine not only theoretical basic science, but also practical clinical work. It is necessary for anaesthetists to know about immunology, haemoglobin levels, blood coagulation and the haemodynamics of circulation, some of these facets being already well known to him from everyday work in the O. R. and at the ICU. The anaesthetist must furthermore be familiar with bed side pretransfusion testing, autologous blood transfusion, the indications for an appropriate use of the different blood components and the danger of adverse effects of blood transfusion. A clear and safe use of blood during surgery and in the intensive care medicine must be the final goal for anaesthesiologists wanting fo fulfil their tasks properly.

ISSN:1660-3796    

DOI:10.1159/000222689

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

ISSN:1660-3796    

DOI:10.1159/000222765

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

摘要:

The transfusion of leukocyte-containing blood products causes a number of side reactions, which among others induces alterations of the immune system of the recipient leading to alloimmunization or immunosuppression. Antibodies against antigenic determinants of the major histocompatibility complex-proteins of class I are the major cause of alloimmunization. Though platelets are easy targets for HLA antibodies, they cannot induce the antibody production themselves. This requires leukocytes, carrying the MHC-proteins of the class II. Standard platelet concentrates for the clinical routine have more than 106 leukocytes. Leukocyte filters with a special surface modification reduce the number of leukocytes in platelet concentrates underneath this CILL-value (critical immunogenic load of leukocytes), thus reducing the antigenic, ímmunogenic effects of leukocyte contamination considerably

ISSN:1660-3796    

DOI:10.1159/000222766

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

摘要:

O2-uptake was measured continuously in 18 polytraumatized and 21 long-term ventilated patients. All patients were on assisted ventilation with sufficient sedation and analgesia. O2-uptake was measured every minute, the values were recorded over 24 h and the mean O2-uptake/ min was calculated. At the same time, the O2-uptake of the last 15 min of every hour was measured separately (e.g. 7.45–8.00, 8.45–9.00, etc.). The mean O2-uptake/min measured continuously was compared and correlated with the mean O2-uptake per day, calculated on the basis of each of the short-term measurements. There were only slight differences between the mean values of the two procedures: In the group of long-term ventilated patients the mean O2-uptake was found to be 364 ml/min in continuous measurements and 363 ml/min in short-term measurements. This O2-uptake corresponded to an energy expenditure of 2360 kcal/day. The mean correlation coefficient was 0.89 (range: 0.79–0.96). If O2-uptake was measured over 2 periods of 15 min each, e.g. in the late morning and in the afternoon, the mean correlation coefficient improved to 0.94 and the standard deviation was reduced. Comparable results were obtained in the group of polytraumatized patients. This study shows that under certain preconditions short-term measurements of O2-uptake of 2 × 15 min allow sufficiently reliable predictions of the daily O2-uptake and energy expenditure in severely traumatized or critically ill pa

ISSN:1660-3796    

DOI:10.1159/000222690

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger

摘要:

The COBE Spectra was evaluated in 71 plateletpheresis procedures. Using the collection and anticoagulant algorithms of the system (n=57) we collected 4.3 ± 1.2×1011 platelets with a mean separation efficiency of 70.2+12.1%. The cell contamination was very low (leukocytes 0.5 ± 1.0×107, red cells 1.5 ± 2.2×107). In four different modifications of the standard separation protocols, we tried to reduce the ACD consumption in order to shorten the donation time and to improve donor safety. A constant ACD/blood ratio of 1 : 9 and increase of the blood flow to 50ml/min (n=14) caused significantly lower yields (3.1+0.7, p < 0.01) and visible spontaneous platelet aggregates in the collection line in 50% and in the PC’s in 29% of the runs. In orderto prevent platelet activation the ACD algorithm had to be maintained, but a reduction of the ACD/ blood ratio to about 15% was acc

ISSN:1660-3796    

DOI:10.1159/000222767

出版商:S. Karger GmbH    

年代:1991

数据来源: Karger