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  • 1
    In: Journal of Parenteral and Enteral Nutrition, Wiley, Vol. 5, No. 5 ( 1981-09), p. 410-413
    Abstract: Fat emulsions are used increasingly for parenteral nutrition in premature infants suffering from various disorders, including respiratory insufficiency necessitating artificial ventilation with positive end expiratory pressure (PEEP). Both PEEP and lipid infusions (LI) may alter pulmonary hemodynamics. The simultaneous effect of LI and PEEP were therefore investigated. Five adult anesthetized Göttinger mini‐pigs were infused with a 20% LI at a high rate of 0.4 g/kg/hr for 30 min, followed by PEEP of 8 cm H 2 O for 15 min. Catheters were inserted into the upper vena cava, the pulmonary artery, the right and left atrium, and the aorta, and pressures recorded continuously. Ventilation volume, respiratory fractional gas concentrations of O 2 and CO 2 (mass snectrometer). and blood gases were measured. The following parameters were calculated : total peripheral resistance, pulmonary arteriolar resistance, right‐to‐left shunt (Q s /Q T ) dead space ventilation (VD/ V T ) and effective compliance. Total peripheral resistance remained unchanged. Pulmonary arteriolar resistance increased significantly during PEEP, PEEP + LI, but not during LI alone. Q S /Q T increased significantly during LI and returned to normal when PEEP was applied. V D /V T and effective compliance did not change during LI. The increased right to left shunt, caused by LI, is reduced by means of PEEP, while the pulmonary arteriolar resistance increased with PEEP and LI.
    Type of Medium: Online Resource
    ISSN: 0148-6071 , 1941-2444
    Language: English
    Publisher: Wiley
    Publication Date: 1981
    detail.hit.zdb_id: 2170060-6
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  • 2
    In: Clinical Chemistry and Laboratory Medicine (CCLM), Walter de Gruyter GmbH, Vol. 54, No. 3 ( 2016-01-1)
    Abstract: Fibrinogen-based clot firmness is reported as the maximum amplitude (MA) when using the citrated functional fibrinogen (CFF) assay in thrombelastography (TEG), and as the maximum clot firmness (MCF) together with several clot amplitude parameters when using the FIBTEM assay in thromboelastometry (ROTEM). Concern is currently being raised that these two tests have different platelet inhibiting performance and consequently provide different values. This is relevant for the clinical setting of fibrinogen replacement. We aim herein to compare the parameters of these two fibrinogen-based clot quality tests and their correlation with the plasma fibrinogen level as determined by the Clauss method. In total 261 whole blood samples taken from 163 clinical routine surgical patients were analyzed with TEG 5000 and ROTEM tests, and correlation with Clauss fibrinogen level was assessed. : Using TEG, the overall fibrin-based clot firmness measured in the CFF assay was significantly higher than the MCF measured by FIBTEM assay. Both assays showed significantly positive correlations with the fibrinogen levels measured using the Clauss method. However, individual values of Clauss fibrinogen concentration corresponded with different values for the two viscoelastometric tests; e.g. within the range of 1.9–2.1 g/L Clauss fibrinogen the median of CFF MA was 16.3 mm whereas FIBTEM MCF was 12.0 mm. : We showed herein by measurements of citrated whole blood samples from surgical patients that CFF MA values were different from FIBTEM MCF values measured in the same sample. Awareness that these whole blood assays provide different clot amplitude results is mandatory, particularly if they are being considered as tools for guiding fibrinogen supplementation. Thromboembolic side effects caused by a potentially too high fibrinogen substitution must also kept in mind in this context.
    Type of Medium: Online Resource
    ISSN: 1437-4331 , 1434-6621
    Language: Unknown
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2016
    detail.hit.zdb_id: 1492732-9
    SSG: 15,3
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