Infusionstherapie (Basel, Switzerland)最新文献

Changes in body composition, in cancer as in benign disease, simple starvation or overfeeding, show the integrated effect of a period of metabolic imbalance. Therefore, accurate measurements of body composition can help to elucidate the mechanisms that bring about the imbalance. Techniques of measurement that depend for their accuracy on the constancy of some property of the entire fat-free tissues are unlikely to give accurate results in obese or wasted patients. It is more informative, and more accurate, to measure fat, water, protein and mineral separately, and at present this is best done by dilution of labelled water and multi-element in vivo neutron activation analysis. Changes should be determined by sequential measurement wherever possible; otherwise results must be compared with 'normal' values found by measuring healthy subjects, correcting if necessary for differences in age and stature between patients and healthy subjects.

In order to determine the risk of bacterial contamination of blood during autotransfusion, blood samples were taken from the autotransfusion system of 25 consecutive total hip replacements at various stages and at different times (9 samples per patient). According to the same principle, samples were taken from the identical system after processing the postoperative drainage blood. Since the danger of contamination depends on the quality of the air which is sucked into the autotransfusion system along with the blood, we also measured the amount of bacteria in the air in two different operating rooms: Horizontal laminar air flow was provided for 20, conventional ventilation for a further 5 operations. Evaluation of airborne contamination in the operating rooms showed at most 656 cfu/m3 in the conventionally ventilated room and at most 344 cfu/m3 in the room with laminar air flow. Micrococci and peptococci were cultivated from 2 samples out of 225. The isolates were derived from 2 different patients (1 in the LAF-OR, 1 in the conventionally ventilated OR); both samples were taken from the retransfusion bag towards the completion of surgery. From these results we conclude that even in a conventionally ventilated operating room during primarily aseptic surgery intraoperative autotransfusion does not involve an increased risk of infection. This also applies to the retransfusion of processed blood from Redon drainages using the identical autotransfusion set.

The field of human body composition research by necessity is based upon assumptions related to tissue chemical content. The 2-compartment model, which requires only 1 measurement in addition to body weight, is the cornerstone of current research in this field. Yet the assumptions upon which 2-compartment models are based were developed on a limited scale and their validity under specified conditions is questionable. Recent developments now allow quantification of previously unmeasured somatic constituents. The capacity to extend our models to 4 or more components is now at hand. Not only will this allow us to vastly expand our validation of two 2-compartment approaches, but our ability to explore new and important physiological questions is within reach.

Early postoperative disorders of blood glucose homeostasis and its hormonal regulation do not allow a normal caloric enteral or parenteral substrate supply in this period. Eleven land pigs were investigated to find out how the surgical trauma of a partial gastrectomy influences the absorptive capacity of the small intestine and the hormonal regulation after intraduodenal administration of a glucose solution. We therefore conducted portal vein measurements to correlate the influence of the liver passage of early postoperative changes in blood glucose and hormonal levels. Our data show that neither the porto-arterial differences in blood glucose nor those in hormonal concentrations are significant. Therefore, we conclude that peripheral measurements can be used as good and reliable parameters for such investigations of absorption or hormonal regulation in the early postoperative period.