Blood Replacement

ISBN-13: 9783540044963 / Angielski / Miękka / 1969 / 284 str.

Ulrich Franz Gruber; L. Oxtoby; R. F. Armstrong

Opis

The manifold problems of shock are still of great importance, diagnostic and therapeutic experience of the "severely ill" being supplied with new information almost every month. In the 5 periodicals which have found their way to my desk during the past few days there are no less than 10 interesting articles on questions concerning shock research see Bibliography 41 b, 53 a, 60 a, 192 a, 242 a, 350 b, 810 a, 941 a, 1069 a, 1082 a]. The most urgent point still is to maintain as complete as possible the objective catalog of the various shock manifestations found in man and in animals - yet at the same time to view interpretations of these phenomena in their relative and temporal "truth." Problems of shock research are not only interesting for their scientific value but also for their clinical implication. In particular, almost every practicing physician is facing problems of blood replacement very frequent ly. The effective or circulating blood volume remains an important theoret ical and therapeutic problem in the shock field. For years, U. F. GRUBER has pursued this question clinically and experimentally. This volume deals with the world literature in an exceptionally thorough manner. This book is made more than a compilation by including a long list of original work done with F. D. MOORE in Boston, in the Surgical Department in Chur, with L. E. GELIN and S. E."

Spis treści

one: Pathophysiology of Blood Loss.- A. Pathophysiology of Hemorrhagic Shock.- B. Spontaneous Regulation Processes of the Organism Following Blood Loss.- I. Losses of 500–1000 ml of Blood.- II. Larger Blood Losses.- C. Problems of Oxygen Transport.- I. Rest Conditions.- II. Jeopardy of Adequate Oxygen Supply.- III. Necessity of Erythrocyte Replacement.- IV. Evaluation of the Oxygen Supply of the Body.- V. Flow Properties of Blood.- VI. To what Extent May the Blood Volume be Replaced with Erythrocyte-free Solutions?.- D. Summary and Conclusions: Pathophysiology of Blood Loss.- TWO: Various Methods of Volume Replacement.- A. Volume Replacement Using Blood.- I. Disadvantages and Dangers of Blood Transfusion.- 1. Mortality.- 2. The Transmission of Disease.- a) The Frequency of Transfusion Hepatitis.- b) Mortality of Transfusion Hepatitis.- c) Measures for Preventing Transfusion Hepatitis.- 3. Reactions due to Bacterial Contamination.- 4. Incompatibility.- 5. Hemolytic Reactions.- 6. Allergic Reactions.- 7. Citrate Toxicity.- 8. Acidity of Preserved Blood.- 9. Temperature Drop after Addition of Larger Amounts of Cold Blood.- 10. Blood Coagulation Disturbances after Massive Blood Transfusions.- 11. Potassium Intoxication.- 12. Ammonia Intoxication.- 13. Post-transfusion Hyperbilirubinemia.- 14. Various other Factors.- 15. Reduction of Bacterial Resistance.- 16. Impairment of the Flow Properties of Blood.- 17. Survival of Transfused Erythrocytes.- II. The Volume Effect of Blood Transfusions — Therapeutic Results.- III. Summary and Conclusions: Volume Replacement with Blood.- B. Volume Replacement with Plasma.- I. The Various Plasma Preparations.- 1. Fresh Plasma.- 2. Pooled Plasma (Aged Plasma, Normal, Whole) Stored at 32° C.- 3. Human Dried Plasma = HDP.- 4. Pasteurized Plasma Protein Solution = PPS.- 5. Albumin.- II. The Volume Effect of Plasma.- 1. Fresh Plasma.- 2. Stored Pooled Plasma.- 3. Dried Plasma.- 4. Pasteurized Plasma Protein Solution.- 5. Albumin.- III. Therapeutic Results.- IV. Summary and Conclusions: Volume Replacement with Plasma.- C. Volume Replacement with Artificial Colloid-Containing Infusion Solutions.- I. Introduction.- II. Terminology.- III. The Requirements for Artificial Colloid-Containing Infusion Solutions.- IV. Physico-chemical Characterization of Artificial Colloids.- 1. Molecular Weight.- 2. Viscosity.- V. The Various Artificial Colloids.- 1. Dextran.- a) Definition.- b) General Preliminary Remarks for Evaluating Literature on Dextran.- c) The Various Dextran Preparations.- d) Compatibility of Macrodex and Rheomacrodex with Medications.- e) Colloid Osmotic Pressure and Effect, Water Retaining Capacity.- f) Metabolism.- g) Plasma Concentration, Excretion in Urine, Renal Function.- h) Histological Investigations.- i) Immunological Investigations.- k) Allergic Reactions.- l) Influence on Sedimentation Rate, Aggregating and Disaggregating Properties 7% m) Influence on Viscosity.- n) Influence upon Blood Group Determination 82 o) Influence upon Defence against Infection and Nonspecific Resistance.- p) Carcinogenicity.- q) Influence upon Blood Coagulation.- r) Pharmacological Properties.- s) Influence on Laboratory Investigations.- t) Stability During Storage.- u) The Volume Effect of Dextran.- v) Hemodynamics.- w) Therapeutic Results.- x) Summary and Conclusions: Volume Replacement with Dextran.- 2. Gelatin.- a) Definition.- b) General Remarks Concerning Evaluation of Gelatin Literature.- c) The Various Gelatin Preparations.- d) Compatibility of Gelatin Preparations with Medications.- e) Colloid Osmotic Pressure and Effect, Water Retaining Capacity.- f) Metabolism.- g) Plasma Concentrations, Excretion in Urine, Renal Function.- h) Histological Studies.- i) Immunological Studies.- k) Allergic Reactions.- l) Influence on Sedimentation Rate, Aggregating and Disaggregating Properties.- m) Influence on Viscosity.- n) Influence on Blood Group Determination.- o) Influence upon Defence against Infection and Nonspecific Resistance.- p) Carcinogenicity.- q) Influence on Blood Coagulation.- r) Pharmacological Properties.- s) Stability during Storage.- t) The Volume Effect of Gelatin.- u) Hemodynamics.- v) Therapeutic Results.- w) Summary and Conclusions: Volume Replacement with Gelatin.- 3. Polyvinyl Pyrrolidone (PVP).- a) Definition.- b) The Various Preparations.- c) Metabolism.- d) Volume Effect.- e) Summary: Polyvinyl Pyrrolidone.- 4. Starch (Hydroxyethyl Starch).- a) Definition.- b) Manufacture.- c) Metabolism.- d) Plasma Concentration.- e) Renal Function.- f) Histological Investigations.- g) Influence on Blood Coagulation.- h) Immunological Studies.- i) Influence on Sedimentation Rate.- k) Pharmacological Properties.- l) Volume Effect.- m) Therapeutic Results.- n) Summary: HO-ethyl Starch.- 5. Alginon.- 6. Levan.- D. Volume Replacement with Colloid-free Solutions.- Three: Discussion.- A. Oral Therapy.- B. Intra-arterial Infusion.- C. Hemoglobin, Oxygen Transport.- I. The Gas Phase.- II. The Blood Phase.- III. The Tissue Phase.- D. Shock Models.- E. Problems of Blood Volume Determination.- F. Colloid Osmotic Pressure, Filtration, Interstitial Pressure.- G. Comparison of the Various Possibilities which are Available for Replacement of Blood Loss.- H. Dextran or Gelatin?.- I. Practical Conclusions.- J. Concluding Remarks.- K. Outlook.- FOUR: Summary.- Literature.- Additional Literature.- Appendix to the Literature.