| 1. |
- Adrian, Katrin, 1966, et al.
(författare)
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Cytokine release during long-term extracorporeal circulation in an experimental model.
- 1998
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Ingår i: Artificial organs. - 0160-564X. ; 22:10, s. 859-63
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to determine the degree of leukocyte activation, as measured by cytokine release, in circulating blood during experimental extracorporeal circulation. Complete in vitro extracorporeal membrane oxygenation (ECMO) circuits were used, and 9 experiments were performed. Whole blood stored at 37 degrees C was used as the control. Blood samples were withdrawn before the start of perfusion and at 24 h of perfusion. Statistically significant releases of interleukin (IL)-1beta, IL-8, and IL-1 receptor antagonist were observed in the perfusion circuits compared to both the control blood and baseline values. Also, increases in plasma tumor necrosis factor (TNF)alpha and IL-6 were seen after 24 h of perfusion although these changes did not reach statistical significance. These results indicate that extracorporeal circulation induced leukocyte activation and cytokine release. These reactions might, as an additional trauma, deteriorate the situation in an already severely ill patient. A search for methods to counteract this untoward activation seems warranted.
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| 2. |
- Adrian, Katrin, 1966, et al.
(författare)
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The effect of albumin priming solution on platelet activation during experimental long-term perfusion.
- 1998
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Ingår i: Perfusion. - 0267-6591. ; 13:3, s. 187-91
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the effect of albumin priming on platelet consumption and activation during long-term perfusion. Two identical in vitro extracorporeal membrane oxygenation circuits were used; one was primed with Ringer's solution containing human serum albumin, the other with Ringer's solution only. Fresh heparinized human blood was pooled, divided between the two systems and circulated for 24 h at 37 degrees C. Platelet count, plasma concentration of betathromboglobulin (BTG), platelet membrane density of glycoprotein (GP) Ib and of GPIIb/IIIa were assayed before the start and at 0.5, 1, 3, 12 and 24 h of perfusion. In total, seven experiments were performed. We found that during the first hour of perfusion, slightly higher platelet counts (p = 0.058) and lower BTG values (p = 0.0005) were observed in the circuits primed with albumin, compared to the control circuits. No statistically significant differences were observed for the platelet membrane expression of GPIb and GPIIb/IIIa. We conclude that albumin priming appears to transiently prevent platelet consumption and activation during long-term perfusion.
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| 3. |
- Mellgren, Karin, 1962, et al.
(författare)
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Blood platelet activation and membrane glycoprotein changes during extracorporeal life support (ECLS). In vitro studies.
- 1995
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Ingår i: The International journal of artificial organs. - 0391-3988. ; 18:6, s. 315-21
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate an in vitro model for investigation of platelet function parameters in an extracorporeal system. Two different perfusion pumps were compared, a roller pump (Polystan) and a centrifugal pump (Biomedicus). A continuous increase in glycoprotein (GP)1b-negative platelets was observed in both circuits. A marked increase of plasma beta-thromboglobulin thromboglobulin concentration and a decrease of the intracellular pool of serotonin was observed, indicating a marked release of alpha as well as of dense granules. The plasma concentration of glycocalicin increased in parallel with a reduced platelet surface expression of GP1b, suggesting that the loss of GP1b is caused by proteolysis rather than by a downregulation of this receptor protein. It is concluded that ECLS results in a pronounced platelet degranulation and causes changes of important membrane receptors which might explain some of the bleeding problems observed in patients treated with ECLS. No significant difference was noted between the roller pump and the centrifugal pump. Trial of strategies, e.g., protease inhibitors and nitric oxide to revert this untoward effect of ECLS are highly warranted.
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| 4. |
- Mellgren, Karin, 1962, et al.
(författare)
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Effect of nitric oxide gas on platelets during open heart operations.
- 1998
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Ingår i: The Annals of thoracic surgery. - 0003-4975. ; 65:5, s. 1335-41
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Tidskriftsartikel (refereegranskat)abstract
- The increased bleeding tendency observed after cardiopulmonary bypass is caused in part by thrombocytopenia and impaired platelet function induced by the procedure. Previous in vitro studies have shown that nitric oxide (NO) added to the oxygenator sweep gas reduces platelet activation during experimental perfusion. We evaluated the effect of 40 ppm of NO, added to the oxygenator sweep gas, on platelet consumption and activation in patients undergoing cardiopulmonary bypass.
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| 5. |
- Mellgren, Karin, 1962, et al.
(författare)
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Nitric oxide in the oxygenator sweep gas reduces platelet activation during experimental perfusion.
- 1996
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Ingår i: The Annals of thoracic surgery. - 0003-4975. ; 61:4, s. 1194-8
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Tidskriftsartikel (refereegranskat)abstract
- Hemorrhage is a major complication experienced in 10% to 35% of neonates treated with extracorporeal life support (ECLS). The increased bleeding tendency is partly due to an ECLS-induced thrombocytopenia and impaired platelet function. In the present study, we evaluated the effect of nitric oxide on the ECLS-induced platelet consumption and activation.
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| 6. |
- Mellgren, Karin, 1962, et al.
(författare)
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Platelet activation and degradation in an experimental extracorporeal system. A comparison between a silicone membrane and a hollow-fibre oxygenator.
- 1996
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Ingår i: Perfusion. - 0267-6591. ; 11:5, s. 383-8
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Tidskriftsartikel (refereegranskat)abstract
- Blood platelets are rapidly activated in contact with biomaterials and, therefore, can be used as markers of the biocompatibility of various components in an extracorporeal system. In the present work two different oxygenators, one membrane oxygenator (Avecor) and one hollow-fibre oxygenator ("Lilliput', Dideco) were compared. Complete in vitro extracorporeal membrane oxygenation circuits were perfused with fresh, heparinized human blood for 24 h. Eight experiments were performed with the hollow-fibre oxygenator and five experiments with the membrane oxygenator. Blood gases, electrolytes, glucose and haematocrit were kept within physiological limits. Platelet count, plasma concentration of beta-thromboglobulin, platelet serotonin content, platelet membrane glycoprotein lb and its degradation product glycocalicin, as well as plasma haemoglobin concentration were assayed. As regards most of these variables, significant differences in favour of the hollow-fibre oxygenator were observed.
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| 7. |
- Mårtensson, Ulrika, et al.
(författare)
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Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy
- 2021
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Adolescents with cerebral palsy may need a feeding tube due to feeding challenges, since nutritional intake and mealtimes may be negatively affected. The purpose of the study was to describe and better understand how one adolescent with cerebral palsy and her parents experienced mealtimes before and after a nasogastric and gastrostomy tube insertion and how the use of these feeding tubes was experienced in daily life. Methods: Individual interviews were performed with one adolescent and each of her parents. In total, six interviews were conducted on two separate occasions. The qualitative approach known as Interpretive Description was used during the analysis. Results: Four thematic patterns were identified within the data: (i) struggling with nutritional intake, (ii) the paradox of using an aid, (iii) being different, and (iv) challenges of public mealtimes. Conclusions: The results showed that four themes influenced daily mealtimes in adolescents with cerebral palsy and a gastrostomy tube. Nutritional intake and mealtimes may be difficult, which is why using a gastrostomy tube can be a relief. However, the gastrostomy tube can also pose a challenge and a paradox. Time of change and acceptance seems necessary in order to meet these challenges.
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| 8. |
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| 9. |
- Adrian, Katrin, 1966, et al.
(författare)
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Procedure-induced inflammation and endothelial cell activation in an artificially ventilated and circulated porcine double-lung model
- 2006
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Ingår i: Artif Organs. - 0160-564X. ; 30:12, s. 922-8
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Tidskriftsartikel (refereegranskat)abstract
- Systemic inflammation is induced during extracorporeal circulation, resulting in an increased bleeding tendency and endothelial cell activation. Lungs from seven piglets were perfused by autologous blood in an extracorporeal circuit, where the lungs and the left atrium were attached to polyvinyl chloride (PVC) tubings and the blood circulated by a roller pump. The trachea was intubated and attached to a ventilator. The lungs maintained good gas exchange, despite a slight increase in lactate levels. Plasma tPA increased slightly over time, suggesting endothelial cell activation. Activation of inflammatory systems was reflected in increased levels of plasma interleukin (IL)-6 and IL-10. A model for the study of lung endothelial activation during extracorporeal circulation has been shown to be reproducible. The lung tissue was shown to be capable of gas exchange and activation of endothelial cells and procedure-induced inflammation were noted.
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| 10. |
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