| 1. |
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| 2. |
- Droog, Eric, et al.
(författare)
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Measurement of depth of burns by laser Doppler perfusion imaging
- 2001
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Ingår i: Burns. - 0305-4179 .- 1879-1409. ; 27:6, s. 561-568
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Tidskriftsartikel (refereegranskat)abstract
- Laser Doppler perfusion imaging (LDPI), is a further development in laser Doppler flowmetry (LDF). Its advantage is that it enables assessment of microvascular blood flow in a predefined skin area rather than, as for LDF, in one place. In many ways this method seems to be more promising than LDF in the assessment of burn wounds. However, several methodological issues that are inherent in the LDPI technique, and are relevant for the assessment of burn depth, must be clarified. These include the effect of scanning distance, curvature of the tissue, thickness of topical wound dressings, and pathophysiological effects of skin colour, blisters, and wound fluids. Furthermore, we soon realised that to examine the perfusion image generated by LDPI adequately the process of analysis was appreciably improved by the simultaneous use of digital photography. In the present investigation we used both in vitro and in vivo models and also examined burned patients, and found that the listed factors all significantly affected the LDPI output signal. However, if these factors are known to the examiner, most of them can be adjusted for. If the technique is further improved by minimizing such effects and by reducing the practical difficulties of applying it to a burned patient in the burns unit, the technique may find uses in everyday clinical decision-making.
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| 3. |
- Droog Tesselaar, Erik, et al.
(författare)
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A protocol for iontophoresis of acetylcholine and sodium nitroprusside that minimises nonspecific vasodilatory effects
- 2004
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Ingår i: Microvascular research. - : Elsevier BV. - 0026-2862. ; 67:2, s. 197-202
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Tidskriftsartikel (refereegranskat)abstract
- Iontophoresis of vasoactive substances is a promising tool for studying pharmacological aspects of the (patho)physiology of the microvasculature. However, nonspecific microvascular responses are a common problem in most protocols used. We studied the effect of current density (mA/cm2), charge density (mC/cm2), drug concentration (mass %) and vehicle concentration (M) on the nonspecific vasodilatation during iontophoresis of sodium chloride, acetylcholine (ACh) and sodium nitroprusside (SNP). We found that nonspecific vasodilatation depended on current density and charge density in both anodal and cathodal iontophoresis. The responses to ACh and SNP were dependent on current density, charge density and drug concentration. We found that by limiting current density (<0.01 mA/cm2) and charge density (<7.8 mC/cm2) and with adjusted concentrations for drugs and vehicles, it is possible to prevent nonspecific effects during iontophoresis of ACh and SNP, while maximum drug effects (plateaus in the dose–response curves) are still obtained. These new findings are important for future iontophoresis studies in which vasoactive drugs are used to assess microvascular function because the presented approach has advantages compared to older techniques, which mainly have attempted to suppress or compensate for the nonspecific responses during iontophoresis by the use of local anaesthetics or the measurement of drug-minus-vehicle responses, both of which present well-known experimental shortcomings.
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| 4. |
- Droog Tesselaar, Erik, et al.
(författare)
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Nonspecific vasodilatation during transdermal iontophoresis : the effect of voltage over the skin
- 2003
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Ingår i: Microvascular research. - 0026-2862. ; 65:3, s. 172-178
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Tidskriftsartikel (refereegranskat)abstract
- We used laser Doppler perfusion imaging (LDPI) to study nonspecific vasodilatation during iontophoresis. In iontophoresis studies, nonspecific vasodilatation occurs as a result either of galvanic currents or of the applied voltage over the skin. We made dose–response measurements to study the effect of ionic strength of the vehicle on the nonspecific vasodilatation during iontophoresis of sodium chloride and deionized water, while we monitored the voltage over the skin. We found that anodal and cathodal ionotophoresis induced a voltage over the skin that was dependent on the ionic strength of the test solution. The nonspecific vasodilatation during anodal iontophoresis was less pronounced than during cathodal iontophoresis, and was independent of the voltage over the skin. The nonspecific vasodilatation in cathodal iontophoresis was related to the voltage over the skin, and was possibly mediated by depolarization of local sensory nerves. In experiments using cathodal iontophoresis, therefore, the ionic strengths of the vehicle and the drug are important when vasoactive drugs are examined, as the nonspecific vasodilatation needs to be controlled for. As the vasodilatation that we observed was heterogeneously distributed within the area of iontophoresis, LDPI may provide more accurate measurements than conventional laser Doppler perfusion monitoring.
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| 5. |
- Horiuchi, Yoshihito, et al.
(författare)
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Role of histamine release in nonspecific vasodilatation during anodal and cathodal iontophoresis
- 2004
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Ingår i: Microvascular research. - : Elsevier BV. - 0026-2862. ; 67:2, s. 192-196
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Tidskriftsartikel (refereegranskat)abstract
- Nonspecific vasodilatation during iontophoresis is an important confounding factor in experimental pharmacology. In this investigation, we studied the involvement of sensory nerves and histamine-related reactions in causing nonspecific vasodilatation in a model of anodal and cathodal iontophoresis of sodium chloride. Firstly, we applied a mixture of local anesthetic (EMLA) cream to confirm its suppressive effect on nonspecific vasodilatation and to measure its efficacy in three different dosages (duration: 1, 2, and 3 h). We then investigated the role of histamine in nonspecific vasodilatation by giving an oral antihistamine drug (cetirizine) to subjects who had and had not been given EMLA. We found substantial suppression of the nonspecific vasodilatation in all EMLA-treated groups (all dosages) compared with untreated controls (with suppression rates of 60–65%). Dosage had no significant effect. A further suppression of nonspecific vasodilatation was seen after oral cetirizine during anodal and cathodal iontophoresis in both EMLA-treated and untreated groups. The antihistamine effect was most pronounced during anodal iontophoresis. These results suggest a histaminergic increase in perfusion that may be independent of neurogenic mechanisms and depend on polarity (anode or cathode). Local nerve blocks (EMLA) together with cetirizine may therefore be used to reduce nonspecific vasodilatation in both anodal and cathodal iontophoresis.
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| 6. |
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| 7. |
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| 8. |
- Huss, Fredrik, 1971-, et al.
(författare)
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Buses as fire hazards : A Swedish problem only? Suggestions for fire-prevention measures
- 2004
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Ingår i: Journal of Burn Care and Rehabilitation. - 0273-8481 .- 1534-5939. ; 25:4, s. 377-380
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, approximately 6% of all human transportation is made via buses. The Swedish Board of Accident Investigation and the Swedish Rescue Services Agency have pointed out repeatedly that buses are potential fire and burn hazards, not only when involved in collisions but also in other circumstances. The number of fire incidents is increasing, especially in newer buses. In conjunction with the Swedish Rescue Services Agency, we examined some of the recent bus fires in Sweden. We did not find any casualties, but the results of our study suggest that casualties as a result of bus fires are imminent unless preventive measures are taken. We also studied experiences from previous bus fires and suggest preventive measures.
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| 9. |
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| 10. |
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| 11. |
- Huss, Fredrik, et al.
(författare)
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[Lightning injuries--a mixture of electrical, thermal and multiple trauma].
- 2004
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 101:28-29, s. 2328-31
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Tidskriftsartikel (refereegranskat)abstract
- There are several misconceptions even among hospital personnel regarding damages and injuries caused by lightning. Few health care providers have experience from lightning injuries as they are rare and different (DC) from the more common high-voltage (AC) injuries. Furthermore, fatalities are uncommon. Burns do occur but are usually minor. Most lightning injuries occur in the summer season during outdoor leisure activities and in the vicinity of a tree or other large structures. In Sweden, on average, approximately seventeen persons per year are hospitalised and 0.2-0.8 persons per million inhabitants and year die due to lightning injuries. The primary treatment follows the general guidelines for other trauma, electrical, and burn injuries, i.e. as is described in the standardised ATLS, ABLS, or A-HLR programmes. However, there are some minor points that are different and may be stressed for a favourable outcome. In this paper these are addressed together with the epidemiology, effects and treatment of lightning injuries that are specific for Sweden. Unfortunately, little is known, apart from what is described in smaller case series, of the long time sequelae experienced by this patient population and further research is therefore particularly warranted in this respect.
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| 12. |
- Karlander, Lars-Erik, 1950-, et al.
(författare)
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Severe contusion of the femoral vessels in rats alters tissue oxygenation and microvascular blood flow regulation in the skeletal muscles of the limb
- 2000
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Ingår i: Journal of Trauma - Injury, Infection and Critical Care. - 1079-6061. ; 48:2, s. 286-291
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Tidskriftsartikel (refereegranskat)abstract
- Background: Severe contusion of an artery often presents clinical problems in that it affects flow distal to the injury. However, the effect of a contusion on the microvascular flow regulation in the distal part of the limb is still largely unknown. Methods: A multipoint microelectrode technique was used to assess both tissue oxygenation (P(t)O2) and microflow (hydrogen clearance) on the skeletal muscle surface in a standard contusion injury to the femoral vessels in rats. Results: A significant increase in and an altered distribution of (P(t)O2) as well as a reduction in and altered distribution of microflow on the muscle surface distal to the injury was found in all animals (n = 27) compared with the uninjured control leg. These findings could not be reproduced experimentally by sympathectomy or when the adjacent skeletal muscle alone was injured. Conclusion: The results suggest that the changes observed distal to the injury are of vascular origin, possibly as a result of endothelial damage at the site of the contusion.
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| 13. |
- Kildal, Morten
(författare)
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Perceived Physical and Psychological Outcome After Severe Burn Injury
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is very little data on physical and psychological long-term outcome after severe burn injury. The aim of the present thesis was to improve current instruments for assessment of these issues, to assess long-term outcome in a cohort of patients with burn injuries, and to explore the contribution of the individual factors of personality and coping on perceived outcome.Patients treated at the Burn Unit, Uppsala University Hospital, between 1980 and 1995 were included on a consecutive basis if they were 18 years of age or older at follow-up, had burn injuries of ten percent or more, or hospitalization times of seven days or more. A total of 350 patients fulfilled these inclusion criteria.A factor analytic approach was used to derive a 40-item instrument called the Burn Specific Health Scale-Brief (BSHS-B), resulting in nine well-defined domains. Most burn patients reported a very good perceived outcome but a subgroup reported problems years after injury. On a group level most problems were related to Heat Sensitivity, Work and Body Image. The depth of injury, gender, marital status and living conditions were all related to outcome. Neurotic personality traits were related to perceived health, and were not confined only to psychological aspects of life but also included physical aspects. A 33-item burn-specific coping scale, the Coping with Burns Questionnaire (CBQ), with six clearly separated domains with acceptable internal consistencies was developed. Coping strategies were strongly related to outcome in the subgroup of patients reporting most problems in perceived health, and coping contributed more to psychosocial than physical health. Avoidant coping and Emotional support seeking had independent effects on outcome.The observation that Neuroticism and Avoidant coping strategies are related to bad outcome after severe burn injury indicates that patients with such characteristics should be given special attention during rehabilitation.
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| 14. |
- Kimme, Peter, 1961-, et al.
(författare)
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Cortical blood flow autoregulation revisited using laser Doppler perfusion imaging
- 2002
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Ingår i: Acta Physiologica Scandinavica. - 0001-6772 .- 1365-201X. ; 176:4, s. 255-262
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Tidskriftsartikel (refereegranskat)abstract
- Methods of laser Doppler perfusion monitoring (LDPM) and imaging (LDPI) have been validated and found useful for measurements of brain blood flow in several studies. The present work was undertaken to examine the cortical blood flow autoregulatory phenomenon as it has lately been questioned and claimed to be method-dependent and related to sample volume. Spatial variations in cerebral cortical blood flow (CBFcortex) in the pressure range 20–140 mmHg (static cerebral autoregulation; caval block/angiotensin infusion) were studied in six mechanically ventilated (hypocapnic, normocapnic and hypercapnic) pigs anaesthetized with propofol and fentanyl. Although the cortical blood flow values sampled were highly heterogeneously distributed, they were strongly pressure-dependent as well as CO2-dependent (P < 0.001). A cumulative cerebral blood flow (CBF)–pressure (MAP) plot comprising all values obtained indicated a pressure range between 70 and 120 mmHg where CBF remained almost constant. However, at the local level in the cortex (mm2) the same type of ‘classic’ autoregulatory flow : pressure graphs (FPG) were found in only a few of the cases of the cortical areas examined (n = 96). Alterations in blood PaCO2 saturation did not affect the pressure : flow relationship at low perfusion pressures, whereas at normal or above normal values, and as anticipated, hypercapnia considerably increased CBF (P < 0.001). ‘Classic’ autoregulatory FPGs were found only when all values sampled were clustered together, whereas, as a new finding, data are presented indicating that autoregulatory capacity is lacking at the local level at some cortical surface areas.
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| 15. |
- Kimme, Peter, 1961-, et al.
(författare)
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Moderate hypothermia for 359 operations to clip cerebral aneurysms
- 2004
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Ingår i: British Journal of Anaesthesia. - : Elsevier BV. - 0007-0912 .- 1471-6771. ; 93:3, s. 343-347
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Tidskriftsartikel (refereegranskat)abstract
- Background. Experimental data have suggested that hypothermia (32–34°C) may improve outcome after cerebral ischaemia, but its efficacy has not yet been established conclusively in humans. In this study we examined the feasibility and safety of deliberate moderate perioperative hypothermia during operations for subarachnoid aneurysms.Methods. A total of 359 operations for intracranial cerebral aneurysms were included in this prospective study. By using cold intravenous infusions (4°C) and convective cooling our aim was to reduce the patient's core temperature to more than 34°C within 1 h before operation. The protocol assessed postoperative complications such as infections, prolonged mechanical ventilation, pulmonary complications and coagulopathies.Results. During surgery, the body temperature was reduced to a mean of 32.5 (sd 0.4) °C. Cooling was accomplished at a rate of 4.0 (sd 0.4) °C h−1. All patients were normothermic at 5 (sd 2) h postoperatively. Peri/postoperative complications included circulatory instability (n=36, 10%), arrhythmias (n=17, 5%) coagulation abnormalities and blood transfusion (n=169, 47%), infections (n=29, 8%) and pulmonary complications (infiltrate or oedema while on ventilatory support) (n=97, 27%). Eighteen patients died within 30 days (5%). There was no significant correlation between the extent of hypothermia and any of the complications. However, there was a strong correlation between the occurrence of complications and the severity of the underlying neurological disease as assessed by the Hunt and Hess score.Conclusion. Moderate hypothermia accomplished within 1 h of induction of anaesthesia and maintained during surgery for subarachnoid aneurysms appears to be a safe method as far as the risks of peri/postoperative complications such as circulatory instability, coagulation abnormalities and infections are concerned.
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| 16. |
- Rousseau, Andreas, 1971-, et al.
(författare)
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Hyperoxaemia does not change concentrations of serotonin and beta‐thromboglobulin in blood of healthy humans
- 2004
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 64:2, s. 81-85
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Tidskriftsartikel (refereegranskat)abstract
- Background: The mechanisms of oxygen‐induced effects on blood vessels (vasoconstriction in hyperoxaemia and vasodilatation during hypoxaemia) are uncertain. Many investigators have suggested that the vasoconstriction seen during hyperoxia/hyperoxaemia is mediated through the endothelium as a result of either increased release or activity of vasoconstrictors (oxygen radicals, endothelin, norepinephrine, angiotensin II, or serotonin (5‐HT)), or reduced activity of vasodilators (prostaglandin E2 and nitric oxide). Serotonin has been assumed to have a central role.Methods: Eight healthy volunteers were exposed to FiO2 of 1.0 for 20 min and serum concentrations of serotonin and activated platelets were measured (indicated by concentrations of β‐thromboglobulin (β‐TG)).Results. During hyperoxaemia in humans, serum concentrations of serotonin and β‐TG remained unchanged.Conclusion: If serotonin is involved in oxygen‐induced vasoconstriction, the mechanism is more likely to be either a potentiating effect of serotonin on other vasoconstrictors or increased activity of serotonin on its receptor.
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| 17. |
- Sjöberg, Folke, 1956-, et al.
(författare)
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Brännskadeboken (Burn Care)
- 2002. - 1
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Ingår i: Brännskador. - Linköping : Linköpings universitet. - 9147051078 - 9789147051076 ; , s. -233
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Brännskador är en lärobok i brännskadevård. Flera av bokens kapitel kan dessutom fungera som snabbreferens i akuta situationer.Boken är inte enbart avsedd för ABLS-kurserna utan också för grund-, vidare- och efterutbildningen av läkare, sjuksköterskor samt övrig civil och militär personal som kommer i kontakt med brännskadade patienter.
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| 18. |
- Sjöberg, Folke, 1956-, et al.
(författare)
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Brännskador
- 2002. - 1
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Ingår i: Brännskador. - Linköping : Linköpings universitet. - 9147051078 - 9789147051076 ; , s. -233
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Brännskador är en lärobok i brännskadevård. Flera av bokens kapitel kan dessutom fungera som snabbreferens i akuta situationer.Boken är inte enbart avsedd för ABLS-kurserna utan också för grund-, vidare- och efterutbildningen av läkare, sjuksköterskor samt övrig civil och militär personal som kommer i kontakt med brännskadade patienter
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| 19. |
- Sjöberg, Folke, 1956-, et al.
(författare)
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Dual mode antimony electrode for simultaneous measurements of PO2 and pH
- 2000
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 44:1, s. 32-36
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Tidskriftsartikel (refereegranskat)abstract
- Background: In biomedical research and clinical medicine there is a demand for potent sensors to measure the components that make up blood gas analyses. Today, as when the electrochemical PO2, PCO2 and pH electrodes were first introduced, these measurements are usually made with the same type of sensor technology. The aims of the present study were, firstly, to find out whether the platinum cathode in the Clark electrode can be replaced by antimony for oxygen measurements (amperometry (A)), secondly, whether, during oxygen measurements, the inherent corrosion potential of the antimony metal can be used for measurement of pH in the same measurement area (potentiometry (P)). Methods: An electrode of purified, crystallographically orientated monocrystalline antimony (COMA) connected to a reference electrode (silver- silver chloride) was used for the P measurements. Measurements of A (at -900 mV) and P were made in an aqueous environment regulated for oxygen, pH, and temperature. Results: Reproducible oxygen sensitivities of 0.925 nA/% oxygen (2% CV (coefficient of variation)) (A), 10.7 mV/% (P), and 0.7mV/% (P) were found in the oxygen range: 0-21%, <5%, and above 5%, respectively. The pH sensitivity was 57 mV/pH unit (P). Oxygen and pH measurements were less accurate at oxygen concentrations close to 0%. Conclusions: Both the oxygen and pH part of the composite electrode signal can be identified by this dual mode technique (A and P). The sensor seems to be promising as it provides measurements of two separate variables (oxygen and pH) and also has the desirable characteristics of a solid state sensor.
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| 20. |
- Sjöberg, Folke, 1956-, et al.
(författare)
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Utility of an intervention scoring system in documenting effects of changes in burn treatment
- 2000
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Ingår i: Burns. - : Elsevier. - 0305-4179 .- 1879-1409. ; 26:6, s. 553-559
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Tidskriftsartikel (refereegranskat)abstract
- The consequences of the introduction of a program of consistent use of topical antimicrobials and early aggressive excision of deep burn wounds by utilizing a comprehensive, computerized patient registry/therapeutic intervention scoring system, were investigated. Prospectively, the clinical course, mortality, outcome and hospital costs were compared for the year preceding (89 patients) and the 4 years following (226 patients) the introduction of the new treatment program. It was found that mortality decreased from 10.1 to 4.6% after change in therapy (P < 0.001), despite an increase in mean burn extent. The length of hospital stay per % burn surface area declined from 1.2 to 1.0 days (P < 0.001). The number and complexity of therapeutic interventions and the associated costs, also declined. Patients in the new treatment program had a better level of physical and psychosocial function at follow up. In conclusion, the introduction of a program of consistent use of topical antimicrobials and early, aggressive surgical excision was associated with an improved outcome at lesser cost. The combined registry-intervention scoring system permits ready analysis of results using data entered on a daily, near-real time basis.
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| 21. |
- Sun, Y, et al.
(författare)
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Volumetric flow mapping for microvascular networks by bimodality imaging with light microscope and laser Doppler imager
- 2004
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Ingår i: Microscopy research and technique (Print). - : Wiley. - 1059-910X .- 1097-0029. ; 65:3, s. 130-138
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Tidskriftsartikel (refereegranskat)abstract
- A method was developed to produce a composite image of microvascular networks with grayscales proportional to volumetric flows. Velocities in arterioles and venules were assessed with a high-resolution laser Doppler imager (LDI). The vascular structures were quantified from the micrograph with a computerized vessel detection algorithm. After registering the detected vascular network with the LDI scan, volumetric flows were calculated along the centerlines of the vessels. In vivo data were obtained from the hamster cheek pouch in 6 studies. Flow continuity of the flow map was evaluated by comparing the main flow (Q) with the sum of branch flows (Qs), averaging over the respective vessel segments incident to each bifurcation. The method was reproducible across the 6 studies with the correlation coefficient (r) between Qs and Q ranging from 0.913 to 0.986. In all, over 20,000 flow estimates from 360 vessel segments (24-160 μm in diameter) at 166 bifurcations were analyzed. With flow normalized between 0 and 1, the linear regression yielded: Qs = 1.03 Q + 0.006, r = 0.952, n = 166, P < 0.0005. The bimodality imaging method exploits a large amount of velocity and diameter data, and therefore should be useful for studying heterogeneous flows in the microvasculature. © 2004 Wiley-Liss, Inc.
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| 22. |
- Thorfinn, Johan, 1970-, et al.
(författare)
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Sitting pressure and perfusion of buttock skin in paraplegic and tetraplegic patients, and in healthy subjects : a comparative study
- 2002
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 0284-4311 .- 1651-2073. ; 36:5, s. 279-283
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Tidskriftsartikel (refereegranskat)abstract
- The distribution of sitting pressure and ability to respond with reactive hyperaemia were studied in a group of paraplegic and tetraplegic patients (n = 8) with spinal cord lesions and healthy controls (n = 10) using a pressure sensitive plate and laser Doppler perfusion imager. The results show that the mean sitting pressure of the patients was 9.9 N/cm2 (left) and 11.7 N/cm2 (right) compared with 3.5 N/cm2 (left) and 3.6 N/cm2 (right) in controls. The differences were significant on both the left (p < 0.01) and right (p < 0.05) sides. The maximum pressure in patients was 42.9 N/cm2 (left) and 48.7 N/cm2 (right), and in controls 12.0 N/cm2 (left) and 12.9 (right) (p < 0.01). Both groups showed a reduction in skin perfusion in the seat area during sitting compared with unloaded resting, and in the controls it was significantly increased (p < 0.001 on both sides) during the reactive hyperaemic phase immediately after sitting. Compared with the preload values, the patients showed a similar but slightly weaker picture significant on the right side (p < 0.05), but not on the left. The hyperaemia was not uniformly distributed, but occurred where the pressure was greater than 2 N/cm2. There was no correlation between the amount of reactive hyperaemia and absolute values of sitting pressures. We conclude that tetraplegic and paraplegic patients have significantly higher sitting pressures than normal controls, and that the hyperaemic response in the buttock region in the upright position after pressure load is slightly weaker in the patients, which could be of importance for the development of decubitus ulcers.
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| 23. |
- Zdolsek, Hans Joachim, 1960-, et al.
(författare)
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Albumin supplementation during the first week after a burn does not mobilise tissue oedema in humans
- 2001
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 27:5, s. 844-852
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To measure water balance and changes in distribution, and the effect of giving supplementary albumin, early after a burn injury.Design: Consecutive patients (matched groups) and healthy controls.Setting: National burn unit in a Swedish university hospital.Patients and subjects: Eighteen patients with 18%-90% total burned surface area and 16 healthy male control subjects.Interventions: The patients were given an intravenous infusion of ethanol over 1 h, 0.35-0.60 g/kg body weight, and a bolus of 3.3 to 6.5 g of iohexol. The control subjects were given the same amounts of either ethanol or iohexol. Patients were subdivided into two groups according to whether or not they received supplementary albumin starting 12 h post-burn.Measurements and results: Blood samples were drawn at 20-30 min intervals over 4 h after the start of the infusion. Serum ethanol was measured by headspace gas chromatography, and iohexol with high-pressure liquid chromatography (HPLC). Distribution volume was calculated from the concentration-time profiles. Total body water (TBW) was measured by the ethanol tracer and bioelectric impedance (BIA) techniques, and estimated extracellular water (ECWest) by iohexol tracer. They were all significantly increased after a burn. Excess water was accumulated mainly in the extracellular compartment. It declined towards normal values (those of volunteers) at the end of the week. Albumin supplementation did not influence the amount or distribution of the excess fluid.Conclusion: Body water increases after a burn. Excess water is mainly deposited in the extracellular space. Tissue oedema fluid is not mobilised by albumin supplementation.
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| 24. |
- Zdolsek, Hans Joachim, et al.
(författare)
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Non-invasive assessment of fluid volume status in the interstitium after haemodialysis
- 2000
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Ingår i: Physiological Measurement. - : IOP Publishing. - 0967-3334 .- 1361-6579. ; 21:2, s. 211-220
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Tidskriftsartikel (refereegranskat)abstract
- During dialysis excess fluid is removed from uraemic patients. The excess fluid is mainly located in the skin and subcutaneous tissues. In this study we wished, with two noninvasive techniques, the IM (impression method) and BIA (bioimpedance analysis), to study what mechanical (IM) and electrical cellular membrane (BIA) effects the fluid withdrawal has on these tissues. The IM measures the resistive force of the tissues when mechanically compressed. From the force curve two parameters are calculated, the F(0), indicative of interstitial tissue pressure and the FT corresponding to the translocation of tissue fluid (interstitial movable water). The BIA phase angle shift (phi), i.e. geometrical angular transformation of the ratio between reactance and resistance, which has been associated with cellular membrane function, was used as a measurement of electrical cellular membrane effects. Twenty patients were studied before and after haemodialysis measuring the F(0), FT and phi. Theresults showed that the patients lost a median of 3.7 kg during the haemodialysis. F(0) increased until after dialysis, but did not reach significant values, whereas FT increased significantly after dialysis, p < 0.001, as compared with before. After a peak at one hour postdialysis the FT value returned to predialysis values at four hours after termination of dialysis. Also phi increased from before to after dialysis, p < 0.001, but already after one hour it returned to predialysis values. It is common knowledge that dialysis alters the dynamics of fluid in the interstitium of the skin and subcutis. We conclude that the impression method is sensitive enough to detect and chronicle these changes. Furthermore, with the BIA, (phase angle) signs of changes in the electrical properties of the tissues, possibly reflecting cellular membrane function, could be detected
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