Progress in clinical and biological research
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Prog. Clin. Biol. Res. · Jan 1987
Comparative StudyFluid resuscitation in canine traumatic-hemorrhagic shock: long-term comparison of hydroxyethyl starch vs. Ringer's lactate.
In 16 anesthetized foxhounds a traumatic-hemorrhagic shock was performed. Following shock the dogs were randomized to treatment with autologous blood and either hydroxyethyl starch (HES, 450/0.5) or Ringer's lactate (RL). The animals were monitored for 24 h after treatment. ⋯ Albumin extravasation, on the other hand, was more pronounced (p less than 0.01) in the RL-group and, moreover, albumin redelivery by lymph was decreased (p less than 0.05). On the basis of this study, both fluid modalities appear to be equally effective in resuscitation from traumatic-hemorrhagic shock without interfering with pulmonary function and ARDS. The importance that the tissue albumin accumulation ranks for final outcome from shock, however, requires further investigation.
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Clinical correlations of the plasma chromogenic Limulus assay were evaluated in 520 septic episodes to assess the diagnostic utility of the assay in a university hospital setting. Otherwise unselected patients undergoing blood culture were studied. An association of plasma Limulus activity with gram negative bacteremia and focal infections was found (p less than .001 and p less than .01, respectively). ⋯ Abnormal neutrophil parameters were unassociated with positive assays in any group. The sensitivity and specificity of the test for a condition known to cause endotoxemia--either gram negative infection or major intestinal disease--were low, 21% and 93% respectively. However, the predictive value of a positive test was 79%, indicating utility for the assay.