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Affiliation(s)
- C Raspé
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle (Saale), Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland.
| | - M Bucher
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle (Saale), Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland
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Rückert F, Charitos E, Krohe K, Hofmann B, Treede H, Raspé C. Prediction of Survival and Quality of Life in Out-of-center Extracorporeal Membrane Oxygenation. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F. Rückert
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - E. Charitos
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - K. Krohe
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - B. Hofmann
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - H. Treede
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - C. Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
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Hofmann B, Gmelin M, Metz D, Raspé C, Wienke A, Treede H, Simm A. Cardiac Surgery Score (CASUS) for Outcome Prediction in Patients Treated with Extra Corporal Life Support (ECLS). Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- B. Hofmann
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - M. Gmelin
- Department of Urology, St. Barbara Hospital, Gladbeck, Germany
| | - D. Metz
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - C. Raspé
- Department of Anesthesiology and Critical Care Medicine, University Hospital Halle (Saale), Halle (Saale), Germany
| | - A. Wienke
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - H. Treede
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - A. Simm
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
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Rückert F, Steinke T, Flöther L, Bucher M, Metz D, Frantz S, Charitos E, Treede H, Raspé C. Out-of-Center Extracorporeal Membrane Oxygenation: Predictors for Outcome and Quality of Life. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F. Rückert
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - T. Steinke
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - L. Flöther
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - M. Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - D. Metz
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - S. Frantz
- Department of Internal Medicine III, Halle-Wittenberg University, Halle (Saale), Germany
| | - E.I. Charitos
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - H. Treede
- Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - C. Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
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Raspé C, Flöther L, Schneider R, Bucher M, Piso P. Best practice for perioperative management of patients with cytoreductive surgery and HIPEC. Eur J Surg Oncol 2016; 43:1013-1027. [PMID: 27727026 DOI: 10.1016/j.ejso.2016.09.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/01/2016] [Accepted: 09/13/2016] [Indexed: 12/17/2022] Open
Abstract
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures. The anesthesiologist has deal with relevant fluid, blood and protein losses, increased intraabdominal pressure, systemic hypo-/hyperthermia, and increased metabolic rate in patients undergoing cytoreductive surgery with HIPEC. It is of utmost importance to maintain or restore an adequate volume by aggressive substitution of intravenous fluids, which counteracts the increased fluid loss and venous capacitance during this procedure. Supplementary thoracic epidural analgesia, non-invasive ventilation, and physiotherapy are recommended to guarantee adequate pain therapy and postoperative extubation as well as fast-track concepts. Advanced hemodynamic monitoring is essential to help the anesthesiologist picking up information about the real-time fluid status of the patient. Preoperative preconditioning is mandatory in patients scheduled for HIPEC surgery and will result in improved outcome. Postoperatively, volume status optimization, early nutritional support, sufficient anticoagulation, and point of care coagulation management are essential. This is an extensive update on all relevant topics for anesthetists and intensivists dealing with CRS and HIPEC.
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Affiliation(s)
- C Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany.
| | - L Flöther
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - R Schneider
- Department of General- and Visceral Surgery, Halle-Wittenberg University, Germany
| | - M Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Germany
| | - P Piso
- Department for General- and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany
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Ache J, Rath S, Schneider R, Dralle H, Bucher M, Raspé C. [Key Points of Intraoperative Diagnostic Measures Performed by Anaesthesiologists]. Zentralbl Chir 2016; 142:375-385. [PMID: 27135866 DOI: 10.1055/s-0041-109987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The main focus of surgeons and anaesthesiologists during a surgical procedure is on safety and optimal treatment of the patient. Within the scope of interdisciplinary collaboration, the intraoperative communication between surgeons and anaesthesiologists is the basis of case-, findings- and surgery-phases-adapted patient management. The perioperative monitoring of patients and the implementation of diagnostic measures by anaesthesiologists are essential for optimal patient management. The results of the examinations may significantly determine the course of surgery. Therefore, it is important for surgeons to be familiar with the relevant intraoperative diagnostic measures.
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Affiliation(s)
- J Ache
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
| | - S Rath
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
| | - R Schneider
- Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle, Deutschland
| | - H Dralle
- Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle, Deutschland
| | - M Bucher
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
| | - C Raspé
- Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Deutschland
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Bushnaq H, Metz D, Treede H, Rückert F, Neitzel T, Stiller M, Steinke T, Raspé C. Inter-hospital Transfer of ECMO-assisted Patients with a Portable Miniaturized ECMO device: 4 Years Experiences. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bushnaq H, Metz D, Neitzel T, Hofmann U, Raspé C, Treede H. First, Implant Experience of a Fully Repositionable and Retrievable TAVI Valve via the Direct Aortic Access. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bushnaq H, Metz D, Neitzel T, Hofmann U, Raspé C, Treede H. A New Technique to Implant a Transcatheter Inflatable, and Fully Repositionable Prosthesis in Aortic Stenosis with Severe Asymmetric Calcification. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Raspé C, Rückert F, Metz D, Hofmann B, Neitzel T, Stiller M, Gielen S, Nestler F, Ebbighausen N, Steinke T, Bucher M, Bushnaq H. Inter-hospital transfer of ECMO-assisted patients with a portable miniaturized ECMO device: 4 years of experience. Perfusion 2014; 30:52-9. [PMID: 24743549 DOI: 10.1177/0267659114531611] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Extracorporeal membrane oxygenation (ECMO) in patients with severe pulmonary failure is able to keep patients alive until organ regeneration, until shunting out for further diagnostic and therapeutic options or until transportation to specialized centers. Nonetheless, extracorporeal techniques require a high degree of expertise, so that a confinement to specialized centers is meaningful. Following from this requirement, the need for inter-hospital transfer of patients with severely compromised pulmonary function is rising. METHODS We report about our experience with a portable ECMO system during inter-hospital air or ground transfer of patients with cardiopulmonary failure. RESULTS The portable ECMO system was used for transportation to the center and in-hospital treatment in 36 patients with an average age of 53 years suffering from respiratory failure. Accordingly, the ECMO system was implanted as a veno-venous extracorporeal system. Pre-ECMO ventilation time was 5.2 (2-9) days. Twelve patients were transported to our institution by ground and 24 patients by air ambulance over a median distance of 46 km. With the assistance of the ECMO device, prompt stabilization of cardiopulmonary function could be achieved in all patients without any technical complications. Post-ECMO ventilation was 9.8 days. Weaning from the ECMO system was successful in 61% of all patients after a median device working period of 12.7 days; median ICU stay was 34 days and a survival rate of 64% of patients was achieved. Technical (8%) and device-associated bleeding (11%)/thromboembolic (8%) complication rates showed very acceptable levels. CONCLUSION Our experience demonstrates that miniaturized, portable ECMO therapy allows location-independent, out-of-center stabilization of pulmonary compromised patients with consecutive inter-hospital transfer and further in-house treatment, so that sophisticated ECMO therapy can be offered to every patient, even in hospitals with primary healthcare.
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Affiliation(s)
- C Raspé
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - F Rückert
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - D Metz
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - B Hofmann
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - T Neitzel
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - M Stiller
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
| | - S Gielen
- Department of Internal Medicine III, Halle-Wittenberg University, Germany
| | - F Nestler
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - N Ebbighausen
- HSD Luftrettung gemeinnützige GmbH, non-profit organisation, Landsberg-Oppin, Germany
| | - T Steinke
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - M Bucher
- Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany
| | - H Bushnaq
- Department of Cardiac and Thoracic Surgery, Halle-Wittenberg University, Halle (Saale), Germany
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Moravec R, Neitzel T, Stiller M, Hofmann B, Metz D, Bucher M, Silber R, Bushnaq H, Raspé C. First experiences with a combined usage of veno-arterial and veno-venous ECMO in therapy-refractory cardiogenic shock patients with cerebral hypoxemia. Perfusion 2013; 29:200-9. [PMID: 23996694 DOI: 10.1177/0267659113502832] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The use of extracorporeal membrane oxygenation (ECMO) is becoming a popular tool in the treatment of cardiogenic shock. We present two case reports where classical veno-arterial peripherally cannulated ECMO therapy proved insufficient with profuse cerebral hypoxemia. After augmenting the setting into veno-veno-arterial ECMO, we achieved a remarkable improvement of all oxygenation parameters. The simultaneous use of veno-venous and veno-arterial ECMO might display as a novel strategy to counteract the coronary and cerebral hypoxemia in veno-arterial ECMO therapy in patients with therapy-refractory cardiogenic shock or in combined cardiopulmonary failure. In this manuscript, the veno-veno-arterial ECMO setup is described in full detail and different venous cannulas are discussed.
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Affiliation(s)
- R Moravec
- Department of Anesthesiology and Critical care medicine, Halle-Wittenberg University, Germany
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Grossmann E, Akyol D, Eder L, Hofmann B, Haneya A, Graf BM, Bucher M, Raspé C. Thromboelastometric detection of clotting Factor XIII deficiency in cardiac surgery patients. Transfus Med 2013; 23:407-15. [DOI: 10.1111/tme.12069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 02/15/2013] [Accepted: 03/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- E. Grossmann
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
| | - D. Akyol
- Department of Anesthesiology; Regensburg University; Regensburg Germany
| | - L. Eder
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
| | - B. Hofmann
- Department of Cardiothoracic Surgery; Halle-Wittenberg University; Halle Germany
| | - A. Haneya
- Department of Cardiothoracic Surgery; Regensburg University; Regensburg Germany
| | - B. M. Graf
- Department of Anesthesiology; Regensburg University; Regensburg Germany
| | - M. Bucher
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
| | - C. Raspé
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
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Hofmann B, Bushnaq H, Kraus FB, Raspé C, Simm A, Silber RE, Ludwig-Kraus B. Immediate effects of individualized heparin and protamine management on hemostatic activation and platelet function in adult patients undergoing cardiac surgery with tranexamic acid antifibrinolytic therapy. Perfusion 2013; 28:412-8. [DOI: 10.1177/0267659113483800] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This randomized prospective study was initiated to clarify whether individualized heparin and protamine dosing has immediate effects on hemostatic activation and platelet function in adult cardiac surgery. Methods: Sixty adults undergoing elective coronary artery bypass grafting (CABG) were assigned to receive individualized heparin and protamine (HMS group, n= 29) or a standard dose (ACT group, n=24). Measures of thrombin generation and Multiplate® (Verum Diagnostica, Munich, Germany) platelet function tests were performed before and after cardiopulmonary bypass (CPB). Results: HMS patients received higher heparin (p = 0.006) and lower protamine (p<0.001) doses. Post-CPB, HMS managed patients showed significantly lower thrombin generation (thrombin-antithrombin (TAT) p<0.02) than the ACT group. Moreover, HMS managed patients had a better preservation of platelet function (COL p = 0.013; ADP p = 0.04; TRAP p = 0.04). Conclusion: An individualized and stable heparin concentration and appropriate dosing of protamine can reduce thrombin generation and preserve platelet function, even in short-time CPB.
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Affiliation(s)
- B Hofmann
- Department of Cardiothoracic Surgery, Martin-Luther-University, Halle, Germany
| | - H Bushnaq
- Department of Cardiothoracic Surgery, Martin-Luther-University, Halle, Germany
| | - FB Kraus
- Department of Biology, Martin-Luther-University, Halle, Germany
| | - C Raspé
- Department of Anesthesiology and Operative Intensive Care Medicine, Martin-Luther-University, Halle, Germany
| | - A Simm
- Department of Cardiothoracic Surgery, Martin-Luther-University, Halle, Germany
| | - RE Silber
- Department of Cardiothoracic Surgery, Martin-Luther-University, Halle, Germany
| | - B Ludwig-Kraus
- Department of Laboratory Medicine, Martin-Luther-University, Halle, Germany
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Raspé C, Höcherl K, Rath S, Sauvant C, Bucher M. NF-κB-mediated inverse regulation of fractalkine and CX3CR1 during CLP-induced sepsis. Cytokine 2012; 61:97-103. [PMID: 23026294 DOI: 10.1016/j.cyto.2012.08.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 08/29/2012] [Accepted: 08/30/2012] [Indexed: 12/21/2022]
Abstract
Fractalkine is a unique member of the CX3C chemokine family by unfolding its potential through the chemokine (C-X3-C motif) receptor 1 (CX3CR1) with dual function acting both as an adhesion molecule and a soluble chemokine. The regulation of this chemokine is still not clear. Therefore, we were interested in the regulation of fractalkine and of CX3CR1 in experimental sepsis. In addition, we investigated the role of NF-κB for the regulation of fractalkine and of CX3CR1. Using a mouse model of cecal ligation and puncture (CLP)-induced sepsis, we found elevated fractalkine mRNA levels in the heart, lung, kidney, and liver, as well as increased plasma levels 24 and 48h after CLP, respectively. In parallel, CLP resulted in a significant downregulation of CX3CR1 mRNA receptor expression in all investigated murine tissues. Septic mice that were pretreated with the selective NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC) were found to have a decreased liberation of proinflammtory cytokines such as TNF-α, IL-1β, IL-6, or IFN-γ. Further PDTC pretreatment attenuated CLP-induced downregulation of CX3CR1 mRNA as well as CLP-induced upregulation of fractalkine mRNA expression in the heart, lung, kidney, liver, and the increase in fractalkine plasma levels of septic mice. In addition, CLP-induced downregulation of renal CX3CR1 protein expression was inhibited by PDTC-pretreatment. Taken together, our data indicate a CLP-induced inverse regulation of the expression between the relating ligand and the receptor with an upregulation of fractalkine and downregulation of CX3CR1, which seems to be mediated by the transcripting factor NF-κB likely via reduced liberation of proinflammtory cytokines in the whole murine organism.
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Affiliation(s)
- C Raspé
- Clinic for Anaesthesiology and Surgical Intensive Care, Unversity Clinic Halle (Saale), Martin-Luther University Halle-Wittenberg, Germany.
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15
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Martin C, Steinke T, Bucher M, Raspé C. [Perioperative Addisonian crisis]. Anaesthesist 2012; 61:503-11. [PMID: 22695777 DOI: 10.1007/s00101-012-2033-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 04/02/2012] [Accepted: 04/19/2012] [Indexed: 10/28/2022]
Abstract
An Addisonian crisis marks an acute adrenocortical failure which can be caused by decompensation of a chronic insufficiency due to stress, an infarct or bleeding of the adrenal cortex and also abrupt termination of a long-term glucocorticoid medication. This article reports the case of a 25-year-old patient with Crohn's disease who suffered an Addisonian crisis with hypotension, hyponatriemia and hypoglycemia during an emergency laparotomy after he had terminated prednisolone medication on his own authority. This necessitated an aggressive volume therapy in addition to an initial therapy with 100 mg hydrocortisone, 8 g glucose and a continuous administration of catecholamines. Under this treatment regimen hemodynamic stabilization was achieved. Reduction of the administration of hydrocortisone after 3 days resulted in cardiovascular insufficiency which required an escalation of the hydrocortisone substitution.
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Affiliation(s)
- C Martin
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Deutschland.
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