TY  - JOUR
A1  - Feuerstein, G.
A1  - Sirén, Anna-Leena
T1  - Effect of naloxone and morphine on survival of conscious rats after hemorrhage
N2  - The endogenous opioid system has been reported to depress the cardiovascular system during shock states, since naloxone, a potent opiate antagonist, enhances recovery of hemodynamic variables in various shock states. However, the effect of naloxone on long-term survival of experimental animals exposed to hypovolemic hypotension is not clear. The present studies tested the capacity of various doses of naloxone to protect conscious rats from mortality following various bleeding paradigms. In addition, the effect of morphine on survival of rats exposed to hemorrhage was also examined. In the six different experimental protocols tested, naloxone treatments failed to improve short- or long-term survival; in fact, naloxone treatment reduced short-term survival in two of the experimental protocols. Morphine injection, however, enhanced the mortality of rats exposed to hemorrhage in a dose-dependent manner. It is concluded that while opiates administered exogenously decrease survival after acute bleeding, naloxone has no protective action in such states and, like morphine, it may decrease survival in some situations.
KW  - Medizin
KW  - shock
KW  - opioid peptides
KW  - hypovolemic hypotension
Y1  - 1986
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-48669
ER  - 
TY  - JOUR
A1  - Kredel, Markus
A1  - Kunzmann, Steffen
A1  - Schlegel, Paul-Gerhardt
A1  - Wölfl, Matthias
A1  - Nordbeck, Peter
A1  - Bühler, Christoph
A1  - Lotz, Christopher
A1  - Lepper, Philipp M.
A1  - Wirbelauer, Johannes
A1  - Roewer, Norbert
A1  - Muellenbach, Ralf M.
T1  - Double Peripheral Venous and Arterial Cannulation for Extracorporeal Membrane Oxygenation in Combined Septic and Cardiogenic Shock
JF  - American Journal of Case Reports
N2  - Background: 
The use of venoarterial extracorporeal membrane oxygenation (va-ECMO) via peripheral cannulation for septic shock is limited by blood flow and increased afterload for the left ventricle.

Case Report: 
A 15-year-old girl with acute myelogenous leukemia, suffering from severe septic and cardiogenic shock, was treated by venoarterial extracorporeal membrane oxygenation (va-ECMO). Sufficient extracorporeal blood flow matching the required oxygen demand could only be achieved by peripheral cannulation of both femoral arteries. Venous drainage was performed with a bicaval cannula inserted via the left V. femoralis. To accomplish left ventricular unloading, an additional drainage cannula was placed in the left atrium via percutaneous atrioseptostomy (va-va-ECMO). Cardiac function recovered and the girl was weaned from the ECMO on day 6. Successful allogenic stem cell transplantation took place 2 months later.

Conclusions: 
In patients with vasoplegic septic shock and impaired cardiac contractility, double peripheral venoarterial extracorporeal membrane oxygenation (va-va-ECMO) with transseptal left atrial venting can by a lifesaving option.
KW  - extracorporeal membrane oxygenation
KW  - myeloid
KW  - leukemia
KW  - acute
KW  - shock
KW  - cardiogenic
KW  - septic
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158193
VL  - 18
ER  - 
TY  - JOUR
A1  - Nass, Maximilian
A1  - Weissbrich, Benedikt
A1  - Huber, Moritz
A1  - Schneider, Elisabeth Marion
A1  - Weiss, Manfred
T1  - BK viremia in critically ill surgical patients with hemorrhagic or septic shock
JF  - BMC Research Notes
N2  - Background
Infections with polyomavirus BK virus (BKV) are a common cause of renal dysfunction after renal transplantation and may also be harmful in surgical patients with shock. The aim of the present study was to determine the frequency of BKV viremia in critically ill surgical patients with septic or hemorrhagic shock, and, if viremia is detectable, whether viremia may be associated with renal dysfunction.
Findings
A total of 125 plasma samples from 44 critically ill surgical patients with septic or hemorrhagic shock were tested by real-time polymerase chain reaction (PCR) for BKV DNA during their stay on the intensive care unit (ICU). BKV viremia occurred in four patients, i.e. in three of the septic and in one of the hemorrhagic shock group. There was no association between viremia and renal dysfunction. All positive samples contained a low viral load (< 500 copies/ml).
Conclusions
Since BK viremia was rarely found and with low viral load only in critically ill surgical patients with shock, it is very unlikely that BK viremia results in BK nephropathy later on.
KW  - acute kidney injury
KW  - BK virus
KW  - polyomavirus
KW  - critically ill
KW  - sepsis
KW  - shock
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-124136
VL  - 5
IS  - 100
ER  -