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Blood Replacement by PD Dr. med. Ulrich F. Gruber (auth.)

By PD Dr. med. Ulrich F. Gruber (auth.)

The manifold difficulties of outrage are nonetheless of significant value, diagnostic and healing event of the "severely sick" being provided with new info virtually each month. within the five periodicals that have stumbled on their strategy to my table prior to now few days there are not any lower than 10 fascinating articles on questions touching on surprise learn [see Bibliography forty-one b, fifty three a, 60 a, 192 a, 242 a, 350 b, 810 a, 941 a, 1069 a, 1082 a]. the main pressing element nonetheless is to take care of as whole as attainable the target catalog of a number of the surprise manifestations present in guy and in animals - but even as to view interpretations of those phenomena of their relative and temporal "truth". difficulties of concern study should not in simple terms attention-grabbing for his or her clinical worth but additionally for his or her scientific implication. particularly, virtually each practising health professional is dealing with difficulties of blood alternative very common­ ly. The powerful or circulating blood quantity continues to be an immense theoret­ ical and healing challenge within the surprise box. For years, U. F. GRUBER has pursued this query clinically and experimentally. This quantity bargains with the realm literature in an extremely thorough demeanour. This publication is made greater than a compilation by means of together with an extended checklist of unique paintings performed with F. D. MOORE in Boston, within the Surgical division in Chur, with 1. E. GELIN and S. E.

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These findings perhaps explain in part the many serious infections which are seen after management of severe blood losses. 16. Impairment of the Flow Properties of Blood In hemorrhagic and traumatic shock, platelet aggregation can occur early. At a later stage erythrocyte aggregation may be ~een [1737] in the areas of stasis in the microcirculation (see p. 5 and 12). In view of the fact that such platelet aggregation often occurs in preserved blood as well, M. SCHNEIDER [1281] doubts that whole blood is always the best means for volume replacement.

Fibrinolysis can occur as a serious complication [742]. R. F. WILSON [1539] observed disturbances in the coagulation system in 34 out of 209 patients who all received 5 litres of blood within 24 hours (cf. also [1561]). 11. Potassium Intoxication Potassium intoxication can occur after transfusion of very large amounts of blood which has been stored for several days when given to patients with reduced renal function, e. g. 28). This conclusion was also confirmed experimentally [882]. When blood is stored for 10 days, the plasma potassium concentration of 4-5 roval/l rises to about 15 mval/I.

6. To what extent the BV in hemorrhagic shock in man can be replaced with erythrocyte-free solutions without danger is not yet proved with any certainty using metabolic data. Considerable clinical experience, however, shows that blood losses of up to 1000 or 1500 ml (reduction of the Hct after replenishment of the BV to approx. 30) in previously healthy individuals can be replaced with erythrocyte-free solutions without any particular risk to the oxygen supply. PART TWO Various Methods of Volume Replacement A.

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