�ber die Bildung von Thrombocytenaggregaten und die �nderung des H�matokrits durch komplette Gehirnisch�mie

Hirsch, Hans Joachim; Breuer, Martin; Hp, Kuenzel; Marx, E; Sachweh, D.

doi:10.1007/bf00244052

Cited by 29 publications

(5 citation statements)

References 6 publications

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“…Blood viscosity increases in the microcirculation during stasis. 16 Hematocrit is the main factor influencing blood viscosity, particularly in the microcirculation. During initial transient hyperemia, we saw no evidence of a persistent no-reflow phenomenon with or without hypertensive hemodilution.…”

Section: Discussionmentioning

confidence: 99%

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Hypertension with hemodilution prevents multifocal cerebral hypoperfusion after cardiac arrest in dogs.

Leonov

Sterz

Šafář

et al. 1992

Stroke

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Background: Improved neurological outcome with postarrest hypertensive hemodilution in an earlier study could be the result of more homogeneous cerebral perfusion and improved O 2 delivery. We explored global, regional, and local cerebral blood flow by stable xenon-enhanced computed tomography and global cerebral metabolism in our dog cardiac arrest model.Methods: Ventricular fibrillation cardiac arrest of 12.5 minutes was reversed by brief cardiopulmonary bypass, followed by life support to 4 hours postarrest We compared control group I (n=5; mean arterial blood pressure, 100 mm Hg; hematocrit, ^35%) with immediately postarrest reflow-promoted group II (n=5; mean arterial blood pressure, 140-110 mm Hg; hypervolemic hemodilution with plasma substitute to hematocrit, 20-25%).Results

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Section: Discussionmentioning

confidence: 99%

“…We used 10 healthy, custom-bred male coon hounds from the same breeding colony, mean age 10 (range, [8][9][10][11][12] months and mean weight 21 (range, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] kg. Control group I (n=5) also served other studies.…”

mentioning

confidence: 99%

Hypertension with hemodilution prevents multifocal cerebral hypoperfusion after cardiac arrest in dogs.

Leonov

Sterz

Šafář

et al. 1992

Stroke

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“…28 -31 The rationale for hemodilution after cardiac arrest is that blood flow is inversely proportional to blood viscosity, which increases in the microcirculation during cerebral ischemia. 32 Hct is the main factor influencing blood viscosity. There is suggestive experimental evidence of a benefit from hemodilution in focal cerebral ischemia.…”

mentioning

confidence: 99%

Hypertension with or without hemodilution after cardiac arrest in dogs.

Sterz

Leonov

Šafář

et al. 1990

Stroke

103

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We studied blood flow-promoting therapies after cardiac arrest in 18 dogs. Our model consisted of ventricular fibrillation (no blood flow) lasting 12.5 minutes, controlled reperfusion with cardiopulmonary bypass and defibrillation within 5 minutes, controlled intermittent positive-pressure ventilation to 20 hours, and intensive care to 96 hours. Group I (control, n=6) dogs were reperfused under conditions of normotension (mean arterial blood pressure 100 mm Hg) and normal hematocrit (>35%). Group II («=6) and III (n=6) dogs were treated with norepinephrine at the beginning of reperfusion to induce hypertension for 4 hours. In addition, group III dogs received hypervolemic hemodilution to a hematocrit of 20% using dextran 40. There were no differences in the time to recovery of electroencephalographic activity among groups. All six group I dogs remained severely disabled; in groups II and III combined, six of the 12 dogs achieved good outcome (/;<0.01). Some regional histopathologic damage scores at 96 hours were better in groups II and/or III than in group I (neocortex: p<0.05 group II different from group I; hippocampus: p<0.01 both groups II and III different from group I). Total histopathologic damage scores were similar among the groups. A hypertensive bout with a peak mean arterial blood pressure of >200 mm Hg beginning 1-5 minutes after the start of reperfusion was correlated with good outcome (p<0.01). Our results support the use of an initial bout of severe hypertension, but not the use of delayed hemodilution. (Stroke 1990;21:1178-1184)

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“…K6ppel (1958) zeigte bei seinen Untersuchungen, dab die Thrombozyten auBerhalb des Kreislaufs sehr rasch quellen, Pseudopodien bilden, zu Aggregationen, Adhgsionen und Extensionen neigen. Wichtig erscheint die Feststellung, dab die Agglutination der Fibrinbildung vorausgeht und der Hinweis, dab Hirsch et al (1964) nach kompletter Ischfimie des Gehirns im ven6sen Blut Thrombozytenaggregate fanden. Die vielfgltigen Erfahrungen lehrten, dab die Metamorphose der Blutpl~ttchen auBerhalb der Gef~iBe in einer nach Sekunden zu bemessenden Zeit beginnt, besonders, wenn diese mit fremden Oberfl~ichen und mit Gewebs-flfissigkeit in Berfihrung kommen (Extrinsic-System der Blutgerinnung).…”

Section: Diskussionunclassified

Verletzungen der gro�en Hirnschlagadern und vitale Reaktion

Krauland

Bratzke

1987

Z Rechtsmed

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In 90 forensic autopsies (Craniocerebral injury, gunshot, stabbing, blow, strangulation, etc.), semithin sections of great arteries were prepared from around 770 Epon blocks and checked for vital reactions at the mural and intimal ruptures. In 21 cases in which death had occurred immediately or soon after the trauma, with three exceptions, there was a subsequent electron microscopic investigation. In all six mural ruptures and in five of ten intimal ruptures, thrombocyte aggregates were found at the rupture margins. In five intimal ruptures, the possibility of the occurrence of preparations injuries had to be considered. In five cases, the results of the histological study were negative. The success rate is limited in principle in such a screening test since there are technical difficulties in preparing serial sections on long vessels. Death was rapid and the thrombocytes were observed to adhere to the injured wall sites immediately after the trauma. The "thrombocyte sign" is thus of substantial importance as the earliest local vital reaction. In two control cases (strangulation), thrombocyte aggregates were found at intimal ruptures of the basilar artery, which were regarded as the results of stretching via the vertebral arteries during attacks to the neck. The healing processes of intimal ruptures and traumatic medial necrosis in incomplete ruptures occurring later in life are discussed. Even if a cadaver is a few days old, the histological findings at the level of the thrombocytes can be evaluated.

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�ber die Bildung von Thrombocytenaggregaten und die �nderung des H�matokrits durch komplette Gehirnisch�mie

Cited by 29 publications

References 6 publications

Hypertension with hemodilution prevents multifocal cerebral hypoperfusion after cardiac arrest in dogs.

Hypertension with hemodilution prevents multifocal cerebral hypoperfusion after cardiac arrest in dogs.

Hypertension with or without hemodilution after cardiac arrest in dogs.

Verletzungen der gro�en Hirnschlagadern und vitale Reaktion

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