Meningokokkensepsis und Purpura fulminans Erfolgreiche Lysetherapie mit rekombinantem Gewebeplasminogenaktivator

Gessler, Peter; Bachmann, D. C. G.; Pfenninger, J.

doi:10.1007/s001120050532

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…Further studies should endeavor to define risk factors for bleeding among surgical patients and to determine whether interventions such as repletion of other coagulation factors, intermittent infusion of APC, or restriction of other anticoagulant therapies may be beneficial. P24 Spanish project on benchmarks related to recombinant human activated protein C use: best clinical practices identification MC Martín 1 , J Ruiz 2 , C León 3 , JA Lorente 4 , A López 5 , A Artigas 6 , F Castillo 7 , JC Ruiz 8 1 Hospital General de Cataluña, General Morato s/n, 08221-Sant Cugat del Vallés, Barcelona, Spain; 2 Hospital Sagrat Cor, 08029 Barcelona, Spain; 3 Hospital de Valme, Sevilla, Spain; 4 Hospital Universitario de Getafe, Madrid, Spain; 5 Hospital Infanta Cristina, Badajoz, Spain; 6 Hospital de Sabadell, CSPT, 08208 Sabadell, Barcelona, Spain; 7 Hospital Duque del Infantado, Sevilla, Spain; 8 Purpose To identify best clinical practices (BCPs) using several benchmarks (BMs) related to rhAPC administration as the starting point.…”

Section: Discussionmentioning

confidence: 99%

“…We studied six patients with severe head injury, with a median (range) initial Glasgow Coma Score 3.5 (3)(4)(5)(6)(7)(8), and X-ray computed tomography (CT) demonstrated contusions in all subjects. All patients were managed using protocoldriven therapy including sedation, neuromuscular blockade and mechanical ventilation, and were imaged at a mean of 63 hours (range 15-90 hours) post injury.…”

Section: Methodsmentioning

confidence: 99%

“…Theoretically, treatment with t-PA may help reverse the procoagulant state. Zenz et al [1] and others [6][7][8] observed significant clinical improvement after a 4-hour infusion of t-PA in a few pediatric patients with FM. This is the first report of successful thrombolysis with t-PA in a patient with FM complicated by MI and shock.…”

Section: P25 Thrombolysis In Fulminant Menigococcemia (Fm) With Myoca...mentioning

confidence: 99%

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Studies on head injury-induced pituitary dysfunction are limited in number and conflicting results have been reported. To further clarify this issue, 29 consecutive patients (24 males), with severe (n = 21) or moderate (n = 8) head trauma, having a mean age of 37 ± 17 years were investigated in the immediate post-trauma period. All patients required mechanical ventilatory support for 8-55 days and were enrolled in the study within a few days before ICU discharge. Basal hormonal assessment included measurement of cortisol, corticotropin, free thyroxine (fT4), thyrotropin (TSH), testosterone (T) in men, estradiol (E2) in women, prolactin (PRL), and growth hormone (GH). Cortisol and GH levels were measured also after stimulation with 100 µg human corticotropin releasing hormone (hCRH) and 100 µg growth hormone releasing hormone (GHRH), respectively. Cortisol hyporesponsiveness was considered when peak cortisol concentration was less than 20 µg/dl following hCRH. TSH deficiency was diagnosed when a subnormal serum fT4 level was associated with a normal or low TSH. Hypogonadism was considered when T (males) or E2 (women) were below the local reference ranges, in the presence of normal PRL levels. Severe or partial GH deficiencies were defined as a peak GH below 3 µg/l or between 3 and 5 µg/l, respectively, after stimulation with GHRH. Twenty-one subnormal responses were found in 15 of the 29 patients (52%) tested; seven (24%) had hypogonadism, seven (24%) had cortisol hyporesponsiveness, five (17%) had hypothyroidism, and two patients (7%) had partial GH deficiency.These preliminary results suggest that a certain degree of hypopituitarism occurs in more than 50% of patients with moderate or severe head injury in the immediate post-trauma period, with cortisol hyporesponsiveness and hypogonadism being most common. Further studies are required to elucidate the pathogenesis of these abnormalities and to investigate whether they affect long-term morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: P25 Thrombolysis In Fulminant Menigococcemia (Fm) With Myoca...mentioning

confidence: 99%

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“…Zenz et al . [1] and others [6-8] observed significant clinical improvement after a 4-hour infusion of t-PA in a few pediatric patients with FM. This is the first report of successful thrombolysis with t-PA in a patient with FM complicated by MI and shock.…”

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confidence: 99%