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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To allow and facilitate endoluminal vein preparation under angioscopic guidance for in situ bypass grafting, a Mill's valvulotome was equipped with a flushing channel. The advantages of the novel valvulotome are obvious: it allows perfect angioscopic view within a saphenous vein that still contained blood by adjusting the jet of lactated Ringer's solution directly to the lens of the angioscope; it permits the use of very small angioscopes without integrated flushing channels, preventing endothelial damage. The described technique was tested in 27 peripheral reconstructions in 26 patients. The secondary cumulative patency rate within a follow-up time of 4 to 30 months (mean, 14 months) was 89%. The described technique substantially facilitates in situ bypass grafting and minimizes early and late complications and further improves surgical outcome.
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PMID:Angioscopy-guided semiclosed technique for in situ bypass with a novel flushing valvulotome: early results. 153 15

Secondary to the i.v. administration of a corn-derived dextrose solution, a 23-y-old pregnant female patient admitted to the hospital at term gestation developed an anaphylactic reaction. Orofacial swelling, difficulty in breathing, hypotension, cardiac arrhythmia, voice hoarseness, total body warmth and flushing occurred within 8 min of initiation of a 5% dextrose Lactated Ringer's solution. The i.v. solution was discontinued and plain lactated Ringer's solution was begun with no sequelae. The patient delivered a viable male infant with a post-operative course being unremarkable. A sample of suspect solution was sent to the manufacturer but no contamination was reported. Although the reaction elicited in this patient was rare, clinicians should be aware of the possibility of corn allergy due to the administration of i.v. fluids containing corn-derived dextrose.
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PMID:Probable anaphylactic reaction to corn-derived dextrose solution. 180 42

Short preservation time still severely limits lung transplantation. To determine the effect of bronchial arterial flush preservation, we studied 54 dogs using the isolated perfused working lung model. After baseline measurements, lungs were flushed with lactated Ringer's solution (60 ml/kg at 8 degrees C) by one of three methods: pulmonary artery perfusion, bronchial artery perfusion through a 15 cm closed aortic segment, or simultaneous pulmonary-bronchial artery perfusion. These groups were further subdivided and tested after 0, 4, and 17 hours of storage at 4 degrees C (n = 6 each). Lungs were ventilated (flow rate 140 ml/kg/min; inspired oxygen fraction 0.21) and continuously reperfused with normothermic deoxygenated autologous blood in a closed loop. Measured variables were hemodynamics, aerodynamics, and leukocytes in bronchoalveolar lavage. Survival time was determined from initial reperfusion to failure of the lung to oxygenate. After 0 and 4 hours of storage, there was no significant difference in survival times. After 17 hours, lungs subjected to pulmonary-bronchial artery perfusion survived longer than those perfused via either the pulmonary or bronchial arteries alone (120 +/- 24 versus 38 +/- 14 or 52 +/- 16 minutes; p less than 0.01). Pulmonary artery pressure and resistance in all groups except at failure were never different from baseline values in the intact animal. Shunts in the pulmonary-bronchial artery perfusion groups were closest to baseline at onset (8% +/- 4%) and remained lower throughout reperfusion than in the groups subjected to pulmonary or bronchial artery perfusion alone. After 17 hours, static compliance of pulmonary artery-perfused lungs was worse than baseline (1.1 +/- 0.2 x 10(-2) versus 3.2 +/- 0.7 x 10(-2) L/cm H2O/sec; p less than 0.05), whereas compliance in the pulmonary-bronchial artery perfusion groups remained constant (3.6 +/- 1.5 x 10(-2) L/cm H2O/sec). Elastic work performed by lungs subjected to pulmonary-bronchial artery flushing at onset was significantly lower when these lungs were reperfused immediately (201 +/- 14 versus 295 +/- 35 gm-m/min for pulmonary artery-flushed lungs) or after 4 hours of storage (229 +/- 30 versus 290 +/- 24 gm-m/min for pulmonary artery-flushed lungs). Bronchoalveolar lavage after 17 hours in the group subjected to pulmonary bronchial artery flushing demonstrated leukocyte counts similar to those of intact lungs (45 +/- 5 versus 29 +/- 8/mm3) and significantly less than in lungs subjected to pulmonary or bronchial artery flushing (137 +/- 18 or 82 +/- 10/mm3, respectively).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Contribution of the bronchial circulation to lung preservation. 825 22

Coronary angioscopy (CA) using ultrathin fiberscopes was performed in 30 patients with coronary heart disease during cardiac catheterization and in 11 patients during bypass surgery. For percutaneous CA the angioscope was introduced from the femoral artery through a 9F guiding catheter. During short-time occlusion of the coronary ostium by the tip of the guiding catheter the viewing field was flushed with Ringer's solution. Intraoperative CA was performed both by the retrograde and antegrade way during flushing with cardioplegic solution. Percutaneous CA was successful in 57% of patients. 13 patients showed eccentrically and irregularly shaped stenoses and 3 of these patients had an additional plaque rupture. In 2/5 patients CA after PTCA revealed intimal dissections not visualized by angiography. Intraoperative CA was successful in 9/11 patients. In 3 patients nonocclusive thrombi were found at the site of the coronary lesion. Additionally we studied the efficacy of angioscopic guidance during intravascular radiofrequency application. In 11/11 thrombotically occluded peripheral vessels this new method allowed a nearly complete recanalization. There was only one perforation of the vessel. We conclude, that CA is a powerful diagnostic tool providing prognostically relevant information in the diagnosis of coronary heart disease.
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PMID:[Diagnostic significance of angioscopy in patients with coronary heart disease]. 326 58

Coronary angioscopy (CA) was performed in 30 patients (pts) during cardiac catheterization (Group 1) and in 11 pts during coronary bypass surgery (Group 2) using ultrathin fiberoptic angioscopes (phi 1.2-1.8 mm). For percutaneous CA (Group 1) the angioscope was introduced through a 9F guiding catheter from the femoral artery. The viewing field was cleared by flushing Ringer's solution and short-time occlusion of the coronary ostium by the guiding catheter. In Group 2 CA was performed retrogradely from the distal arteriotomy and through the bypass vein during flushing with cardioplegic solution. In Group 1 in 17/30 pts the coronary artery could be successfully examined by CA. In 13 pts the obstruction was eccentric and irregular shaped. In 2/5 pts, in whom CA was performed successfully pre and post balloon dilatation, CA after PTCA revealed an intimal rupture without clinical or angiographical signs of the intimal dissection. In Group 2 in 9/11 pts good visualization of stenoses could be achieved. At the obstruction site CA revealed thrombi in 3 pts and ulcer in 1 pts. In contrast to angiography, which estimates the lumen diameter of a segmental lesion, CA gives information about the luminal shape and the underlying substance of the obstruction (e.g. atheroma, thrombus, ulceration). The main problems in percutaneous CA are the insufficient intraluminal guidance, the insufficient depth of view of the angioscopes, and the limited examination time.
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PMID:Coronary angioscopy during cardiac catheterization and cardiac surgery. 326 97

Liver preservation and transplantation was performed in pigs. For flush perfusion cold (2 degrees C) and warm (15 degrees C) lactated Ringer's solution were compared. Administration of cold Ringer's resulted in a severe endothelial damage of sinusoids that was aggravated after recirculation, as shown by electron microscopic examination. Using warm Ringer's solution this alteration was limited. Liver parenchymal cells are impaired mainly during reflow as a consequence of microcirculatory disturbance. After cold flushing animals died within a few hours, whereas after flushing with warm Ringer's solution pigs survived definitively.
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PMID:Preservation damage in liver transplantation. Influence of rapid cooling. 352 51

The hygienic condition of 6 milking installations, 3 sanitized by circulation cleaning (CC) with chlorine-based chemicals and 3 by flushing with acidified boiling water (ABW), was tested using rinses of quarter strength Ringer's solution. The bacterial content of the rinses was determined using both colony counts and the direct epifluorescent filter technique (DEFT). A comparison of testing methods gave correlation coefficients between colony count and DEFT of 0.82 for plants using CC and 0.46 for plants using ABW. Five strains of bacteria belonging to different genera and commonly found on milking equipment were exposed to various degrees of heat and to various concentrations of chlorine. The effects of such treatments on the staining characteristics of the organisms were studied. It was observed that Staphylococcus aureus and Streptococcus lactis, although killed by heat treatment, stained a bright orange when treated with acridine orange dye. Pseudomonas fluorescens, Escherichia coli and vegetative cells of Bacillus cereus did not take up the orange stain after heat treatment, nor did any of the 5 strains stain orange after treatment with NaOCl. It is suggested that the DEFT is a useful and rapid means of counting bacteria in rinses of equipment where sterilization is due primarily to chlorination, but in the absence of a stain which can differentiate more accurately between dead and living organisms its use is limited where sterilization is carried out solely by heat.
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PMID:Evaluation of the direct epifluorescent filter technique for assessing the hygienic condition of milking equipment. 634 24

High levels of magnesium can reverse the anticoagulation of cryoprecipitated plasma (CPP), resulting in fibrin formation. When pig cadaver kidneys were flushed with Collins' C2 solution containing a high concentration of magnesium, clotting of CPP perfusate occurred when the CPP initial magnesium level was high, but not with low magnesium levels. Flushing with C2 and preservation with an albumin perfusate, or flushing with Ringer's solution before CPP perfusion, did not result in fibrin formation. Small amounts of heparin added to CPP did not prevent fibrin formation. C2-preserved kidneys should not be additionally preserved with CPP perfusion preservation without special consideration of magnesium levels.
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PMID:Kidney preservation failure using combined Collins' solution and plasma perfusion. 686 24

Hemodynamic instability and hyperkalemia are common after reperfusion and may cause ischemic damage on the hepatic allograft. Two techniques for flushing hepatic grafts before reperfusion were studied to evaluate their effects on intraoperative hemodynamic and metabolic status and on early graft function in 83 consecutive adult hepatic transplantations. In the first 41 patients (group 1), the hepatic grafts were rinsed with 500 milliliters of lactated Ringer's solution (LR). In the subsequent 42 patients (group 2), in addition to LR rinse, the first 500 milliliters of portal blood to flush and reperfuse the liver were drained through the cannula inserted into the donor vena cava before unclamping the vena cava. After reperfusion, the mean arterial pressure decreased 30 +/- 4 percent in group 1 versus 17 +/- 2 percent in group 2 (p < 0.02), and serum K+ increased by 1.9 +/- 0.2 in group 1 versus 0.8 +/- 0.2 milliequivalents per liter in group 2 (p < 0.01). Hyperkalemic cardiac arrest was only seen in two patients in group 1. The K+ concentration in the first 100 milliliters of discarded blood was found to be 40 +/- 2 milliequivalents per liter. The 500 milliliters of discarded blood contained 8.3 +/- 0.4 milliequivalents, which was correlated with graft liver weight (p < 0.001). Early graft function, as measured by serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, total bilirubin and prothrombin time on postoperative day No. 2, was significantly better in group 2 than in group 1 (p < 0.05). The six-month graft and patient survival rates in group 1 were 66 and 75 percent, versus 90 and 95 percent in group 2 (p < 0.01 and p < 0.02, respectively). Further flushing with 500 milliliters of autologous portal blood resulted in smaller intraoperative shifts in serum K+, greater hemodynamic stability, better graft function and improved graft and patient survival.
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PMID:Flushing with autologous blood improves intraoperative hemodynamic stability and early graft function in clinical hepatic transplantation. 819 45

The conversion from xanthine dehydrogenase (XD) to xanthine oxidase (XO) and the effect of trifluoperazine (TFP), a calmodulin inhibitor, on the conversion were examined during the normothermic ischemia of the rat small intestine. Rat jejunums were stored in lactated Ringer's solution (LR) at 37 degrees C for various hours after intravascular flushing with LR. The extents of the conversion from XD to XO (%XO) constituted 21.1% +/- 3.0%, 36.2% +/- 7.0%, 63.2% +/- 8.1%, and 88.2% +/- 8.6% after 0, 2, 4, and 6 hours of the preservation, respectively (control group). The preservation without the intravascular flushing showed significant increase in the %XO (99.5% +/- 6.0%) only after 6 hours compared with those in the control group (P < .05). When the intestines were stored in LR containing 50 mg/L of TFP at 37 degrees C, or stored in LR at 37 degrees C after the intraperitoneal pretreatment with 10 mg/kg of TFP 1 hour before laparotomy showed significant decrease in the extents of the conversion after 4 hours (P < .005) and 6 hours (P < .025) of the preservation, compared with those in the control group. When the dose of TFP for the pretreatment was increased to 50 mg/kg, the suppressive effect on the conversion was found even after 2 hours (P < .025) as well as after 4 hours (P < .005) and 6 hours (P < .025) of the preservation. These results suggest that TFP could be effective on reducing the XO-mediated postischemic reperfusion injury by means of inhibiting the conversion during ischemia of the rat small intestine.
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PMID:Conversion of xanthine dehydrogenase to xanthine oxidase during ischemia of the rat small intestine and the effect of trifluoperazine on the conversion. 848 75


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