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  • 1
    ISSN: 1432-1440
    Keywords: Internal jugular vein ; Shaldon Catheter ; Percutaneous insertion ; Hemodialysis ; Acute renal failure ; Chronic renal failure ; Hemofiltration ; Hemoperfusion ; Plasmapheresis ; V. jug. int. ; Shaldon-Katheter ; perkutane Punktion ; Haemodialyse ; akutes Nierenversagen ; chronische Niereninsuffizienz ; Haemofiltration ; Haemoperfusion ; Plasmafiltration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Seit 2 Jahrzehnten wird die perkutane Punktionstechnik nach Seldinger zur Einlage von großlumigen Kathetern zur Haemodialysebehandlung angewandt. Bisher wurden die Femoral- und Subclaviagefäße benutzt. Wir berichten über eigene Erfahrungen mit der Katheterisierung der V. jugularis interna mittels großlumiger Katheter (Shaldon-Katheter), die wir bei 194 Patienten mit insgesamt 237 Punktionen gewinnen konnten. Erforderlich wurde die perkutane Punktion der V. jugularis zur Durchführung akuter Haemodialysen, Hämofiltrationen, Hämoperfusionen oder bei Dauerdialyse-Patienten zur Überbrückung, bis andere Anschlußmöglichkeiten zur Verfügung standen. Ebenfalls wurde diese Methode auch als Gefäßzugang zur Plasmafiltration (Plasmapherese) verwendet. Wesentliche Komplikationen sind nicht aufgetreten. Ihre Häufigkeit ist aufgrund von Literaturangaben und eigener Erfahrungen gegenüber den anderen Zugangswegen geringer. Die Katheterisierung der V. cava superior über V. jugularis interna erscheint somit als geeignetes Verfahren, um schnell und ohne großen Aufwand eine Anschlußmöglichkeit zur Haemodialyse, Haemofiltration, Haemoperfusion oder Plasmafiltration zu schaffen.
    Notes: Summary For almost 2 decades, the chosen method for hemodialysis has been the transcutaneous Seldinger technique, using large-bore catheters. Traditionally, the femoral or subclavian veins have been used. We report our experience on introducing the catheter (Shaldon Catheter) into the internal jugular vein in 237 cases in 194 patients. The percutaneous insertion was necessary for acute hemodialysis, hemofiltration, hemoperfusion, or for temporary vascular access. This method was using for plasmapheresis, too. Major complications did not occur, which is in agreement with other authors, where by the frequency of complications relating to the catheter itself has been lower using this approach. It thus seems that the cannulation of the superior vena cava through the internal jugular vein is a suitable means of obtaining fast vascular access for the purposes of hemodialysis, hemofiltration, hemoperfusion or plasmapheresis.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Posttransfusion purpura ; Thrombocytopenia ; Blood transfusion ; Platelet antibodies ; HLA antigens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirteen cases of posttransfusion purpura (PTP) which were diagnosed in Germany and Austria from 1977–1985 are described. All patients were women with a mean age of 58.6 years (range, 36–77 years). All but one had been pregnant and received blood transfusions 2 to 12 days prior to the onset of PTP. The thrombocytopenic purpura was always severe with a nadir of platelet counts below 10×109/l and lasted between 3 and 60 days. All patients recovered from PTP. Optimal therapy consisted of administration of high-dose IgG. Twelve of the 13 patients had developed platelet-specific Zwa antibodies (eight of them together with HLA antibodies), in one Zwa positive individual only HLA antibodies were detectable. Five of six HLA-DR typed patients carried DR3 which is considered an immunogenetic risk factor in PTP. Clinical awareness of this rare, but serious iatrogenic transfusion complication is prerequisite for prompt diagnosis and improved therapy.
    Type of Medium: Electronic Resource
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