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A F Grootendorst

Publications and source records attributed to A F Grootendorst.

22 records · Page 2Linked to original sources
PubMed1988

Albumin abuse in intensive care medicine.

Albumin is a much abused and expensive drug in intensive care units. One of the motivations for its use is the prevention of pulmonary edema by enhancing the colloid osmotic pressure (COP). Fear of pulmonary edema has led to the formation of a magic (arbitrary) albumin value varying from one intensive care unit to another. Many intensive care units start substituting albumin when it is below 25 g/l. The objective of this paper is to look at the rationale of this policy. Our results show that in intensive care patients, with a variety of primary diagnoses, a poor correlation exists between COP and serum albumin concentration (r = 0.56; p less than 0.001). To get an index of the colloid osmotic status of the I. C.-patient measuring albumin concentration is useless and COP should be measured instead. From 19 patients with a COP in the 15.0-20.0 mmHg range (corresponding albumin range: 12.0-25.0 g/l) and from 10 patients with a COP in the 11.6-15.0 mmHg range (corresponding albumin range 10.5-19.2 g/l) none developed pulmonary edema. It is questionable if expensive, scarce albumin is the drug of choice with which to increase COP, for the mean increase (+/- SD) in COP after infusion of 100 grams albumin is 2.2 (+/- 1.5) mmHg (p less than 0.001). Adopting a COP action level of 15 mmHg can lead to considerable savings.

Albumins↗
PubMed1980

Adaptation of the vestibulo-ocular reflex in albino rabbits by selective exposure of the anterior sector of the visual field.

Horizontal optokinetic reflexes (OKN) are inverted in an anterior (90-180 degrees) sector of the visual field in albino rabbits. We investigated whether the inverted processing of direction-selective information would affect long-term adaptation of the vestibulo-ocular reflex (VOR). Normal posterior parts of the visual fields were masked for periods up to 80 days. The inversion of OKN, with instability of the eyes and head in the light, was not corrected in this period. The amplitude of the VOR was progressively reduced, but a true inversion was not achieved. Recovery was seen after removal of the masks. These changes were larger and more consistent in Himalayan than in Polish rabbits. Normal, Dutch pigmented rabbits which served as controls showed no significant reduction of VOR gain. Phase lead of the VOR for low stimulus frequencies increased in both pigmented and albino rabbits. In short-term experiments with forced oscillation, similar but smaller changes were observed.

Animals↗