Biomedical subjects

R De Vivie

Publications and source records attributed to R De Vivie.

8 recordsLinked to original sources

PubMed1998

The significance of oncometry for infusion therapy during pediatric heart surgery.

BACKGROUND: The colloid osmotic pressure (COP) is not routinely assessed during pediatric heart surgery. Two cases of unrecognized hyperoncotic states associated with renal failure have been observed after pediatric heart surgery. We studied the hypothesis that the COP cannot be estimated from the total plasma protein (TPP) or albumin level. METHODS: The course of COP and its correlation to the TPP and albumin level were investigated in 25 children undergoing elective heart surgery. Infusion therapy was performed solely on the basis of clinical parameters and TPP/albumin levels. COP values were determined in a blinded fashion at the end of the study. RESULTS: No correlation between TPP/albumin and the COP could be determined preoperatively. On arrival at the ICU correlation was strong. A weak correlation was observed at 24 hours and 48 hours after surgery. However, the observed wide range of the confidential bands indicates that the COP cannot be estimated correctly, neither from the TPP, nor from the albumin level. Due to colloidal oversubstitution COP was significantly increased compared to preoperative level at 48 hrs following surgery. CONCLUSIONS: As estimation of COP from TPP or albumin level is inaccurate, oncometry should be performed during pediatric heart surgery.

Blood Proteins↗

PubMed1995

The importance of colloid osmotic pressure measurements to prevent oncotic overdosage during cardiac surgery.

OBJECTIVE: Colloidal infusion therapy during cardiac surgery has changed from the principal use of human albumin to the preference for synthetic colloids. Despite the possible interference of synthetic plasma expanders with the biuret determination of total plasma protein (TPP), perioperative infusion therapy is frequently directed on the basis of TPP and albumin levels. The hypothesis that the level of TPP or albumin does not reflect the plasma colloid osmotic pressure (COP) if synthetic plasma expanders are used was studied. MATERIALS AND METHODS: In 61 patients undergoing elective cardiac surgery the course of COP and its correlation to the TPP and albumin levels were investigated. Natural and artificial colloids were used for colloidal infusion therapy. RESULTS: No correlation between TPP/albumin levels and COP was found preoperatively and on arrival at the ICU, only a weak correlation was observed at 24 hours and 48 hours postoperatively. The wide range of the confidential interval indicates that the COP cannot be estimated correctly neither from the TPP nor the albumin level. The postoperative COP was significantly increased compared to the preoperative levels indicating oncotic overdosage. CONCLUSIONS: In order to avoid oncotic disturbances, indication for colloidal volume replacement during cardiac surgery should be controlled by oncometry if natural and synthetic colloids are administered.

Blood Proteins↗

PubMed1985

Biology of metastasizing ameloblastoma.

The present report of a malignant metastasizing ameloblastoma and a critical review of literature was undertaken in an attempt to better understand the biological potential and behavior of this rare tumor and thus to facilitate its clinical management. Most of the 26 patients with a proven malignant ameloblastoma including the present case had developed multiple recurrences. The lung was the most frequent metastatic site (88%) followed by regional lymph nodes (27%). Furthermore metastases were observed in some cases in the bone, brain, kidney, small intestine and liver. The interval between diagnosis of tumor and manifestation of metastases was long with a median of 11.1 years. The average survival time was 13.1 years. By contrast, the interval between diagnosis of metastatic disease and death was relatively short (median: 2.6 years). The histologic and cytologic pattern of malignant ameloblastoma and of its metastases was not significantly different from that of non-metastatic ameloblastoma. Because of the lack of morphological criteria of malignancy the biological behavior of ameloblastomas cannot be predicted. It is difficult to be certain which factors are important in the delayed induction of metastases. It is suspected that ameloblastomas possess an inherent low grade malignancy which is stimulated by multiple recurrences. It is further assumed that the metastatic tumor cells have a slow growth rate resulting in late clinical manifestation of metastases. When lung metastases occur we recommend their surgical removal in order to prolong live expectancy or even to obtain a curative effect.

Adult↗

PubMed1979