RESUMEN
BACKGROUND: Airway management during resuscitation is pivotal for treating hypoxia and inducing reoxygenation. This German Resuscitation Registry (GRR) analysis investigated the influence of the type of airway used in patients treated with manual chest compression (mCC) and automated chest compression devices (ACCD) after out-of-hospital cardiac arrest (OHCA). METHODS: Out of 42,977 patients (1 January 2010-30 June 2016) information on outcome, airway management and method of chest compressions were available for 27,544 patients. Hospital admission under cardiopulmonary resuscitation (CPR), hospital admission with return of spontaneous circulation (ROSC), hospital discharge and discharge with cerebral performance categories 1 and 2 (CPC 1,2) were used to compare outcome in patients treated with mCC vs. ACCD, and classified by endotracheal intubation (ETI), initial supraglottic airway device (SAD) changed into ETI, and only SAD use. RESULTS: Outcomes for hospital admission under ongoing CPR, hospital admission with ROSC, hospital discharge and neurologically intact survival (CPC 1,2) for mCC (84.8%) vs. ACCD (15.2%) groups were: 8.4/38.6%, 39.2/27.2%, 10.6/6.8%, 7.9/4.7% (p < 0.001), respectively. Only mCC with SAD/ETI for ever ROSC (OR 1.466, 95% CI: 1.353-1.588, p < 0.001) and mCC group with SAD/ETI for hospital admission with ROSC showed better outcomes (odds ratio [OR] 1.277, 95% confidence interval [CI]: 1.179-1.384, p < 0.001) in comparison to mCC treated with ETI. Compared to mCC/ETI, all other groups were associated with a decrease in neurologically intact survival. CONCLUSION: Better outcomes were found for mCC in comparison to ACCD and ETI showed better outcomes in comparison to SAD only. This observational registry study raised the hypothesis that SAD only should be avoided or SAD should be changed into ETI, independent of whether mCC or ACCD is used.
Asunto(s)
Manejo de la Vía Aérea/métodos , Reanimación Cardiopulmonar/métodos , Paro Cardíaco Extrahospitalario/terapia , Anciano , Anciano de 80 o más Años , Manejo de la Vía Aérea/estadística & datos numéricos , Reanimación Cardiopulmonar/estadística & datos numéricos , Servicios Médicos de Urgencia , Femenino , Alemania/epidemiología , Humanos , Intubación Intratraqueal , Masculino , Persona de Mediana Edad , Paro Cardíaco Extrahospitalario/epidemiología , Intervención Coronaria Percutánea , Estudios Prospectivos , Sistema de Registros , Estudios RetrospectivosRESUMEN
Commercial heparin preparations induce the aggregation of human polymorphonuclear neutrophils (PMNs). The minimum aggregating concentration (MAC) of different heparin lots was measured under standardized conditions. It was found to vary between 0.3 and 15 units/ml. Gel filtration of heparin showed that the aggregating activity eluted in a sharp peak with a pattern different from heparin. When heparin was bound to antithrombin III-Sepharose, the aggregating activity eluted totally in the high-affinity fraction. When PMNs are partially aggregated with heparin, further aggregation by N-formyl-methionyl-leucyl-phenylalanine (FMLP) or phorbol myristate-acetate (PMA) is not affected. Pretreatment of PMNs with a low-aggregating heparin fraction, inhibits further aggregation by a high-aggregating heparin fraction. These results suggest that the PMNs have binding sites for heparin different from those for PMA and FMLP. Binding of heparin is not enough for inducing aggregation. Certain structural requirements of the heparin molecule are probably essential for aggregation.
Asunto(s)
Heparina/farmacología , Neutrófilos/fisiología , Antitrombina III , Agregación Celular/efectos de los fármacos , Separación Celular/métodos , Cromatografía de Afinidad/métodos , Cromatografía en Gel/métodos , Heparina/aislamiento & purificación , Humanos , Cinética , Neutrófilos/citología , Neutrófilos/efectos de los fármacosAsunto(s)
Fosfatos de Dolicol/metabolismo , Glicoproteínas/biosíntesis , Microsomas Hepáticos/metabolismo , Fosfatos de Poliisoprenilo/metabolismo , Animales , Monofosfato de Dolicol Manosa/metabolismo , Fosfatos de Dolicol/aislamiento & purificación , Glucolípidos/metabolismo , Hidrólisis , Oligosacáridos/metabolismo , Azúcares de Poliisoprenil Fosfato/metabolismo , Porcinos , Uridina Difosfato Glucosa/metabolismo , Uridina Difosfato N-Acetilglucosamina/metabolismoRESUMEN
Previous work showed that liver microsomes catalyze the transfer of glucose from dolichol monophosphate glucose to an endogenous acceptor believed to be a dolichol pyrophosphate derivative of an oligosaccharide. This oligosaccharide has now been prepared on a larger scale so as to permit the determination of its sugars. The purification procedure includes, as a last step, a thin layer chromatography on kieselguhr-silica gel to obviate glucose-containing contaminants. After complete hydrolysis mannose, glucose and a small amount of hexosamine were detected.
Asunto(s)
Lipopolisacáridos , Oligosacáridos , Animales , Glucosa/análisis , Hexosaminas/análisis , Lipopolisacáridos/aislamiento & purificación , Hígado , Manosa/análisis , Oligosacáridos/aislamiento & purificación , Fosfolípidos/análisis , PorcinosAsunto(s)
Hexosiltransferasas/metabolismo , Microsomas Hepáticos/enzimología , Oviductos/enzimología , Fosfolípidos/biosíntesis , Animales , Pollos , Cromatografía DEAE-Celulosa , Cromatografía en Gel , Cromatografía en Capa Delgada , Femenino , Glicósido Hidrolasas , Guanosina , Hexosaminidasas , Humanos , Manosa , Microsomas/enzimología , Azúcares de Nucleósido Difosfato , Oligosacáridos/biosíntesis , Especificidad de Órganos , Oviductos/citología , Plantas/enzimología , Saliva/enzimologíaRESUMEN
Incubation of GDP-[(14)C]mannose with liver microsomes and magnesium ions led to the formation of dolichol monophosphate mannose and of other acidlabile compounds that contain oligosaccharides. Formation of these compounds was enhanced by addition of an acceptor lipid in the same fractions of DEAE-cellulose chromatography where bound dolichol is found. Alkaline treatment of the oligosaccharides, obtained by acid methanolysis, followed by paper electrophoresis, gave rise to the formation of two positively charged substances believed to be formed by deacetylation of hexosamine residues. Incubation of the oligosaccharide-containing compounds with liver microsomes and manganese ions resulted in a transfer to endogenous protein. The role of dolichol derivatives in glycoprotein synthesis is discussed.
Asunto(s)
Diterpenos/metabolismo , Alcoholes Grasos/metabolismo , Glicoproteínas/biosíntesis , Manosa/metabolismo , Microsomas Hepáticos/metabolismo , Oligosacáridos/biosíntesis , Animales , Radioisótopos de Carbono , Cromatografía DEAE-Celulosa , Cromatografía en Papel , Transporte de Electrón , Nucleótidos de Guanina/metabolismo , Hidrólisis , Técnicas In Vitro , Magnesio , Manosa/análisis , Oligosacáridos/análisis , Oligosacáridos/metabolismo , RatasAsunto(s)
Disacáridos/biosíntesis , Lípidos/biosíntesis , Microsomas Hepáticos/metabolismo , Acetatos/biosíntesis , Acetatos/metabolismo , Animales , Borohidruros , Isótopos de Carbono , Cromatografía DEAE-Celulosa , Cromatografía en Papel , Electroforesis en Papel , Alcoholes Grasos/metabolismo , Glucosamina/biosíntesis , Glucosamina/metabolismo , Hidrólisis , Magnesio/farmacología , Microsomas Hepáticos/efectos de los fármacos , Oxidación-Reducción , Ratas , Terpenos/metabolismo , Azúcares de Uridina Difosfato/metabolismoAsunto(s)
Glucofosfatos , Glucolípidos , Terpenos , Animales , Sitios de Unión , Borohidruros , Isótopos de Carbono , Cromatografía en Papel , Concanavalina A , Alcoholes Grasos , Glucolípidos/metabolismo , Hígado/metabolismo , Microsomas Hepáticos/metabolismo , Oligosacáridos , Oxidación-Reducción , Ácido Peryódico/metabolismo , Ratas , Porcinos , Factores de Tiempo , TritioRESUMEN
It has been reported that liver microsomes catalyze the transfer of glucose from uridine diphosphate glucose to dolichol monophosphate so as to produce dolichol monophosphate glucose. Dolichol is a polyprenol containing about 20 isoprene units. The glucosyl residue of dolichol monophosphate glucose is transferred to an endogenous acceptor on further incubation with liver microsomes. The glucosylated endogenous acceptor appears to be an oligosaccharide of about 20 monosaccharide units bound to dolichol through a phosphate or pyrophosphate bridge. In this paper it is reported that liver microsomes catalyze the transfer of the oligosaccharide from the glucosylated endogenous acceptor to an endogenous protein. This transfer reaction requires the presence of bivalent cations, manganese being more effective than magnesium. The presence of deoxycholate is also required. Besides the glycoprotein, several water-soluble products are also formed. Preliminary evidence indicates that they are glucose, iligosaccharides of different size, and possibly oligosaccharides bound to amino acids.
Asunto(s)
Glicoproteínas/biosíntesis , Microsomas Hepáticos/metabolismo , Polisacáridos/metabolismo , Terpenos/metabolismo , Animales , Borohidruros , Isótopos de Carbono , Embrión de Pollo , Cromatografía en Gel , Cromatografía en Papel , Quimotripsina/metabolismo , Ácido Desoxicólico/metabolismo , Alcoholes Grasos/análisis , Alcoholes Grasos/metabolismo , Glicoproteínas/análisis , Glicoproteínas/metabolismo , Manganeso/metabolismo , Compuestos Organofosforados/análisis , Compuestos Organofosforados/metabolismo , Papaína/metabolismo , Polisacáridos/análisis , Pronasa/metabolismo , Desnaturalización Proteica , Ratas , Terpenos/análisisAsunto(s)
Alcoholes Grasos , Glucosa , Lípidos/análisis , Microsomas Hepáticos/análisis , Terpenos , Animales , Isótopos de Carbono , Fenómenos Químicos , Precipitación Química , Química , Cloroformo , Cromatografía DEAE-Celulosa , Cromatografía en Capa Delgada , Ácido Clorhídrico , Hidrólisis , Hidróxidos , Lípidos/aislamiento & purificación , Metanol , Compuestos Organofosforados , Solubilidad , TritioRESUMEN
The product formed by incubation of dolichol monophosphate glucose with liver microsomes was studied. It is insoluble in most solvents, but is soluble in a chloroform-methanol mixture with a high content of water. Treatment with ammonia gave rise to the formation of a water soluble, negatively charged compound of molecular weight 3550. The negative charge could be removed by treatment with phosphatase. Acid hydrolysis of the original compound led to the liberation of an uncharged, water-soluble compound (molecular weight 3550). Acetolysis of the latter gave rise to the formation of a series of products, which appeared to be oligosaccharides when chromatographed on paper or silica plates. The original substance behaved like a polyprenol pyrophosphate when chromatographed on DEAE-cellulose. Molecular weight measurements of the deoxycholate inclusion compound gave a value of 14,300, while dolichol monophosphate glucose under the same conditions gave 11,300. It is tentatively suggested that the compound is dolichol joined through a phosphate or pyrophosphate bridge to an oligosaccharide containing about 20 monosaccharide residues.
Asunto(s)
Glucosa/metabolismo , Hexosafosfatos/metabolismo , Microsomas Hepáticos/metabolismo , Alcoholes/metabolismo , Amoníaco/farmacología , Transporte Biológico , Isótopos de Carbono , Fenómenos Químicos , Química , Cromatografía DEAE-Celulosa , Cromatografía por Intercambio Iónico , Cromatografía en Capa Delgada , Glucofosfatos/metabolismo , Hidrólisis , Microsomas Hepáticos/efectos de los fármacos , Peso Molecular , Azúcares de Nucleósido Difosfato/metabolismo , Solubilidad , Terpenos/metabolismo , Tritio , Nucleótidos de Uracilo/metabolismoAsunto(s)
Alquenos/metabolismo , Hexosaminas/metabolismo , Hexosas/metabolismo , Microsomas Hepáticos/metabolismo , Nucleótidos/metabolismo , Ácidos Fosfóricos/metabolismo , Aminoácidos/metabolismo , Animales , Animales Recién Nacidos , Ácidos y Sales Biliares , Encéfalo/metabolismo , Catálisis , Cerebrósidos , Cromatografía en Capa Delgada , Colágeno/metabolismo , Estabilidad de Medicamentos , Ácidos Grasos/metabolismo , Galactosa/metabolismo , Glucosamina/metabolismo , Glucosa/metabolismo , Glicoles/metabolismo , Nucleótidos de Guanina/metabolismo , Concentración de Iones de Hidrógeno , Manosa/metabolismo , Microsomas Hepáticos/enzimología , Azúcares de Nucleósido Difosfato , Compuestos Organofosforados , Polímeros , Ratas , Piel/enzimología , Solubilidad , Tensoactivos , Temperatura , Nucleótidos de Uracilo/metabolismoRESUMEN
The microsomal fraction of liver has been found to catalyze glucose transfer from UDPG to a lipid acceptor which appears to be identical to the compound obtained by chemical phosphorylation of dolichol. The substance formed (dolichol monophosphate glucose) is acid labile and yields 1,6-anhydroglucosan by alkaline treatment. It can be used as substrate by the enzyme system yielding a glucoprotein which is subsequently hydrolyzed to glucose.