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Biomedical subjects

B Homann

Publications and source records attributed to B Homann.

25 records · Page 2Linked to original sources

[Intraoperative autotransfusion and haemolysis (author's transl)].

In 29 patients (12 vascular and 17 trauma cases) receiving autotransfusion the effects of haemolysis caused by the Bentley ATS-system were examined. The following parameters were monitored: 1. Overall haemolysis rate and fractions in serum and urine, --2. Total and direct bilirubin in all patients with or without preexisting icterus, --3. Plasma-proteins: Albumen, haptoglobin, haemopexin, transferrin and C3-activator. --In both groups extremely high rates of free haemoglobin in serum were found in some cases. The peak of haemoglobinuria was observed several hours after the autotransfusion or at the end of the operation. The different plasma proteins showed increased activity to cope with haemolysis within the first 24 h. After one week they still showed overshooting levels in some cases which permitted conclusions concerning the extent of the reactions. The transformation of free haemoglobin in bilirubin has to be strongly suspected. The changes of the parameters were not in relation to the volume of autotransfusion. No irreversible complications due to haemolysis caused by the autotransfusion systems were observed.

Blood Transfusion, Autologous

[Intraoperative autotransfusion and its influence on the blood-clotting-system (author's transl)].

In 12 vascular and 17 trauma cases the changes in the coagulation system due to intraoperative autotransfusion (IAT) were examined immediately after the IAT as well as 24, 48, 72 h and one week later. The following parameters were monitored: 1. Platelet count. --2. Prothrombin-time, partial-thromboplastin-time, factors II, V, VII, X and thrombin-clotting-time. --3. Fibrinogen, alpha-1-antitrypsin, alpha-2-macroglobulin, antithrombin III and plasminogen in 5 trauma cases. --4. Euglobulin-Lysis-Time. --After the IAT a loss of platelets, factors I, II, V, X, plasminogen and antithrombin III was found. Alpha-1-antitrypsin and alpha-2-macroglobulin remained unchanged or showed a slight increase. 24 h after treatment with Ugurol and heparin, fresh frozen plasma, fibrinogen and Cohn I-fraction in selected cases, an increasing normalisation of most parameters was seen, except for the plasma proteins active in coagulation. They showed a combination of "consumption coagulophathy" and "hyperfibrinolysis" up to the 7th day. Under treatment outlines above even marked laboratory changes remained without any clinical significance. Thus our results confirm that IAT does not cause any additional irreversible damage to the coagulation system. Therefore IAT can be considered as method of choice for the emergency treatment of massive bleeding.

Blood Cell Count

[Hydroxy-ethyl-starch as plasma substitute in transurethral prostatectomy with the "cold-punch" method (author's transl)].

Each of 24 patients undergoing transurethral prostatectomy under spinal anaesthesia received 1000 ml HES and, depending from the clinical situation, some patients received blood-transfusion. Afterwards two groups were formed: group A (11 patients), who received HES only, and group B (13 Patients) with additional blood-transfusions. The following parameters were monitored simultaneously: blood pressure, heart rate, stroke index, cardiac output, active blood volume, hemoglobin and hematocrit in whole blood as well as in the irrigatin fluid of the bladder. They showed HES to be a useful plasma substitute for older patients. It is well tolerated and has a slow stabilising effect on circulation, which was effective for several hours. Furthermore, HES-infusion reduced the average need of bloodtransfusion by 500 ml.

Aged

[Intraoperative instrumental autotransfusion. 1st experiences in vascular surgery and traumatology].

Intraoperative autotransfusion with the Bentley-ATS system was performed in 22 patients, saving a total of 98 000 ml of their own blood. In addition 77 000 ml of homologous blood were given, intraoperatively. Eleven patients underwent major vascular surgery and 11 were operated for major traumatic injuries. There was a total of 11 deaths overall but none related to the autotransfusion. It is concluded that intraoperative autotransfusion is a safe and simple method of rapid transfusion which can save significant volumes of precious homologous blood.

Abdominal Injuries

[On the use of concentrated haptoglobin in the treatment of a haemolytic transfusion accident of the ABO-system (author's transl)].

The clinical course and the treatment of a case of severe haemolytic ABO-incompatibility are described. In addition to the routine therapy 3 times 2000 units of haptoglobinconcentrate were given since it is known according to the literature to metabolize free haemoglobin. The clinical result seems to confirm the beneficial effect. The course remained free of complications and the hospital stay was not prolonged. Further clinical experience is needed to confirm the effectiveness of the treatment with haptoglobin in cases with severe haemolysis.

ABO Blood-Group System