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Biomedical subjects

B Homann

Publications and source records attributed to B Homann.

29 records · Page 2Linked to original sources
PubMed1978

[The effect of citrate or heparin coagulation on the dog's heart work in autotransfusion].

During massive autotransfusion in the dog, the different anticoagulation processes have an important influence on heart work and performance. This is especially marked with citrate, depending on the amount and the transfusion rate. In spite of normovolemia both parameters show a transient decrease up to 40% - 50% with ACD and up to 60% - 70% with CPD. These different reactions may be due to the corresponding composition of each stabilizer. The effect is abolished by simultaneous use of citrate and calcium, which may prove that the observed changes are caused mainly by a depletion of ionized calcium caused by the rapid transfusion. This is comparable to the well-known citrate intoxication. In contrast both cardiac parameters decrease only about 10% with heparin anticoagulation. Heparinization seems to be preferable to citrate as regards heart work and performance during massive autotransfusion. Also the two citrate stabilizers significantly differ in their effect on both cardiac parameters, the use of ACD being favoured.

Animals↗
PubMed1977

[Intra-operative autotransfusion for massive bleeding (author's transl)].

Only intra-operative re-infusion with a special apparatus is suitable for autotransfusion in the management of massive and unexpected haemorrhage. Haemolysis and air embolism are the only problems directly related to it. Since haemolysis does not cause clinical complications it can be ignored, while air embolism can be prevented by continuous close supervision. Clotting disorders are the combined result of the underlying disease, circulatory shock, massive homologous blood transfusion and autotransfusion. No pulmonary problems have been encountered. The Bentley ATS system has proven to be the most effective means of replacing volume in life-threatening massive bleeding. It is a safe procedure which not only helps to save large volumes of homologous blood but also the life of many patients with extreme massive haemorrhages.

Adult↗
PubMed1977

[Intraoperative autotransfusion, technical management and its influence on blood circulation, on kidney and electrolytes (author's transl)].

From February 1975 until July 1976 12 patients who elective surgery and 15 trauma victims received intraoperative autotransfusion. The effects of this method on these patients were controlled by monitoring the behaviour of circulation and of important laboratory parameters. The procedure was well tolerated: 1. Only three of 29 patients showed evidence of cardiac insufficiency (lowering of ST. elevated T-peak, low blood pressure, high central venous pressure) which disappeared after reducing the rate of infusion. --2. Blood pressure, pulse rate and central venous pressure were stable at the end of the operation. --3. There was no renal insufficiency under dopamine (210 microgram/min) and 15% manitol (250 ml i.v.). --4. Serum creatine showed only minor changes from the initial level during the time of observation. --5. The same was true for beta2-microglobulin. --6. Serum urea rose slightly during 7 days. --7. There were minor changes of electrolytes without hypocalcaemia or high potassium. --8. The observed changes showed no relation to the method of anticoagulation and to time or volume of autotransfusion.

Blood Pressure↗
PubMed1977

[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↗
PubMed1977

[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↗
PubMed1977

[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↗
PubMed1977

[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↗
PubMed1977

[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↗