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Biomedical subjects

P Klaue

Publications and source records attributed to P Klaue.

At least 19 recordsLinked to original sources
PubMed1990

[Subjective sequelae of splenectomy].

111 of 806 former patients splenectomized at the Würzburg university hospital during the years 1968-1983 were interviewed for their complaints since their operation. Investigations included the use of Beck's inventory for measuring depression and the Giessen questionnaire for the evaluation of general complaints used in psychosomatic medicine. There was a significant increase of symptoms after splenectomy as compared to the normal population. A special list of 18 questions to investigate typical postsplenectomy complaints was answered by 95 of these 111 persons and by a control group of "statistical twins" with similar upper abdominal surgery without splenectomy. The leading difference was the highly significant increase of the susceptibility to infections after splenic loss followed by accelerated exhaustion and increased physical and mental weakness. The distribution of other complaints like for instance the intolerance to alcohol hitherto judged as typical sequelae of splenectomy was not statistically different in both splenectomy was not statistically different in both groups. Since the symptoms listed above as significantly increased in the splenectomized patient were closely correlated with the susceptibility to infection they seem to be rather the expression of the decreased resistance than direct consequences of the loss of the spleen.

Adolescent↗
PubMed1986

[Long-term sequelae of splenic loss].

Beside the increased risk of infection there are further long lasting consequences of splenectomy. The hematologic changes include morphological alterations of red cells, lymphocytosis, monocytosis and increased blood viscosity. There are complaints about general disturbances like physical weakness, abdominal pain or intolerance of alcohol. The response to certain vaccinations is impaired especially in the early postoperative period. Findings concerning the influence on the growth of cancer are controversial. There seems to be an increased risk of disturbed wound healing.

Follow-Up Studies↗
PubMed1984

pH-control via secretin or antacid: prophylaxia of stress ulcers in high-risk surgical patients.

The efficacy of an antacid or synthetic secretin in elevating the intragastric pH above 4 was tested in a controlled, prospective study. Twenty-one high-risk surgical patients received an antacid and 17 secretin. Antacid prophylaxis resulted in a significantly higher intragastric pH than with secretin. This was especially true in patients with several risk factors. The percent of secretin patients with a pH below 4 was higher. An increase in dosage was necessary in 4 of the 17 patients receiving secretin and in none of those receiving antacids. One stress ulcer hemorrhage occurred during secretin prophylaxis.

Aged↗
PubMed1982

[Experiences with the Haemonetics cell saver].

The Haemonetics-Cell-Saver offers a new method for autotransfusion. It was used in 25 patients intraoperatively as well as in the intensive care ward. Total blood losses amounted to 67 l, of which 47.7 l could be recollected into the sterile processing system. Thus 17.8 l of washed red cell concentrates with an average haemoglobin content of 17.8 g/dl and a haematocrit of 53.8% could be produced, which corresponded to a 53% recovery of RBC loss. Activators of haemostasis and cell debris were successfully eliminated. Changes in cellular and fluid homeostasis and in exogenic and endogenous clotting parameters following autotransfusion were studied.

Adolescent↗
PubMed1981

[The value of diagnostic peritoneal lavage in perforating abdominal injuries].

From July to October 1980 40 patients with deep torso injuries caused by shrapnel or high velocity missiles were treated in the ICRC-Field Hospital at Kao-I-Dang near the Cambodian border in Thailand. In 17 cases indication for laparotomy was evident, whereas in 23 patients paracentesis and lavage of the abdomen were performed. In 12 cases with positive results, immediate laparotomy revealed significant intra-abdominal injuries. Of ten patients with negative or weakly positive results nine were treated conservatively and their recovery was uneventful. Only one patient was operated and a retro-peritoneal hematoma not requiring surgery was found. It is concluded that peritoneal lavage is a useful diagnostic procedure in evaluating penetrating abdominal injuries.

Abdominal Injuries↗
PubMed1981

[Changes in the pump function of the right ventricle during "pressure-autotransfusion" with citrate and heparin (author's transl)].

Nine anaesthetized, splenectomized dogs, heparinized with 300 IU/kg bodyweight heparin i.v. had one tenth of their total blood volume returned to them by autotransfusion under maximum pressure with the Bentley-system. For the "Heparin"-autotransfusion (n = 49) 1:5 0,9% NaCl was added to the blood; whilst for the "Citrate"-autotransfusion 1:5 ACD-B(n = 28) or CPD (n = 30) stabilisor was added. Autotransfusion was performed as follows: Heparin-ACD-B- Heparin-DPD- Heparin-ACD-B etc. The pump function of the right ventricular myocardium was measured by the force of contraction (PRV, IP, SV, T1) as well as by criteria of contractility (dp/dtmax, VCEmax, KI1, KI2). Immediately after acute bleeding a reduction of the force of contraction to 50% was seen, but the contractility remained unchanged. During the maximum pressure autotransfusion of the blood the force of contraction consistently increased irrespective of the anticoagulant used. The contractility remained unchanged. In the following phase the force of contraction and the contractility normalised when heparin was employed, whilst when citrate was used there was a reduction of the force of contraction and of the contractility corresponding with the different dose of citrate of ACD-B and CPD. This short phase was followed by spontaneous stabilisation of the circulation. The force of contraction and the contractility returned to normal when heparin and ACD-B were employed, whilst a reduction of these criteria occurred when CPD was used. From these findings, the scheme of anticoagulation for citrate under clinical conditions should be modified by a prior injection of 2,000-3,000 IE of heparin i.v. and the addition of citrate in the ratio of 1:7 for ACD-B or 1:8 for CPD.

Animals↗
PubMed1981

[The QT-interval during "pressure-autotransfusion" with heparin and citrate (author's transl)].

Nine anaesthetized, splenectomized dogs, heparinized with 300 IU/kg heparin i.v. had one tenth of their blood volume returned to them by autotransfusion under pressure. The blood was mixed with 1:5 0,9% NaCl for the "Heparin-Autotransfusion", and with 1:5 ACD-B or CPD-stabilisor for the "Citrate-Autotransfusion". The blood was removed from an opening made in the left renal artery, and autotransfused with the Bentley-System. A Stathem-Element was used to monitor the aortic pressure and the tracing obtained was divided into four phases: V is at the end of the blood loss before autotransfusion, G is at the peak, S is at the trough and ST is at the phase when the aortic pressure becomes stable. In these four phases the heart rate was also measured in the normal way using needle electrodes in the extremities. Following the method of Colletti the QT intervals of the ECG (RR, QoTc, QTc, SaTc, SoTc) were measured. Immediately after the blood loss (phase V) we found no alteration in the heart rate, depolarisation, isoelectric phase or repolarisation of myocardium. In phase G during the increase in blood volume, the heart rate slowed slightly, but the QT interval was unchanged. In the following phase S, during Heparin-Autotransfusion the heart rate was slightly reduced whilst the ECG remained unchanged. During Citrate-Autotransfusion there was a reduction in heart rate, and a corresponding prolongation of the QTc and QoTc, significantly, without any relationship to the infused dose of citrate. The prolongation of the SaTc and especially of the SoTc correlated directly with the infused dose of citrate. In phase ST using CPD only SaTc and SoTc were prolonged.

Animals↗