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Biomedical subjects

R Molnar

Publications and source records attributed to R Molnar.

5 recordsLinked to original sources
PubMed2002

Absence of D alloimmunization in D- pediatric oncology patients receiving D-incompatible single-donor platelets.

BACKGROUND: Guidelines are lacking for prophylaxis against D alloimmunization after D-incompatible platelet transfusion. A rational basis for the application of prophylaxis would be beneficial for institutions in which inventory constraints demand the administration of large numbers of D-incompatible platelets. STUDY DESIGN AND METHODS: A retrospective analysis was performed of all D-incompatible platelet transfusions administered at a pediatric research hospital over a 1.5-year period. Patients exclusively received single-donor WBC-reduced platelets and did not receive RhIg immunoprophylaxis. Numbers, source, ABO type, duration of serologic follow-up, and level of RBC contamination of D-incompatible transfusions were analyzed. All positive D serologies in the institution over a 3.5-year period were examined to determine cause and potential association with platelet transfusion. RESULTS: Thirty-five patients not receiving bone marrow transplant and seven bone marrow transplant patients received 490 and 255 D-incompatible transfusions, respectively, over 1.5 years. Patients had various diagnoses, predominantly malignancies. Seventy-nine percent of D-incompatible transfusions were ABO compatible. An estimated 2300 incompatible transfusions were performed over 3.5 years. No case of D alloimmunization was detected. CONCLUSIONS: D immunoprophylaxis is generally unnecessary in pediatric oncology patients receiving D-incompatible, WBC-reduced, single-donor platelets not visibly contaminated by RBCs. Further studies to validate these observations in the pediatric population and to extend them to other population groups are warranted.

Adolescent↗
PubMed1992

Intraoperative patient-controlled analgesia: an alternative to physician administration during outpatient monitored anesthesia care.

Outpatients undergoing minor diagnostic and therapeutic procedures associated with intermittent discomfort are frequently given bolus injections of intravenous opioid analgesics. In a group of 80 healthy women undergoing vaginal ovum pickup procedures, we evaluated patient-controlled administration of alfentanil using a patient-controlled analgesia device (with a lockout interval of 3 min) as an alternative to conventional physician-controlled administration. The two alfentanil administration techniques were equally effective in providing intraoperative analgesia. The average alfentanil dosage requirements were 1.49 +/- 0.50 and 1.46 +/- 0.55 micrograms.kg-1.min-1 (mean +/- SD) in the physician- and patient-controlled groups, respectively. The incidence of postoperative nausea was the same in both treatment groups (8%). Even with the mandatory lockout interval, intraoperative patient-controlled administration of alfentanil was comparable to physician-controlled administration with respect to patient comfort and satisfaction during vaginal ovum pickup procedures.

Adult↗
PubMed1990

Pre-bypass myocardial ischaemia in patients undergoing coronary artery surgery.

One hundred patients undergoing elective coronary artery surgery were studied to determine the incidence of pre-bypass myocardial ischaemia. Leads II, aVF and V5 of the electrocardiogram (ECG) were recorded at five-minute intervals from arrival in the anaesthetic room until onset of cardiopulmonary bypass. Thirteen patients developed sixteen episodes of significant ST depression on the ECG during the study period. Three patients were diagnosed as having postoperative myocardial infarction by ECG criteria and creatine phosphokinase-MB rise above 80 units. None of these patients had pre-bypass ST depression. Comparisons of these results with similar studies are presented.

Adult↗