ABSTRACT
Sixteen patients suffering from various cardiac arrhythmias were treated surgically. Intraoperative computerised electrophysiologic mapping was used in 14. Thirteen patients were suffering from Wolff-Parkinson-White syndrome. They underwent surgical division or cryoablation of accessory pathways. Two patients who had rheumatic mitral stenosis with left atrial clot underwent "Maze III" procedure with open mitral commissurotomy and clot removal. One patient with paroxysmal refractory ventricular tachycardia and a left ventricular aneurysm had an aneurysmectomy with subendocardial resection of the arrhythmic focus. All antiarrhythmic medications were discontinued preoperatively. Morphine was the principal anaesthetic agent, supplemented with halothane. Muscle relaxation was provided with pancuronium bromide. The various problems encountered included hypotension and arrhythmia during placement of epicardial band array for mapping (4 patients), ventricular tachycardia during internal jugular vein cannulation (1 patient) and continuance of delta wave after cryoablation in 2 patients. Halothane may have interfered with electrophysiologic mapping and accurate localization of accessory pathway leading to persistence of delta wave. The choice of anaesthetic agents should be guided by the electrophysiologic effects and potential influence of these agents on the accessory pathways.
Subject(s)
Anesthesia , Tachycardia/surgery , Adult , Anesthetics, Inhalation , Blood Transfusion, Autologous , Cryosurgery , Electrophysiology , Female , Halothane , Heart Conduction System/abnormalities , Heart Conduction System/surgery , Humans , Male , Muscle Relaxation , Neuromuscular Nondepolarizing Agents , Pancuronium , Wolff-Parkinson-White Syndrome/surgeryABSTRACT
BACKGROUND: In Germany autologous blood therapy (ABT) is a widespread therapy for infectious diseases in complementary medicine. Clinical data for its use for common cold is lacking. METHODS: In a double-blind randomized controlled trial 139 patients with common cold were enrolled either to ABT (gluteal intramuscular reinjection of venous blood three times a week) or to placebo (sterile sodium chloride solution). Main criterion was time period of illness after initiation of treatment, measured by a modified symptom diary adapted from Jackson. RESULTS: 58 and 56 patients completed therapy. In both groups illness duration was 7 days (5.0-10.0 for verum and 5.25-9.0 for placebo). CONCLUSIONS: This trial found no effect of ABT as treatment for common cold. Because of a rather highly selected patient sample another RCT on this topic is reasonable. Further research to analyse the effect of other doses or of autologous blood therapy in addition to homeopathic preparations or vitamin preparations is needed.
Subject(s)
Blood Transfusion, Autologous/methods , Common Cold/therapy , Complementary Therapies , Adult , Double-Blind Method , Female , Germany , Humans , Injections, Intramuscular , Male , Middle Aged , Time Factors , Treatment Outcome , VeinsABSTRACT
For autologous plasma predeposit there are commonly two types of cell-separators in use: 1. Discontinuous centrifugation (Plasma Collection System PCS, Haemonetics Company). 2. Discontinuous membrane filtration (Plasmapur-Monitor, Organon Teknika Company). Normally donation volume is 900 ml. The rate of undesired secondary effects does not exceed those numbers known of regular homologous donors. Shed wound blood processing by a wash-centrifuge cell separator (Type Cell-Saver, Haemonetics Company) stands for optimal quality of the refusable red blood cells. Depending on the type of operation and the accuracy of wound blood suction, up to 75% of the red blood cells lost may be harvested. In order to achieve more widespread mechanical autotransfusion, one issue is to lower the rather high costs of the disposables by simplifying the too highly sophisticated systems. From clinical experience with orthopedic patients, at least practical advice is given on how to use the single autologous transfusion methods in a comprehensive strategy.
Subject(s)
Blood Component Removal/instrumentation , Blood Component Transfusion/instrumentation , Blood Transfusion, Autologous/instrumentation , Cell Separation/instrumentation , Equipment Design , Humans , PlasmaABSTRACT
Four plasmapheresis procedures (manual blood bag centrifugation plasmapheresis, and the three plasmapheresis machines P.C.S./Haemonetics, Autopheresis-C/Baxter-Travenol, Plasmapur Monitor/Organon Teknika) were studied comparatively. The three machine procedures could be performed more easily and more rapidly and were well accepted by donors, autologous donors (patients) and staff. Compared with the traditional, well established manual procedure, a possible impairment of the plasma donors seems reduced rather than raised. Activation of the hemostatic system of the donors, measured with very sensitive methods, was found to be less pronounced when plasmapheresis was performed with the machines than when it was performed conventionally. The plasma product obtained by machine plasmapheresis was found to be of higher quality. All three systems showed less activation of the clotting system. Especially the plasma obtained by the P.C.S. showed a higher clotting factor yield. Plasma obtained by the Autopheresis-C and by the Plasmapur Monitor (both systems are equipped with filters) was markedly less contaminated with cells. The recently found low activation of the clotting system of plasma recipients, however, showed no differences when plasma obtained conventionally or by the Plasmapur Monitor was used. In summary, the new machine plasmapheresis devices offer a good alternative to the conventional blood bag centrifugation method and set new standards for the production of high quality plasma.