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Biomedical subjects

E Wabeke

Publications and source records attributed to E Wabeke.

5 recordsLinked to original sources
PubMed1989

[Autopsies at a nursing home].

We studied the clinical data and the autopsy findings of 88 patients to evaluate the importance of autopsies in Dutch nursing homes. The results of this retrospective analysis showed that 28% of the clinical diagnoses were not confirmed by autopsy. In 40% of the cases the direct cause of death was different from that expected by the clinician. In particulars, pneumonia and congestive heart failure relatively often caused diagnostic problems in a psychogeriatric nursing home. Autopsies appear to be useful to study causes of death, to verify the clinical diagnoses and to evaluate the results of treatment.

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PubMed1988

An automatic autotransfusion system with a centrifugal pump: a hematologic evaluation in dogs.

The requirements that have to be met by an on-line autotransfusion system (ATS) in case of massive blood loss are a sufficient capacity for reinfusing the shed blood, an optimal hemocompatibility, ability to prevent reinfusion of aspirated air, and ease of operation. In a previous study we tested a diaphragm pump in our pneumatically driven ATS that met these requirements. In this study a centrifugal pump was used as an outflow pump in otherwise the same system. A centrifugal pump has important advantages: It prevents the occurrence of massive air embolism, accidental obstruction of the outflow line will not cause bursting of the tubing, and there is no spallation. There are also indications that a centrifugal pump causes less stimulation of the coagulation cascade than do other pumps. Because of these advantages, we were interested in the hemocompatibility and pumping characteristics of the centrifugal pump in our ATS. From this study we conclude that the hemocompatibility of the centrifugal pump was not significantly different from that of the previously tested diaphragm pump. Also, the system can easily and safely be operated by non-specialized personnel. Because of the advantages, especially in pumping characteristics, the centrifugal pump is our choice in on-line ATSs.

Animals↗
PubMed1986

An automatic pneumatically driven autotransfusion system: a hematologic evaluation in dogs.

An automatic, pneumatically driven autotransfusion system (ATS) was developed because ATSs driven by roller pumps are complicated to set up and require an experienced operator. In this ATS blood is aspirated into a cardiotomy reservoir by means of a constant vacuum applied on that reservoir. Damage to blood cells is reduced by an electronic device that regulates an automatic tubing clamp in the suction line to prevent suction of air along with blood (controlled suction). The blood is reinfused by a diaphragm pump driven by alternating vacuum and compressed air. The frequency of this pump is regulated by a level sensor in the cardiotomy reservoir to maintain a constant preset level. When we tested this automatic ATS in dogs, platelet function and platelet numbers substantially recovered after a dip during an autotransfusion period of 1 hour. Advantages of this ATS are that it causes only minor blood damage, it does not require a specially trained operator, and it is ready to use in every operating room. The diaphragm pump can be made disposable and integrated in the bottom of a cardiotomy reservoir.

Animals↗
PubMedDate not supplied

Clear prime for infant cardiopulmonary bypass: a miniaturized circuit.

The extracorporeal circuit used clinically to perform cardiopulmonary bypass (CPB) in small infants is relatively large requiring blood to prime the circuit to reduce hemodilution. To study the merits of clear prime also in infants, we did experiments in rabbits with two extracorporeal circuits: one employing traditional venous gravity drainage (priming volume 330 ml) and the other employing vacuum drainage (priming volume 90 ml). The first circuit still had to be primed with blood, whereas the second circuit could be primed with a clear solution. Both circuits were automatically controlled to lighten the task of the perfusionist to operate the CPB safely and accurately. We demonstrated that the clear priming solution in the second circuit eliminates the hemodynamic deterioration caused by blood prime in the first circuit. Studying the effect of various modes of regulation, we showed that automatic control of CPB based on venous return is similar to autoregulation of the heart according to Starling's law, and maintains not only normal hemodynamics, but also an optimal microcirculation.

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