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Biomedical subjects

H Baudisch

Publications and source records attributed to H Baudisch.

9 recordsLinked to original sources
PubMed1990

Suicidal ingestion of formalin with fatal complications.

After ingestion of an unknown amount of formalin with suicidal intent, a 55-year-old female and a 34-year-old male were admitted to the hospital with extensive gastrointestinal corrosive damage, circulatory shock, metabolic acidosis, respiratory insufficiency and impairment of renal function, which rapidly progressed to acute renal failure. Metabolic acidosis was in part due to high plasma levels of formic acid, the main metabolite of formaldehyde, and hyperlactatemia. Both patients underwent hemodialysis and hemofiltration treatment. In the male patient, a gastrectomy had to be performed. The further clinical course in the patients was characterized by sepsis and protracted pulmonary complications. Both patients died after developing adult respiratory distress syndrome and global cardiac insufficiency. In vitro experiments on formaldehyde reactivity to proteins yielded evidence for almost complete but reversible binding to plasma and blood. Formaldehyde probably exerts systemic toxicity in the form of its labile Schiff's base with proteins, but not as free formaldehyde.

Adult↗
PubMed1988

Inadvertent metal loading of critically ill patients with acute renal failure by human albumin solution infusion therapy.

Recent reports on the metal contamination of human albumin solutions (HAS) have raised concern about possible medical implications. Large amounts of HAS are infused to premature babies with respiratory distress syndrome, patients with plasmapheresis treatment or acute renal failure. For assessment of the risk of metal loading in patients with acute renal failure, commercially available HAS were analyzed for aluminium, nickel, chromium, manganese, cobalt, zinc, copper, cadmium, lead, and mercury. A considerable contamination of HAS was found for Al, Ni, Cr, Mn, and in part for Co. Additionally, the influence of 3 weeks of daily HAS infusion on metal blood levels was studied in 8 critically ill patients with acute renal failure, protein catabolism, ventilator therapy and hemodialysis treatment. Since most metals are primarily eliminated with the urine, these patients seemed to be at high risk for metal loading. In all patients, a considerable increase in the blood concentrations of Al, Ni, Cr, and in some patients of Mn and Co was found. In addition, the daily dose of Al, Ni, Cr, Mn, and Co by HAS was calculated for the 21st day after start of HAS infusion. In most patients, the dose of Al, Ni, and Cr considerably exceeded (up to a factor of 10) the average daily metal dose absorbed from the diet by healthy subjects. The increase in Mn and Co blood levels, despite a low dose of Mn and Co with the daily HAS infusion, was most likely caused by depletion of Mn and Co tissue stores due to the catabolic state of the patients. The contamination of HAS probably originated from the use of aluminum hydroxide and from contact of plasma with stainless steel surfaces during the Cohn fractionation process. The high extent of contamination of HAS with Al, Ni and Cr cannot be accepted since it is already technically feasible to produce HAS with metal concentrations comparable to the normal serum level range.

Acute Kidney Injury↗
PubMed1987

[Content of trace elements in solutions for parenteral nutrition and blood derivatives].

Intravenous solutions contain both essential and nonessential trace elements. The manufacturer is not obliged to declare the concentration of trace elements contained therein. Therefore, a study was done to investigate the concentration of magnesium, copper, chromium, manganese and cobalt, as well as a possible contamination by aluminum and nickel, in 15 solutions used for parenteral nutrition and blood products applied in Germany. Measured against the daily parenteral requirements, negligible concentrations were found for all essential trace elements with the exception of chromium and cobalt. A marked contamination by the nonessential metal ions aluminum and nickel was detected in the 5% protein- and 20% albumin-solutions. Aluminum concentration was 16-49 mumol/l in the blood products and up to 4.9 mumol/l in the nutrient solutions. The concentration of nickel found in the protein- and hydroxyethyl starch solutions was 250 times higher than the normal serum level. It must be assumed that different manufacturing procedures lead to the different degrees of contamination of the solutions (up to 100%). In view of more recent publications, the aluminum contamination may be a potential hazard to patients with prolonged parenteral nutrition and certain risk groups among the critically ill.

Blood Transfusion↗
PubMed1986

Fatal poisoning with selenium dioxide.

Two hours after suicidal ingestion of an unknown amount of selenium dioxide, a 17-year-old male was admitted to hospital with asystolia and apnea. Attempts at resuscitation failed and the patient was pronounced dead. Findings at autopsy included congestion of lungs and kidneys, diffuse swelling of the heart, and brain edema. The most impressive finding was an orange-brown discoloration of the skin and all viscera, probably due to hemolysis and/or pigmentation related to ingestion of selenium dioxide. Selenium blood and tissue levels were increased by a factor of 100-1000 as compared to normal. The highest concentrations were found in pancreas, spleen, liver, and adipose tissue. For elucidation of the chemical nature of selenium in tissues, a new analytical method which was based on carbon disulfide extraction was developed. Carbon disulfide is a good solvent for non-polar selenium compounds like elemental selenium and selenium disulfide, but not for polar compounds like selenite and selenoproteins. A major fraction of selenium in tissues was extractable by carbon disulfide, which seems to indicate the presence of elemental selenium and/or selenium disulfide. The color of these substances is red and orange, respectively. This might explain at least part of the discoloration of skin and tissues. In vitro experiments suggested that trace amounts of hydrogen selenide, which is an intermediate of selenite metabolism, probably induced hemolysis. For evaluation of the therapeutic value of hemoperfusion in selenium poisoning in vitro hemoperfusion experiments were performed, which revealed only a moderate effect on selenium blood levels.

Adolescent↗
PubMed1983

[Rapid and direct lead determination in honey].

Use of honey as a biological indicator for heavy metal contamination entails the analysis of a greater number of samples. To date the complex sugar matrix required sample preparation using digestion methods, which were time consuming and involved a high risk of contamination or loss. It is now possible, using the method described here, to measure lead in honey without degradation with the help of microprocessor-programmed conditions of temperature and time in the ggraphite tube of the Atomic-Absorption-Spectrophotometer. Two samples were analysed. One had a low lead content (I), the other had a high lead content (II). The statistical variation for a series of determinations was 8.3% (I, N=10) and 5.6% (II, N=22). These results can be considered satisfactory.

Chemical Phenomena↗
PubMed1982

Methoxyethylmercury chloride poisoning: clinical findings and in vitro experiments.

A patient attempting suicide ingested 5682 mg methoxyethylmercury chloride, which corresponds to 4375 mg mercury. The bulk of the dose was eliminated by vomiting and gastric rinsing. About 706 to 977 mg mercury were absorbed in the gastrointestinal tract. Only 11.2 mg mercury could be removed by two activated charcoal hemoperfusions. Chelating agents were given for 12 weeks. The terminal elimination half-life calculated from blood and urine mercury levels was 23 and 25 d, respectively. No toxic effects on the kidneys and central nervous system were seen. The identification of methoxyethylmercury chloride in the gastric rinsing fluid was done by gas chromatography/mass spectrometry. The protein binding of methoxyethylmercury chloride was determined by ultrafiltration (93%). In the presence of dimercaprol sulfonate and penicillamine, protein binding was 83 and 88%, respectively. Activated charcoal and amberlite hemoperfusion revealed equal in vitro clearances for methoxyethylmercury chloride (62 mL/min at a flow rate of 80 mL/min).

Dimercaprol↗