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H Fredin

Publications and source records attributed to H Fredin.

58 records · Page 4Linked to original sources
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Angiographic evaluation of scintigraphic abnormalities in screening for pulmonary embolism after total hip replacement.

Among 240 consecutive patients subjected to total hip replacement, 206 underwent perfusion scintigraphy in screening for pulmonary embolism 10 to 14 days after surgery. All patients with perfusion abnormalities (n = 77) also underwent ventilation scintigraphy with a dry 99Tcm microaerosol. The scintigraphic abnormalities were classified according to a detailed coding system and in 50 patients pulmonary angiography was performed within 24 hours for correlation. Emboli were diagnosed in 19 patients at angiography. All patients with ventilated segmental (n = 6) or larger (n = 5) perfusion defects or multiple subsegmental defects larger than half a segment (n = 2) had emboli. Two of 8 patients with abnormally ventilated subsegmental perfusion defects larger than half a segment had emboli. Four of 21 patients with wedge-shaped subsegmental perfusion defects smaller than half a segment or defects with a rounded border towards the hilum and a peripheral extension equal to or less than that of a segment had emboli. In one of them the site of the emboli correlated to the site of the perfusion defect but occurred in normally perfused areas in the remaining 3. Ventilation scintigraphy was of no value in this group of patients. No emboli were found in patients who had areas with decreased but not totally lost perfusion (n = 8). No emboli were diagnosed in 27 lungs with a normal perfusion.

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PubMedDate not supplied

Low molecular weight heparin compared with dextran as prophylaxis against thrombosis after total hip replacement.

The effect of low molecular weight (LMW) heparin given once daily as prophylaxis against venous thrombosis was compared with that of dextran 70 in an open randomised trial of 100 patients undergoing elective total hip replacement. Four patients were withdrawn after randomisation and thus 96 were included in the final analysis. The development of thrombus was surveilled by the 125I fibrinogen test, and positive readings were verified by venography. Nine of 47 patients given LMW heparin developed thromboses (19%) compared with 18 of 49 given dextran (37%) (p = 0.09). Two further patients who received LMW heparin developed thromboses after leaving hospital (clinical signs became apparent on days 13 and 17, respectively), giving an overall rate of thrombosis in this group of 23%. Minor wound haematomas occurred in two of 47 in the LMW heparin group and three of 49 in the dextran group (4% and 6%, respectively), and blood loss, transfusion requirements, and reduction in postoperative haemoglobin concentration did not differ between the two groups. The studied LMW heparin given subcutaneously once a day was no less safe or effective than dextran in preventing thromboembolism after total hip replacement.

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