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Biomedical subjects

J O Solem

Publications and source records attributed to J O Solem.

29 records · Page 2Linked to original sources
PubMed1988

Hemoconcentration by ultrafiltration during open-heart surgery.

Ultrafiltration was used during extracorporeal circulation (ECC) with heart-lung machine in 17 critically ill cardiac patients. In ultrafiltration (hemofiltration), water and small molecules (e.g. urea, creatinine and electrolytes), are separated from the blood by hydrostatic pressure generated on the blood side of a semipermeable membrane. The patients had severe water overload for three reasons, viz. congestive heart failure (10), renal failure (6) or iatrogenic extreme hemodilution (1). On average 2090 (800-5700) ml water was filtered off, increasing the hematocrit from 25 to 33%. Three indications for ultrafiltration during ECC and two modes of such treatment are exemplified in three case reports. No negative effect of the treatment was observed. Ultrafiltration during ECC thus may help to improve the postoperative course in patients with severe water overload due to congestive heart failure, renal failure or iatrogenic extreme hemodilution.

Aged↗
PubMed1987

Cell saver versus hemofilter for concentration of oxygenator blood after cardiopulmonary bypass.

Concentration of superfluous blood in the oxygenator after the termination of a cardiopulmonary bypass was studied in 46 aortocoronary bypass patients. 15 patients were treated with a centrifugation system, the Haemonetics Cell Saver, 16 patients were treated with the Gambro Hollow Fibre Hemofilter and the remaining 15 patients received as much as possible from the untreated oxygenator contents and served as controls in a coagulation study. Both methods functioned well, the time consumption for operation of the two systems was similar. The products differed greatly as centrifugation revealed highly concentrated red cells in saline solution while hemofiltration produced protein-rich concentrated whole blood. A coagulation study of the patients who had received the concentrated products showed no signs of activation of the coagulation factors nor of the fibrinolytic system.

Adult↗
PubMed1987

Mediastinal drainage blood. Potentialities for autotransfusion after cardiac surgery.

The rate of postoperative bleeding was studied in 32 patients with aortocoronary bypass surgery and in 18 with aortic valve replacement. In 12 of the 50 patients, more than 500 ml of shed mediastinal blood could be saved within 8 postoperative hours. Aerobic and anaerobic cultures of such blood were obtained from the suction reservoir in 20 cases 2, 4 and 6 hours postoperatively. The results were negative, apart from Staphylococcus albus in one 6-hour sample. The blood, which was in some degree hemolyzed, contained acceptable amounts of red cells and albumin. Alterations of the coagulation and fibrinolytic systems indicated massive proteolysis with degradation of the proteins to an extent that precluded coagulation. This proteolysis had taken place in the mediastinum, resulting in total defibrinogenation of the blood. The authors conclude that in about one-fourth of cases in cardiac surgery, postoperatively shed blood is worth saving for red cell and volume substitution.

Aortic Valve↗
PubMed1987

Postoperative autotransfusion of concentrated drainage blood in cardiac surgery. Experience with a new autotransfusion system.

A new autotransfusion system was evaluated postoperatively in six patients undergoing aortocoronary bypass surgery. A hollow fiber hemofilter was integrated in the system, making it possible to concentrate the shed blood. The device functioned well, 825 ml diluted mediastinal drainage blood with a hematocrit of 23 was concentrated to a volume of 475 ml with a hematocrit of 36 and retransfused. Proteins were preserved, thus albumin concentration increased from 23 to 37 g/l in the autotransfusate. No negative side effects were registered after autotransfusion. A thorough coagulation study after retransfusion did not reveal any sign of activation of the coagulation cascade, nor were there any signs of an increased fibrinolysis.

Aged↗
PubMed1986

Late cardiac tamponade following open-heart surgery. Diagnosis and treatment.

Late cardiac tamponade is a rare but serious complication following open-heart surgery. It occurred in 9 (0.8%) of 1 094 consecutive patients 6 to 13 (median 8) days after operation. Six patients had undergone valve replacement and three coronary bypass surgery. All were on anticoagulant medication postoperatively (median TT index 7%). Early symptoms of cardiac tamponade were nausea and general malaise (present in all 9 cases), whereas classical signs of tamponade such as arterial hypotension and distended neck veins appeared late. The cardiac silhouette was radiographically enlarged in all cases, but this finding was seldom diagnostic. Computed tomography gave the surest diagnosis and permitted quantitative assessment of the fluid in the pericardium. Pericardial needle puncture was effective in temporarily relieving the tamponade, but insertion of a tube by the subxiphoid approach gave definitive drainage.

Aged↗
PubMed1983

Acute immobilization of the disc in the Björk-Shiley aortic tilting disc valve prosthesis. A report of 3 cases.

Acute non-thrombotic immobilization of the disc in the Björk-Shiley aortic valve prosthesis occurred as a result of extrinsic factors in three patients. Unravelled suture or long suture ends were the cause in two cases. Tissue detached from the aortic intima migrated into the valve and locked the disc in closed position in one case. The mechanisms of extrinsic disc immobilization and its prevention and treatment are discussed.

Acute Disease↗
PubMedDate not supplied

Lack of glutathione transferase activity in intermittent claudication.

Glutathione transferase activity towards trans-stilbene oxide (GT-tSBO), an enzyme involved in the detoxification of many substances such as polycyclic aromatic hydrocarbons, was studied in 77 consecutive patients operated with coronary bypass, 73 patients with intermittent claudication, 78 healthy smokers and in 38 healthy non-smokers. The mean ages of these groups were similar. Lack of GT-tSBO was recorded in 45% of coronary bypass patients, in 39% of smoking coronary bypass patients, in 61% of patients with intermittent claudication, in 41% of healthy smokers and in 31% of healthy non-smokers. The lack of GT-tSBO was significantly more frequent among patients with intermittent claudication compared to healthy non-smokers (p less than 0.01) and healthy smokers (p less than 0.025) and to smoking coronary bypass. It is concluded that the lack of GT-tSBO is found more frequently among patients with intermittent claudication and this might contribute to explain the sensitivity to smoking among these subjects.

Angina Pectoris↗
PubMedDate not supplied

A new method for autotransfusion of shed blood.

A new autotransfusion device for collection and retransfusion of whole blood is described. The construction, function and possible advantages of the system compared with currently available systems are discussed. The system is built up around a hollow fibre haemoconcentrator (dialysis filter), a cardiotomy reservoir and a large volume infusion bag. To prevent clotting, citrate (ACD-solution) is added in the suction tubing as well as locally. The blood is driven through the system by a roller pump.

Blood↗
PubMedDate not supplied

Autotransfusion of whole blood in massive bleeding. An experimental study in the pig.

An experimental model for controlled massive bleeding in pigs was developed to evaluate a new method for intraoperative autotransfusion of concentrated whole blood. The animals were injured in the descending thoracic aorta, creating a massive bleeding into the left pleural cavity. By means of a new system for autotransfusion, the animals were kept alive by retransfusing the blood at the same rate as it was shed. All animals were in good condition after autotransfusion of bleeding corresponding to three blood volumes. The postoperative hematological status including hemoglobin, hematocrit, platelet counts and electrolytes was not significantly different from the values before the experiment. The coagulation assays, including platelet adhesiveness, were normal after the experiment. In one pig the urine was positive for hemoglobin using a Hemostix test although it was macroscopically clear. This new method allows autotransfusion of whole blood with a desired hematocrit, with intact platelets and coagulation factors.

Animals↗