Biomedical subjects
K F Kopp
Publications and source records attributed to K F Kopp.
The conflict between anticoagulation and hemostasis during hemodialysis.
Anticoagulation with comparatively small amounts of heparin has been carried out in more than 3,000 acute and chronic hemodialysis procedures without problems. In a selected high risk group of postoperative and polytrauma patients no patient hemorrhages have occurred, nor have there been any clotting problems in the dialyser circuit. Studies to elucidate the underlying mechanisms of coagulation and anticoagulation in the extracorporeal environment have been performed. Minimal intermittent heparin administration based on plastic anticoagulation monitoring with the APTT method, has proven to be particularly safe.
[Heparin dosage in chronic hemodialysis (author's transl)].
Over a period of 10 months hemodialyses in 20 patients with chronic renal failure were performed with a 40% lower heparin-dose. Blood coagulation was controlled from the activated partial thromboplastin time (APTT). There were no unfavourable side-effects, also the effectivity of the hemodialyses was not changed. However, we measured a significant increase in the hemoglobin-concentration and in the packed cell volume. Bleeding from the punctures was significantly shortened.
[Angiographic findings due to malfunction of Cimino shunts in haemodialysis patients (author's transl)].
Both the arterial and venous limb of a Cimino shunt can be well demonstrated by injection of contrast medium into the shunt vein during transient arterial and venous ccompression with a blood pressure cuff. Twenty-four angiograms in patients with shunt malfunctions carried out in this way were analysed with respect to various vascular changes.
[Advances in infusion technics].
Two interesting developments in the area of infusion technology are being presented. The first product concerns a rather simple, but precise, and manually ajustable flow control device for intra-venous fluid administration without the need of having an infusion pump. The second product concerns a continuous flush device for arterial and venous indwelling cannulae. The main area of clinical application of the latter product is the combination with intraarterial catheters which are used to monitor various arterial pressures. Adaptation of the device to intravenous catheters is also possible. The main benefit derived from the flushing device is a significant prolongation of catheter function and patency.
[Uremic tendencies for hemorrhage and hemodialysis].
By means of a simple heparin test which reflects the actual processes in the contact of the blood with heterogeneous surfaces we can securely regulate the heparinisation in each phase of the dialysis, which, as I tried to explain, brings considerable consequences for the clinic.
Artificial organ support strategies in combined renal, circulatory, pulmonary and liver failure.
Within recent years we have significantly broadened the indication for the treatment of acute renal failure in intensive care patients, even in the presence of multiple organ failure. This was made possible by: 1. safe heparinization of the extracorporeal circulation while avoiding bleeding tendencies 2. hemofiltration of patients threatened by pulmonary complications early during renal failure and 3. the simultaneous use of various special intensive care measures. By this approach we have succeeded in a number of cases to break the chain of complications leading to multiple organ failure and death.
[Control of the heparin induced bleeding risk in haemodialysis patients (author's transl)].
Partial-Thromboplastin-Time (PTT) has been used as a bedside-method to control the dosage of heparin in haemodialysis patients at a high bleeding risk. The practical procedures and the advantages of the method as compared to current coagulation controls are outlined. As a result a technique of "minimal intermittent heparinization" has been developed which effectively prevents bleeding in the heparinized patient on haemodialysis.
[Need-adapted heparinization in hemodialysis].
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An up-to-date appraisal of single needle dialysis (SND).
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[Hydroxyproline in the dialysate as a parameter of secondary hyperparathyroidism. Effects of phosphate reduction and alkalization].
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