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Biomedical subjects

R Marten

Publications and source records attributed to R Marten.

5 recordsLinked to original sources

The effect of oral communication on intravenous wastage: talk is cheap.

The authors describe decreases in wastage and return rates in their Pharmacy Service department in a 471-bed tertiary hospital. Through procedural changes in mixing and delivery schedules, stability updating, and daily communication with the Nursing Service, Pharmacy Service dropped from a 3.9% to a 1.44% wastage rate and from a 15.75% to an 8.2% return rate in a period of 17 months. The specific changes that led to this result are presented for consideration. The primary focus was on determining and noting accountability of involved staff members to decrease returns, missed treatments, and ultimately wastage of costly intravenous admixtures. The 0.9% wastage rate in the seventeenth month suggests that continued efforts may lead to further reductions.

Cost Savings↗

How to catch urea? Considerations on urea removal from hemofiltrate.

Hemofiltration imitates the first step in the natural function of the kidney. After separation from corpuscular and high molecular weight blood components, a filtrate remains which contains urea together with electrolytes and other low molecular weight metabolites. To use a hemofilter in a recirculating closed-loop system, a big quantity of urea must be eliminated. A survey of published attempts to solve this problem is presented. Reasons are given for the difficulty to eliminate urea directly from dilute aqueous solutions. Explanations for ambiguous results of some reactions proposed for urea removal are discussed. The concept of hard and soft acids and bases is used to develop demands to the structure of a reagent which reacts preferentially with urea in aqueous solution. On monomeric model substances-activated aldehydes-this hypothesis is proven in vitro. In spite of the given technical possibility of urea removal, the authors doubt whether solving the problem of urea removal will enable a closed-loop system for alternative simpler or more economic ways of treating renal failure.

Blood↗

Urea elimination using a cold activated-carbon artificial tubulus for hemofiltration.

Urea adsorption on active carbon is reversible and temperature-dependent. Urea adsorption isotherms of different carbons were determined at 0 degrees C and 65 degrees C within the equilibrium concentration range of 1.0-3.4 gm/L. At low urea concentrations considerable differences (3.4-13.0 gm/kg carbon at concentrations of 1.0 gm/L) were found between different types of activated carbon. The overall internal surface area was of minor importance compared to the pore size distribution. Adsorbing at low temperature, desorbing at high temperature, and flushing the carbon adsorber with a limited volume of the liquid to be purified yielded an "artificial urine." Compared to the original urea concentration of the filtrate, this "artificial urine" had an increased urea concentration. From a 36-liter volume containing 90 grams urea dissolved in saline, 18 liters were recirculated at a flow rate of 100 ml/min. The influence of adsorption and desorption time intervals was evaluated. After one to one and a half hours the carbon was saturated with urea. After saturation, about 1.4 grams urea were eliminated per cycle. In the "artificial urine" urea concentrations of up to 4.5 gm/L were found when the original solution contained only 2.5 gm/L. In the "patient" volume the urea concentration decreased from 2.5 gm/L to 1.9-2.1 gm/L. Within three hours a total of 22 grams of urea was removed by 3 x 120 grams activated carbon corresponding to removal of 50% of the urea passing the "artificial tubulus." The advantage of this system is that after priming, no additional physiological solution would be necessary. The necessity of excessive safety controls, additional electrolyte adjustment, energy demand in the form of direct current, and great amounts of waste in solid form lead to the conclusion that for intermittent hemofiltration treatment, commercially produced and controlled infusion solution is preferable.

Adsorption↗

Determination of copper and iron in human blood serum by energy dispersive x-ray analysis.

Human blood serum has been analyzed by X-ray fluorescence spectroscopy utilizing the effect of background reduction by total reflexion of the incident X-ray beam on an optical flat as sample support. For sample preparation a drop of 10 microliter serum was pipetted onto the support and dried to a thin film. The minimum detectable limit was about 1.5 mmol/l in 1000 s and the precision in the 20 mmol/l range of the metals was 3-5%.

Copper↗