Several parameters indicating quality of stored blood were constant in whole blood independent of the kind of preparation during a storage of 49 days. This is in contrast to the main part of specific scientific communications. A beneficial influence of leukocyte depletion was observed for some coagulation parameters whereas increasing characteristics of activated coagulation in CPDA1-stored whole blood at the end of storage time had to be observed. The preparation of whole CPDA1-blood is recommended for autologous predonation, if storage time does not exceed 30 days. Storage time of > 40 days seems to be possible for autologous whole blood after filtration for leucocyte depletion.
Temporary myocardial pacing leads are routinely used for diagnosis and treatment of postoperative arrhythmias following open-heart surgery. The intention of this study is to compare five different electrodes for reliability during the postoperative period. A standardised technique of implantation was used to place 147 ventricular and 81 atrial wire electrodes in 149 patients. During operation and then daily over the next ten days, the stimulation threshold, P- and R-wave sensing, and impedance were measured with a pacing system analyser to evaluate the reliability of the pacing and sensing function. Five measurements were taken at each time; the mean values were statistically analysed. The number of failures in pacing and sensing and the course of the tested parameters during the postoperative period were compared. As a result, bipolar pacing leads (Osypka TME 64a/66a) proved to be more reliable than unipolar wires (Ethicon HD 12S, Osypka TME 60/60a), particularly in atrial sensing. Also the Medtronic 6400/6500 showed good reliability for the ventricle, so that they can be recommended for VVI-mode pacing. In conclusion, for reliable function during the postoperative course up to 10 days a specially developed bipolar temporary pacemaker electrode can be recommended for both atrial and ventricular or sequential pacing.
In order to ascertain the current clinical concepts in treating acute necrotizing pancreatitis (ANP), an inquiry was made covering 28 anesthesiologic, medical and surgical departments. Problems of particular concern were antibiotics, indication for mandatory ventilation, estimation of ERCP and needle biopsy, methods of treating intestinal stasis, criteria for surgical intervention, estimation of hemofiltration and estimation of mortality and hospital stay in survivors. Twenty-three affiliations participated in the study. Opinions varied significantly concerning antibiotic treatment, value of ERCP and needle biopsy, treatment of intestinal stasis and estimation of clinical course and outcome. Most participants were in agreement regarding the management of mechanical ventilation, nutritional support and surgical intervention. Eleven participants did not prefer a special medical discipline for the treatment of ANP but stressed the importance of efficient teamwork.
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