Zentralblatt für Chirurgie
-
For diminishing transfusion risks and for ethical and economical reasons a rational hemotherapy is indispensable. The "Berner model" referred to here contains an acceptable explanation. ⋯ Coagulational active plasma fractions have unchanged indications for a rational substitution of coagulation factors. New indications for some blood components are described.
-
From 1969 to 1980, 1316 patients underwent surgery for gastric and duodenal ulceration. In 302 cases (23%) the indication was a vital one (158 times [12%] perforation and 144 times [11%] heavy bleeding). 1014 operations (77%) were of selective character: 1159 times partial gastrectomy, 60 times vagotomy and 97 times nonresective emergency procedures. ⋯ The total mortality rate came up to 3.0%. Our results demonstrate the fact that surgery for gastric and duodenal ulcer is mainly burdened by mortality following perforation and haemorrhage.
-
During the past 7 years, 85% of all red cell units have been transfused as concentrates (RCC) with a haematocrit of 70% at our University Hospital. The basic concept is to exploit the differing critical levels of various parameters in the circulation of the patient. ⋯ A retrospective, but carefully controlled study of 372 patients showed that this system has no negative effects on the postoperative course. Its logistic advantage is that the plasma from the blood donations used to treat about 80% of surgical patients can be diverted to fractionation into specific derivatives, whereas it does not increase the needs for albumin.