[Effect of acute aprotinin (Gordox) therapy on hemostasis in heart surgery patients, with special reference to hyperfibrinolysis]. / Az akut aprotinin (Gordox) terápia hatása a haemostasisra szívsebészeti betegekben, különös tekintettel a hyperfibrinolysisre.

Authors have studied the effect of Gordox-therapy on haemostasis after open heart surgery in a prospective clinical trial. Thirty seven patients (pts) undergoing cardiac surgery due to their valve disease were randomly assigned either to control-group (20 pts) or to Gordox-group (17 pts). The patients in the Gordox group were given Gordox according the following scheme: 2 M IU within 20 min. after induction of anaesthesia followed by 0.5 M IU/hour infusion until the end of the operation. One M IU also was given into the oxygenator before starting the extracorporeal circulation. The postoperative chest tube drainage was less in Gordox-group (534 +/- 260 ml vs. 987 +/- 583 ml, p less than 0.005), and donor blood and fresh frozen plasma requirement was also lower in this group (534 +/- 633 ml vs. 935 +/- 718 ml p less than 0.05; 70 +/- 153 ml vs. 211 +/- 245 ml p less than 0.05, respectively). There was no significant difference between the two groups concerning the postoperative activated partial thromboplastin time, prothrombin time, thrombin time values. The authors could document significantly higher fibrinogen concentration and significantly lower fibrinolytic activity postoperatively in the Gordox-group (p less than 0.05). Gordox therapy has advantageous effect on haemostasis after open heart surgery which can be documented both by clinical and laboratory examination.

Early clinical experience with a simple method for autotransfusion in cardiac surgery.

A simple method for intraoperative autotransfusion (ATF) in open-heart surgery was tested in a prospective clinical trial. The patients were randomly assigned to a control group (33) or to the ATF group (35). The intraoperative ATF was combined with preoperative collection of blood and postoperative ATF. The postoperative chest-tube drainage was reduced by 24.3%, the donor-blood requirement by 43.3% and the consumption of fresh-frozen plasma by 43.9% in the ATF group as compared with the controls (all differences statistically significant). To investigate possible haematologic side effects of ATF, measurements of haemoglobin, haematocrit, fibrinogen concentration, thrombin, prothrombin and partial thromboplastin time, antithrombin-III and fibrinolytic activity were made in all patients preoperatively and on postoperative days 1 and 2. No statistical differences were then found between the controls and the ATF group. Microbiologic tests of blood sampled from the cardiotomy reservoir gave satisfactory results.

[Defibrination syndrome in gastric tumors (author's transl)]. / Defibrinierungs-Syndrom bei Magentumoren

The two cases reported here were clinically misleading because of the negative history. A 49-year-old woman was treated for thrombosis migrans of the vena cava and a consumption coagulopathy; a 15-year-old boy for gastro-intestinal hemorrhages and hematemesis with fibrinolysis syndrome. Since the coagulation disturbances did not subside in spite of the treatment, an exploratory laparotomy was performed which revealed a solid carcinoma of the stomach in both cases. The hemorrhagic tendency can be traced back to the coagulation accelerator factors which escape from the tumor and metastases into the blood.