- Email: [email protected]
Concentrated aqueous heparin. A new form of intramuscular administration
SELECTED
149
ABSTRACTS
valves were normal. The mitral valve showed slight thickening but was not deformed and had no vegetations. Microscopically, the mitral valve showed evidence of an old rheumatic infection which had not healed completely. A pure culture of Hernophilus injkenzze, Type B, was isolated Inasmuch as this organism had not been found from the vegetations on the tricuspid valve. ante mortem, streptomycin therapy had not been tried. As far as the authors can determine, this represents the first reported case of subacute bacterial endocarditis due to Hemophilus injuenzze, Type B. It is also of special interest because of the isolated involvement of the tricuspid valve. DIJRANT. Stats,
D., Neuhof, Administration.
II.:
Concentrated Aqueous Heparin. Am. J.M. SC 214:159 (Aug.), 1947.
A New
Form
of Intramuscular
This communication describes the clinical utilization of a new preparation of concentrated aqueous heparin which can be administered intramuscularly. This preparation contains 100 mg. of heparin per c. c., is free from foreign substances or vasoconstrictor agents, and is watery in appearance and viscosity. It has been injected by nurses into the gluteal muscles with the regular intramuscular syringes and needles at eight to twelve hour intervals. The dosage required is roughly correlated Adequate prolongation of the coagulation time is usually ohwith the body weight of the patient. tained in patients weighing between 100 and 130 pounds by administering 100 mg. every eight hours or 120 mg. every twelve hours. In heavier individuals larger doses may be required. The maximum daily dose should not exceed 450 milligrams. The successful heparinization of patients \veighing over 170 pounds may be obtained by giving 1 mg. per pound of body weight as the initial dose and between 0.5 and 0.7 mg. per pound at eight hour intervals subsequently. The medication was administered over a period of several months to most of the postoperative patients of a general surgical service. There was no existing intravascular thrombosis in this group of ninety patients and none developed venous thrombosis. It was found that bleeding at the operative site could be averted if the anticoagulant was withheld until forty-eight to sixty hours had elapsed after the operation. In a small group of cases with thrombophlebitis which the authors have also treated, they observed the same rapid subsidence of fever, tenderness, and edema in the affected extremity that others have described with different preparations of heparin and other anticoagulants. They conclude that this preparation provides a simple, safe, and essentially painless form in which heparin can be administered intramuscularly to achieve a desired anticoagulant elect. DCJR
Parin,
V. V.: Circulation.
The
Role of Pulmonary Am. J. M. SC. 214:167
Vessels in (Aug.), 1947.
the
Reflex
Control
of
the
km.
Rlood
This Russian investigator has studied reflexes originating in the pulmonary circulation in a large series of experiments using cats as the experimental animal. The left pulmonary artery rvas cannulated and the left pulmonary veins ligated so that, while the left lung had its innervation in tact, it was completely isolated from the main blood circulation. Under these circumstances, an increase of pressure in the vessels of the excluded lung caused extensive changes of the whole circulatory system which had incontestably a reflex character. These changes consisted in a reaction which was depressor in type and had two components; a cardiac one with a considerable drop in the heart rate, and a vasomotor one with peripheral vasodilatation. Hence, the reaction was analogous to those observed in the known depressor and carotid reflexes, though not so strong as the latter. This reflex should have an appropriate place among those mechanisms which play an important role in In such increases of pressure in the pulmonary vascuthe “automatic” regulation of the circulation. lar stream as may arise in a number of physiologic and pathologic conditions (Valsalva’s experiment, embolism of the pulmonary artery, and so forth), the reflex from the pulmonary arteries, by lowering of the heart action and by transfer of blood into the greater circulation via extensive vasodilatation and increase in the capacity of the depot, prevents the weak musculature of the right ventricle from being overburdened by work. At the same time, this reflex has probably some significance in the prevention of pulmonary edema which easily occurs in cases of prolonged increase of pressure in the pulmonary artery system. DLYR.%W.
149
ABSTRACTS
valves were normal. The mitral valve showed slight thickening but was not deformed and had no vegetations. Microscopically, the mitral valve showed evidence of an old rheumatic infection which had not healed completely. A pure culture of Hernophilus injkenzze, Type B, was isolated Inasmuch as this organism had not been found from the vegetations on the tricuspid valve. ante mortem, streptomycin therapy had not been tried. As far as the authors can determine, this represents the first reported case of subacute bacterial endocarditis due to Hemophilus injuenzze, Type B. It is also of special interest because of the isolated involvement of the tricuspid valve. DIJRANT. Stats,
D., Neuhof, Administration.
II.:
Concentrated Aqueous Heparin. Am. J.M. SC 214:159 (Aug.), 1947.
A New
Form
of Intramuscular
This communication describes the clinical utilization of a new preparation of concentrated aqueous heparin which can be administered intramuscularly. This preparation contains 100 mg. of heparin per c. c., is free from foreign substances or vasoconstrictor agents, and is watery in appearance and viscosity. It has been injected by nurses into the gluteal muscles with the regular intramuscular syringes and needles at eight to twelve hour intervals. The dosage required is roughly correlated Adequate prolongation of the coagulation time is usually ohwith the body weight of the patient. tained in patients weighing between 100 and 130 pounds by administering 100 mg. every eight hours or 120 mg. every twelve hours. In heavier individuals larger doses may be required. The maximum daily dose should not exceed 450 milligrams. The successful heparinization of patients \veighing over 170 pounds may be obtained by giving 1 mg. per pound of body weight as the initial dose and between 0.5 and 0.7 mg. per pound at eight hour intervals subsequently. The medication was administered over a period of several months to most of the postoperative patients of a general surgical service. There was no existing intravascular thrombosis in this group of ninety patients and none developed venous thrombosis. It was found that bleeding at the operative site could be averted if the anticoagulant was withheld until forty-eight to sixty hours had elapsed after the operation. In a small group of cases with thrombophlebitis which the authors have also treated, they observed the same rapid subsidence of fever, tenderness, and edema in the affected extremity that others have described with different preparations of heparin and other anticoagulants. They conclude that this preparation provides a simple, safe, and essentially painless form in which heparin can be administered intramuscularly to achieve a desired anticoagulant elect. DCJR
Parin,
V. V.: Circulation.
The
Role of Pulmonary Am. J. M. SC. 214:167
Vessels in (Aug.), 1947.
the
Reflex
Control
of
the
km.
Rlood
This Russian investigator has studied reflexes originating in the pulmonary circulation in a large series of experiments using cats as the experimental animal. The left pulmonary artery rvas cannulated and the left pulmonary veins ligated so that, while the left lung had its innervation in tact, it was completely isolated from the main blood circulation. Under these circumstances, an increase of pressure in the vessels of the excluded lung caused extensive changes of the whole circulatory system which had incontestably a reflex character. These changes consisted in a reaction which was depressor in type and had two components; a cardiac one with a considerable drop in the heart rate, and a vasomotor one with peripheral vasodilatation. Hence, the reaction was analogous to those observed in the known depressor and carotid reflexes, though not so strong as the latter. This reflex should have an appropriate place among those mechanisms which play an important role in In such increases of pressure in the pulmonary vascuthe “automatic” regulation of the circulation. lar stream as may arise in a number of physiologic and pathologic conditions (Valsalva’s experiment, embolism of the pulmonary artery, and so forth), the reflex from the pulmonary arteries, by lowering of the heart action and by transfer of blood into the greater circulation via extensive vasodilatation and increase in the capacity of the depot, prevents the weak musculature of the right ventricle from being overburdened by work. At the same time, this reflex has probably some significance in the prevention of pulmonary edema which easily occurs in cases of prolonged increase of pressure in the pulmonary artery system. DLYR.%W.