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bleeding AND chest tube

Jeffrey E Keenan, Hanghang Wang, Brian C Gulack, Asvin M Ganapathi, Nicholas D Andersen, Brian R Englum, Yamini Krishnamurthy, Jerrold H Levy, Ian J Welsby, G Chad Hughes
BACKGROUND: Moderate (MHCA) versus deep (DHCA) hypothermia for circulatory arrest in aortic arch surgery has been purported to reduce coagulopathy and bleeding complications, although there are limited data supporting this claim. This study aimed to compare bleeding-related events after aortic hemiarch replacement with MHCA versus DHCA. METHODS: Patients who underwent hemiarch replacement at a single institution from July 2005 to August 2014 were stratified into DHCA and MHCA groups (minimum systemic temperature ≤20°C and >20°C, respectively) and compared...
August 28, 2016: Journal of Thoracic and Cardiovascular Surgery
Ian Smith, Bronwyn L Pearse, Daniel J Faulke, Rishen Naidoo, Lisa Nicotra, Peter Hopkins, Elizabeth G Ryan
OBJECTIVE: Lung transplantation is associated with high rates of bleeding and frequent blood transfusion. The authors aimed to determine if point-of-care coagulation testing (POCCT) reduced transfusion requirements. DESIGN, SETTINGS, AND PARTICIPANTS: A before-and-after cohort analysis conducted at a single tertiary referral center. Ninety-three sequential adult patients between January 2010 and January 2014 undergoing isolated lung transplant without preoperative extracorporeal support were analyzed...
June 27, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Aly Makram Habib, Ahmed Yehia Mousa, Zohair Al-Halees
UNLABELLED: A retrospective observational study to review the safety and efficacy of rFVIIa in persistent hemorrhage in post cardiac surgical patients. METHODS: Patients who had bleeding of 3 ml/kg/h or more for 2 consecutive hours after cardiac surgery were arranged into two groups; control group, who received conventional treatment and rFVIIa group, who received conventional treatment and rFVIIa. RESULTS: There was no significant difference in demographic and surgical characteristics of both groups...
October 2016: Journal of the Saudi Heart Association
Aly Makram Habib
AIM OF THE STUDY: A retrospective observational study to compare safety and efficacy of high and low doses of recombinant activated factor VIIa (rFVIIa) in severe postcardiac surgical bleeding. PATIENTS AND METHODS: From 2004 to 2014, all patients who received rFVIIa for bleeding after cardiac surgery were included and arranged in two groups; Group 1: Low dose (40-50 mcg/kg) (n = 98) and Group 2: High dose (90-120 mcg/kg) (n = 156). RESULTS: There was no significant difference in demographic and surgical characteristics of both groups on admission to Cardiac Surgical Intensive Care Unit (CSICU)...
September 2016: Indian Journal of Critical Care Medicine
J Trent Magruder, Stephen Belmustakov, Rika Ohkuma, Sarah Collica, Joshua C Grimm, Todd Crawford, John V Conte, William A Baumgartner, Ashish S Shah, Glenn R Whitman
BACKGROUND: We sought to quantify the effect of severe postoperative bleeding in hemodynamically stable patients following cardiac surgery. METHODS: We reviewed the charts of all cardiac surgery patients operated on at our institution between 2010 and 2014. After excluding patients with tamponade or MAP <60, we propensity matched patients having chest tube output >300 mL in the first postoperative hour, >200 mL in the second, and >100 mL in the third ("bleeding" group) with patients having <50 mL/h of chest tube output ("dry" group)...
September 20, 2016: General Thoracic and Cardiovascular Surgery
V Filingeri, S Francioso, D Sforza, F Santopaolo, F M Oddi, G Tisone
OBJECTIVE: In the last decades, liver biopsy was the reference procedure for the diagnosis and follow-up of liver disease. Aim of present retrospective analysis was to assess the prevalence of complications and risk factors after Percutaneous Liver Biopsy (PLB) performed for diagnosis and staging in patients with chronic liver disease and for monitoring the graft in liver transplanted patients PATIENTS AND METHODS: Data were collected from a total of 1.011 PLB performed with the Menghini technique between January 2004 and December 2014 at the Hepatology and Transplant Units of the University of Rome Tor Vergata...
September 2016: European Review for Medical and Pharmacological Sciences
Dong Jung Kim, Yoon Chul Shin, Dong Jin Kim, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
OBJECTIVE: This study aimed to investigate the efficiency and safety of resternotomy performed in the intensive care unit (ICU) for emergent bleeding control after cardiac surgery when transport of the patient to the operating room (OR) was unsafe or delayed. METHODS: Medical records were retrospectively reviewed for 101 patients who underwent resternotomy for bleeding control after cardiac surgery between July 2003 and July 2013. A reoperation was performed in the OR for 61 patients (the OR group) and in the ICU for 40 patients (the ICU group)...
September 7, 2016: Journal of Cardiac Surgery
Abeer M Rababa'h, Salah E Altarabsheh, Osama Haddad, Salil V Deo, Yagthan Obeidat, Sayer Al-Azzam
OBJECTIVES: Hawthorn extract consumption is becoming more widespread among the Jordanian population with cardiovascular disorders. We conducted this prospective observational longitudinal study to determine the impact of hawthorn extract on bleeding risk in patients who undergo cardiac surgery. METHODS: A prospective observational study was performed on 116 patients who underwent cardiac surgery in the period between June 2014 and May 2015. Patients were divided into two groups: Group I (patients recently consumed hawthorn extract) and Group II (patients never consumed hawthorn extract)...
2016: Heart Surgery Forum
Jeffrey B Riley, Gregory J Schears, Gregory A Nuttall, William C Oliver, Mark H Ereth, Joseph A Dearani
Excessive bleeding and allogeneic transfusion during adult post-cardiotomy venoarterial extracorporeal membrane oxygenation (ECMO) are potentially harmful and expensive. Balancing the inhibition of clotting and distinguishing surgical from non-surgical bleeding in post-operative period is difficult. The sensitivity of coagulation tests including Thromboelastography(®) (TEG) to predict chest tube drainage in the early hours of ECMO was examined with the use of receiver-operating characteristics (ROC). The results are useful to incorporate in clinical evidence-based algorithms to guide management decisions...
June 2016: Journal of Extra-corporeal Technology
Simon Maltais, Mary E Davis, Nicholas A Haglund, Louis Perrault, Sudhir S Kushwaha, John M Stulak, Edward M Boyle
Chest tubes are utilized to evacuate shed blood after left ventricular assist device (LVAD) implantation, however, they can become clogged, leading to retained blood. We implemented a protocol for active tube clearance (ATC) of chest tubes to determine if this might reduce interventions for retained blood. 252 patients underwent LVAD implantation. 77 had conventional chest tube drainage (Group 1), whereas 175 patients had ATC (Group 2). A univariate and multivariate analysis adjusting for the use of conventional sternotomy (CS) and minimally invasive left thoracotomy (MILT) was performed...
August 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jungsil Lee, Yoon Jun Kim, Hyung-Jun Kim, Jee-Min Kim, Young-Chan Kim, Sun Mi Choi
A 59-year-old man presented with acute dyspnea following sudden productive cough and expectoration of a full cup of "blood-tinged" sputum. He had been diagnosed with hepatitis B virus-related hepatocellular carcinoma and had received transarterial chemoembolization 5 years ago for a 20-cm hepatic mass; he denied any history of hematemesis and the last esophagogastroduodenoscopy from a year ago showed absence of varix. Chest computed tomography (CT) with angiography showed new appearance of right basal lung consolidation but no bleeding focus...
July 2016: Tuberculosis and Respiratory Diseases
Allison L Hollis, Ashleigh V Lowery, Mehrnaz Pajoumand, Si M Pham, Julia F Slejko, Kenichi A Tanaka, Michael Mazzeffi
BACKGROUND: Cardiac transplantation can be complicated by refractory hemorrhage particularly in cases where explantation of a ventricular assist device is necessary. Recombinant activated factor VII (rFVIIa) has been used to treat refractory bleeding in cardiac surgery patients, but little information is available on its efficacy or cost in heart transplant patients. METHODS: Patients who had orthotopic heart transplantation between January 2009 and December 2014 at a single center were reviewed...
July 2016: Annals of Cardiac Anaesthesia
James Ellis, Oswaldo Valencia, Agnieszka Crerar-Gilbert, Simon Phillips, Hanif Meeran, Vivek Sharma
AIM: With an increase in the number of patients who are on antiplatelet medications until the day of surgery, we undertook a prospective observational study to assess the ability of thromboelastography, thromboelastography platelet mapping and aggregometry via multiplate to detect platelet dysfunction and predict blood loss following coronary artery bypass grafting (CABG) surgery. METHODS: Platelet function was evaluated pre- and post-cardiopulmonary bypass via thromboelastography, thromboelastography platelet mapping and aggregometry via multiplate in 52 patients undergoing coronary artery bypass grafting surgery...
July 6, 2016: Perfusion
Joanne P Starr, Richard N Gates, Brian A Palafox, Allison Quill
Purpose To evaluate effectiveness of a novel hemostatic dissection tool in patients with congenital heart disease undergoing redo pericardiac dissections. Description This dissection tool employs ferromagnetic energy to cut and coagulate. The unit passes no electric current through the patient, thus eliminating cautery-induced dysrhythmias and electrical interference. Ferromagnetic dissection is precise and reduces thermal injury spread by as much as 90%. Evaluation We case matched 22 patients undergoing reoperation for congenital heart surgery by weight/operation...
October 2016: Surgical Innovation
Matthew Ing, Rema A Oliver, Brian G G Oliver, William R Walsh, Jonathan P Williamson
BACKGROUND: Transbronchial lung biopsy using a cryoprobe is a novel way of sampling lung parenchyma. Correlation of freezing time with biopsy size and complications has not been evaluated in vivo. OBJECTIVES: The primary aim of the study is to evaluate the correlation between transbronchial cryobiopsy freezing time and size. The secondary aims are to evaluate histological quality of the biopsy and evaluate procedure-associated complications. METHODS: Transbronchial lung cryobiopsies were obtained from two anaesthetised sheep using a 1...
2016: Respiration; International Review of Thoracic Diseases
Adnan Majid, Fayez Kheir, Alejandro Folch, Sebastian Fernandez-Bussy, Sumit Chatterji, Ashish Maskey, Meghan Fashjian, George Cheng, Sebastian Ochoa, Daniel Alape, Erik Folch
RATIONALE: Treatment of pleural infection with instillation of intrapleural tissue plasminogen activator (tPA) and human recombinant DNase (DNase) has been proven to decrease the length of hospital stay, decrease surgical referral, and improve drainage. The optimal dosage, administration, timing, and frequency of the regimen remain unclear. It is unknown if the two drugs can be administered immediately one after the other (referred to as concurrent) instead of instilling them separately with a 1- to -2-hour interval in between...
September 2016: Annals of the American Thoracic Society
Krzysztof Jaworski, Krystyna Maślanka, Artur Jakimiuk, Patrycja Łopacz, Paweł Panin, Dariusz A Kosior
BACKGROUND: Transfusion-related acute lung injury (TRALI) is a major cause of death associated with transfusion. Nevertheless it is still misdiagnosed and underreported. We present a case of this serious complication in order to make it more familiar to clinicians and indicate proper medical management, which is significant not only for the patients presenting TRALI symptoms but also for future recipients of blood components. CASE PRESENTATION: A 32-year-old white woman with in-vitro fertilization in anamnesis was admitted to Department of Obstetrics and Gynecology because of abdominal pain...
2016: Ginekologia Polska
Kristopher Lyon, Vin Shen Ban, Nicole Bedros, Salah G Aoun, Tarek El Ahmadieh, Jonathan White
BACKGROUND: Ventriculoperitoneal shunts are prone to common complications such as infection or mechanical failure, but more insidious events can easily be missed. Distal shunt migration into the vascular system is a rarely observed phenomenon, and there are no established guidelines for its management. We present a case of a distal catheter migration into the pulmonary vasculature, review existing cases in the literature, and present recommendations for their management. CASE DESCRIPTION: A 71-year-old man presented to the clinic with normal pressure hydrocephalus...
August 2016: World Neurosurgery
Feng Shao, Zhengcheng Liu, Yanqing Pan, Hui Cao, Rusong Yang
BACKGROUND: Our study aims to determine the value of bronchial anastomosis using complete continuous suture. METHODS: Six patients diagnosed with central lung carcinoma who were candidates for right-sided sleeve lobectomy and underwent sleeve resection of the right upper lobe by thoracoscopic surgical procedure. RESULTS: The mean surgical time was 182 min (range, 110 to 260 min). The mean time of bronchial anastomosis was 49 min (range, 18 to 76 min)...
2016: World Journal of Surgical Oncology
E Bignami, M Cattaneo, G Crescenzi, M Ranucci, F Guarracino, C Cariello, R Baldassarri, G Isgrò, E Baryshnikova, G Fano, A Franco, C Gerli, M Crivellari, A Zangrillo, G Landoni
BACKGROUND: Previous studies showed that desmopressin decreases post-operative blood loss in patients undergoing cardiac surgery. These studies were small and never studied the effect of desmopressin in patients with active bleeding. Objective of the study was to determine whether desmopressin reduces red blood cells transfusion requirements in patients with active bleeding after cardiac surgery who had been pre-treated with tranexamic acid. METHODS: This multicenter, randomized, double-blind, placebo-controlled, parallel-group study randomized elective patients with bleeding after cardiac surgery despite pre-treatment with tranexamic acid, to receive placebo (saline solution) or a single administration of desmopressin (0...
August 2016: Acta Anaesthesiologica Scandinavica
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