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https://www.readbyqxmd.com/read/28079399/safety-and-efficacy-of-tissue-plasminogen-activator-tpa-and-deoxyribonuclease-dnase-for-complicated-pleural-effusions-secondary-to-abdominal-pathology
#1
Adnan Majid, Sebastian Ochoa, Sumit Chatterji, Sebastian Fernandez-Bussy, Fayez Kheir, Estefania Rivera, George Cheng, Erik Folch
RATIONALE: Exudative pleural effusions may arise secondary to inflammation of intra-abdominal structures. Pleural space loculations can complicate these effusions, preventing adequate chest tube drainage and leading to consideration of surgical intervention. Previous studies have demonstrated that intrapleural administration of tissue plasminogen activator (tPA) combined with human recombinant deoxyribonuclease (DNase) can improve fluid drainage and reduce surgery for patients with loculated parapneumonic effusions; however, the efficacy of this treatment has not been evaluated for complicated pleural effusions attributed to intraabdominal inflammation...
January 12, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28062681/dialyzer-based-cell-salvage-system-a-superior-alternative-to-conventional-cell-salvage-in-off-pump-coronary-artery-bypass-grafting
#2
Amber Malhotra, Pankaj Garg, Arvind Kumar Bishnoi, Pranav Sharma, Vivek Wadhawa, Komal Shah, Sanjay Patel, Umesh Kumar Ahirwar, Dayesh Rodricks, Himani Pandya
OBJECTIVES: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters. METHODS: Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) (n = 75), (2) conventional cell salvage (CCS) (n = 73) and (3) without cell salvage (WCS) (n = 74)...
January 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28035579/extra-pleuric-coaxial-system-for-ct-guided-percutaneous-fine-needle-aspiration-biopsy-fnab-of-small-%C3%A2-20%C3%A2-mm-lung-nodules-a-novel-technique-using-multiplanar-reconstruction-mpr-images
#3
Raffaella Capasso, Rita Nizzoli, Marcello Tiseo, Giuseppe Pedrazzi, Luca Brunese, Antonio Rotondo, Massimo De Filippo
The aim of the study is to present the diagnostic feasibility, usefulness, and safety of a novel technique for coaxial CT-guided fine-needle aspiration biopsy of small (≤20 mm in diameter) lung nodules. A 18-gauge (G) (1.2 × 40 mm) needle is inserted through the skin in the depth of the thoracic wall tissues remaining outside the pleura. Its positioning is planned and adjusted using multiplanar reconstruction (MPR) images along the 18-G guide needle axis tracing a reference outline extended from the needle tip to the target nodule...
February 2017: Medical Oncology
https://www.readbyqxmd.com/read/27831547/recombinant-tissue-plasminogen-activator-to-restore-catheter-patency-efficacy-and-safety-analysis-from-a-multihospital-nicu-system
#4
D M Scott, C Y Ling, B C MacQueen, V L Baer, E Gerday, R D Christensen
OBJECTIVE: In 2001, the US Food and Drug Administration approved recombinant tissue plasminogen activator (alteplase, Cathflo Activase) to reestablish patency of central catheters occluded, presumably, by a fibrin clot. We conducted a multicenter quality improvement study to determine the value of this procedure in our Neonatal Intensive Care Unit (NICUs), including analyses of efficacy, safety and costs. STUDY DESIGN: We conducted a retrospective quality analysis of neonates in level III NICUs, who received alteplase for the purpose of reestablishing patency of occluded central catheters...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27830349/use-of-adenosine-diphosphate-receptor-inhibitor-prior-to-left-ventricular-assist-device-implantation-is-not-associated-with-increased-bleeding
#5
Anjan Tibrewala, Michael E Nassif, Adam Andruska, Jerrica E Shuster, Eric Novak, Justin M Vader, Gregory A Ewald, Shane J LaRue, Scott Silvestry, Akinobu Itoh
Current guidelines recommend adenosine diphosphate receptor inhibitors (ADPRi) be discontinued 5-7 days prior to cardiac surgery due to increased bleeding events, rates of re-exploration, and transfusions. However, the risks of left ventricular assist device (LVAD) implantation in patients taking an ADPRi have not previously been studied. We retrospectively identified 134 eligible patients with ischemic cardiomyopathy that underwent LVAD implantation between July 2009 and August 2013. The cohorts received an ADPRi ≤5 days of surgery (n = 25) versus >5 days prior or not at all (n = 109)...
November 9, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27821834/impact-of-postoperative-bleeding-on-short-term-outcome-in-patients-after-orthotopic-heart-transplantation-a-retrospective-cohort-study
#6
Anna Kędziora, Karol Wierzbicki, Piotr Mazur, Bryan HyoChan Song, Jacek Piątek, Irena Milaniak, Piotr Węgrzyn, Bogusław Kapelak, Rafał Drwiła, Dorota Sobczyk, Izabela Górkiewicz-Kot, Krzysztof Bartuś, Bogdan Niekowal, Jerzy Sadowski
BACKGROUND Orthotopic heart transplantation (HTX) remains the ultimate treatment option in patients with end-stage heart failure, endorsed by the European Society of Cardiology guidelines. The aim of the study is a complex evaluation of the postoperative bleeding after HTX and its influence on short-term outcome. MATERIAL AND METHODS A retrospective cohort study consisted of 53 patients (4 females and 49 males, median age 52.5 years, IQR 17 years) who underwent HTX in the Department of Cardiovascular Surgery and Transplantology of John Paul II Hospital in Krakow between 2007 and 2014...
November 8, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27821822/-tension-pneumothorax-developing-hemothorax-after-chest-tube-drainage
#7
Takehiro Sakai, Masahiro Sawada, Yutaka Sato, Futoshi Kimura, Nobuo Yagihashi, Tadashi Iwabuchi, Daisuke Kimura, Takao Tsushima, Ryo Hatanaka
A 61-year-old man visited a physician complaining of progressive chest pain and dyspnea. The chest radiography showed complete collapse of the right lung suggesting tension pneumothorax. The patient was transferred to our hospital. A small amount of the right pleural effusion was also seen in addition to pulmonary collapse on the chest radiography. Chest drainage was performed, and continuous air leakage was seen. At 2 hours later, air leakage was disappeared but the bloody effusion was noted. The chest radiography revealed massive effusion and the enhanced computed tomography showed active bleeding...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27798792/bleeding-risk-associated-with-eptifibatide-integrilin-bridging-in-thoracic-surgery-patients
#8
Nathan H Waldron, Torijaun Dallas, Loretta Erhunmwunsee, Tracy Y Wang, Mark F Berry, Ian J Welsby
Antiplatelet use for treatment of coronary artery disease (CAD) is common amongst thoracic surgery patients. Perioperative management of antiplatelet agents requires balancing the opposing risks of myocardial ischemia and excessive bleeding. Perioperative bridging with short-acting intravenous antiplatelet agents has shown promise in preventing myocardial ischemia, but may increase bleeding. We sought to determine whether perioperative bridging with eptifibatide increased bleeding associated with thoracic surgery...
October 31, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27692949/does-moderate-hypothermia-really-carry-less-bleeding-risk-than-deep-hypothermia-for-circulatory-arrest-a-propensity-matched-comparison-in-hemiarch-replacement
#9
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...
December 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27692703/targeted-bleeding-management-reduces-the-requirements-for-blood-component-therapy-in-lung-transplant-recipients
#10
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
https://www.readbyqxmd.com/read/27688669/recombinant-activated-factor-vii-for-uncontrolled-bleeding-postcardiac-surgery
#11
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
https://www.readbyqxmd.com/read/27688624/comparison-of-low-and-high-dose-recombinant-activated-factor-vii-for-postcardiac-surgical-bleeding
#12
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
https://www.readbyqxmd.com/read/27650660/attributable-harm-of-severe-bleeding-after-cardiac-surgery-in-hemodynamically-stable-patients
#13
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
https://www.readbyqxmd.com/read/27649662/a-retrospective-analysis-of-1-011-percutaneous-liver-biopsies-performed-in-patients-with-liver-transplantation-or-liver-disease-ultrasonography-can-reduce-complications
#14
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
https://www.readbyqxmd.com/read/27600712/the-safety-of-resternotomy-in-the-intensive-care-unit-for-postcardiotomy-bleeding-control
#15
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)...
November 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27585196/hawthorn-herb-increases-the-risk-of-bleeding-after-cardiac-surgery-an-evidence-based-approach
#16
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)...
August 22, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27578897/coagulation-parameter-thresholds-associated-with-non-bleeding-in-the-eighth-hour-of-adult-cardiac-surgical-post-cardiotomy-extracorporeal-membrane-oxygenation
#17
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
https://www.readbyqxmd.com/read/27556153/active-clearance-of-chest-tubes-reduces-re-exploration-for-bleeding-after-ventricular-assist-device-implantation
#18
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. A total of 252 patients underwent LVAD implantation. Seventy-seven patients 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...
November 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27433178/acute-respiratory-failure-caused-by-hepatopulmonary-fistula-in-a-patient-with-hepatocellular-carcinoma
#19
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
https://www.readbyqxmd.com/read/27397445/impact-on-postoperative-bleeding-and-cost-of-recombinant-activated-factor-vii-in-patients-undergoing-heart-transplantation
#20
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
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