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Perioperative coagulation

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https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#1
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29749244/influence-of-perioperative-hypothermia-on-blood-clotting-in-children
#2
A Trckova, P Stourac
OBJECTIVES: The decrease of body temperature is one of the causes of blood clotting disorders. BACKGROUND: Accidental hypothermia during anesthesia is a common condition and children, especially newborns, are the most sensitive patients to the side effects of hypothermia. METHODS: Web of Science, SCOPUS and PubMed search was performed to retrieve both original and review articles addressing both, hypothermia during surgery and coagulation disorder in pediatric patients...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29707861/perioperative-replacement-therapy-in-haemophilia-b-an-appeal-to-b-more-precise
#3
H C A M Hazendonk, T Preijers, R Liesner, P Chowdary, D Hart, D Keeling, M H E Driessens, B A P Laros-van Gorkom, F J M van der Meer, K Meijer, K Fijnvandraat, F W G Leebeek, R A A Mathôt, P W Collins, M H Cnossen
INTRODUCTION: Haemophilia B is caused by a deficiency of coagulation factor IX (FIX) and characterized by bleeding in muscles and joints. In the perioperative setting, patients are treated with FIX replacement therapy to secure haemostasis. Targeting of specified FIX levels is challenging and requires frequent monitoring and adjustment of therapy. AIM: To evaluate perioperative management in haemophilia B, including monitoring of FIX infusions and observed FIX levels, whereby predictors of low and high FIX levels were assessed...
April 29, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29690952/refinement-of-perioperative-feeding-in-a-mouse-model-of-vertical-sleeve-gastrectomy
#4
Carolyn M Doerning, Lisa A Burlingame, Alfor G Lewis, Andriy Myronovych, Randy J Seeley, Patrick A Lester
Provision of liquid enteral nutrition (LEN) during the perioperative period is standard practice for rodents undergoingbariatric surgery, yet these diets are associated with several challenges, including coagulation of the liquid diet within thedelivery system and decreased postoperative consumption. We investigated the use of a commercially available high-caloriedietary gel supplement (DG) as an alternative food source for mice during the perioperative period. C57BL/6J male mice werefed high-fat diet for 8 to 10 wk prior to surgery...
April 24, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29661410/use-of-prothrombin-complex-concentrate-for-management-of-coagulopathy-after-cardiac-surgery-a-propensity-score-matched-comparison-to-plasma
#5
J Fitzgerald, M Lenihan, J Callum, S A McCluskey, C Srinivas, A van Rensburg, K Karkouti
BACKGROUND: An important cause of coagulopathy in cardiac surgery is impaired thrombin generation. While plasma is often used to correct this element of the coagulopathy, studies in vitro suggest that prothrombin complex concentrates (PCCs) might be more effective. Comparative data, however, are scant. METHODS: We compared the outcomes of those who received only plasma with those who received PCCs (with or without plasma) for management of coagulopathy in patients who underwent cardiac surgery with cardiopulmonary bypass at a single institution from 2012 to 2016...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29658352/chronic-subdural-collection-overlying-an-intra-axial-hemorrhagic-lesion-in-chronic-myelomonocytic-leukemia-special-report-and-review-of-the-literature
#6
Anne-Laure Bernat, Stefano Maria Priola, Ahmad Elsawy, Faisal Farrash, Shervin Taslimi, Fred Gentili
Chronic myelomonocytic leukaemia (CMML) is a clonal hematopoietic stem cell disorder characterized by the presence of an absolute monocytosis in the peripheral blood (>1 x 109 /L) and the presence of myelodysplastic and myeloproliferative features in the bone marrow. Involvement of the central nervous system (CNS) is uncommon in CMML. Areas covered: Herein described is a case report of a CMML patient who presents with symptomatic chronic subdural collection overlying a haemorrhagic brain lesion, along with diffuse dural infiltration, after two cycles of azacytidine...
April 19, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29596103/changes-in-international-normalized-ratios-after-plasma-transfusion-of-varying-doses-in-unique-clinical-environments
#7
Matthew A Warner, Andrew C Hanson, Timothy J Weister, Andrew A Higgins, Nageswar R Madde, Darrell R Schroeder, Justin D Kreuter, Daryl J Kor
BACKGROUND: Plasma transfusion is commonly performed for the correction of abnormal coagulation screening tests. The goal of this investigation was to assess the relationship between the dose of plasma administered and changes in coagulation test results in a large and diverse cohort of patients with varying levels of coagulation abnormalities and comorbid disease and in a variety of clinical settings. METHODS: In this single-center historical cohort study, all plasma transfusion episodes in adult patients with abnormal coagulation screening tests were extracted between 2011 and 2015...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29588239/coagulation-alternation-and-deep-venous-thrombosis-in-brain-tumor-patients-during-the-perioperative-period
#8
Xiaopeng Guo, Fa Zhang, Yue Wu, Lu Gao, Qiang Wang, Zihao Wang, Chenzhe Feng, Yi Yang, Bing Xing, Zhiqin Xu
OBJECTIVE: To explore coagulation function in brain tumor patients before and after craniotomy and tumor resection and to analyze its correlation with deep vein thrombosis (DVT). METHODS: Overall, 133 brain tumor patients were consecutively enrolled into this study. Coagulation evaluation and limb venous ultrasonography were performed before and after surgery. Clinical characteristics and dynamic changes in the coagulation parameters were recorded, and their correlations with DVT were analyzed...
March 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29577004/staged-surgical-palliation-for-hlhs-in-a-girl-with-severe-factor-x-deficiency
#9
Ahmed F Elmahrouk, Mohamed F Ismail, Abdulbadee Bugis, Nashwa Badawy, Hesham Mohamed Aboelghar, Tamer Hamouda, Ahmed Jamjoom
Background  Factor X deficiency (also known as Stuart-Prower factor deficiency) is an autosomal recessive extremely rare hereditary hematologic disorder, affecting around 1:1,000,000 of the general population. Case Presentation  This case report describes a patient with hypoplastic left heart syndrome and severe factor X deficiency, who underwent staged surgical palliation. From stage 1 Norwood palliation, through superior cavopulmonary anastomosis and ending with total cavopulmonary connection with satisfactory hemostasis and no significant perioperative bleeding complication...
January 2018: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/29539628/prenatal-abo-rhd-genotyping-a-new-paradigm-to-allow-for-fresh-whole-blood-for-cardiopulmonary-bypass-in-the-immediate-newborn-period
#10
Juliet Chhay Bishop, Karin Blakemore, Luca Vricella, Priya Sekar, Katelynn Sagaser, Jude Crino, Paul Ness, Benjamin K Kogutt, Joan Boyd, Susan Aucott, Angie C Jelin, Joanne Chiu, Eric Gehrie, Kristen Nelson McMillan
Compared to standard component therapy, fresh whole blood (FWB) offers potential benefits to neonates undergoing cardiopulmonary bypass (CPB) in the context of open cardiac surgery: decreased blood loss and subsequent risk of volume overload, improved coagulation status, higher platelet counts during and following CPB, circumvention of limited vascular access, and significantly reduced donor exposures. Obtaining FWB, however, entails 2-5 days of preparation, which often precludes its availability for neonates requiring CPB in the immediate newborn period...
March 14, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29532455/a-study-of-coagulation-changes-at-early-stage-after-total-knee-arthroplasty
#11
Jian Huang, Peng Zhang, Dawei Wang
Coagulation changes after total knee arthroplasty (TKA) can provide evidence for optimization of timing of perioperative anticoagulation medicine. To evaluate the changes, 50 patients with knee osteoarthritis or rheumatoid arthritis were recruited for the study and underwent thrombelastography tests pre-, 6 hours, 12 hours, and 24 hours after TKA surgery and Doppler ultrasound examination 20 to 24 hours after surgery. The results have shown prolonged clotting time ( R value) at 6 and 12 hours, while shortened at 24 hours...
January 30, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29504128/the-use-of-acute-normovolemic-hemodilution-in-paediatric-cardiac-surgery
#12
W M Crescini, A Muralidaran, I Shen, A LeBlan, J You, C Giacomuzzi, M M Treggiari
BACKGROUND: Acute normovolemic hemodilution (ANH) is considered safe and effective in decreasing perioperative transfusion in paediatric populations undergoing high blood-loss surgeries. We determined the association between ANH and the intraoperative use of allogeneic blood products in paediatric cardiac surgery patients. METHODS: This is a single-centre retrospective cohort study including paediatric patients between 0 and 36 months of age undergoing surgical repair or palliation of their cardiac defect with the use of cardiopulmonary bypass between November 2013 and November 2014...
March 4, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29485284/carbon-nanotube-strain-sensor-based-hemoretractometer-for-blood-coagulation-testing
#13
Zida Li, Yize Wang, Xufeng Xue, Brendan McCracken, Kevin Ward, Jianping Fu
Coagulation monitoring is essential for perioperative care and thrombosis treatment. However, existing assays for coagulation monitoring have limitations such as a large footprint and complex setup. In this work, we developed a miniaturized device for point-of-care blood coagulation testing by measuring dynamic clot retraction force development during blood clotting. In this device, a blood drop was localized between a protrusion and a flexible force-sensing beam to measure clot retraction force. The beam was featured with micropillar arrays to assist the deposition of carbon nanotube films, which served as a strain sensor to achieve label-free electrical readout of clot retraction force in real time...
March 23, 2018: ACS Sensors
https://www.readbyqxmd.com/read/29482908/blood-product-administration-in-the-critical-care-and-perioperative-settings
#14
REVIEW
Sofie Louise Rygård, Lars Broksø Holst, Anders Perner
The critical care and perioperative settings are high consumers of blood products, with multiple units and different products often given to an individual patient. The recommendation of this review is always to consider the risks and benefits for a specific blood product for a specific patient in a specific clinical setting. Optimize patient status by treating anemia and preventing the need for red blood cell transfusion. Consider other options for correction of anemia and coagulation disorders and use an imperative non-overtransfusion policy for all blood products...
April 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29475933/association-of-diaphragmatic-surgery-as-part-of-cytoreductive-effort-in-advanced-stage-ovarian-cancer
#15
Nicolae Bacalbasa, Irina Balescu, Cristian Balalau, Olivia Ionescu, Claudia Stoica
BACKGROUND/AIM: Diaphragmatic surgery in advanced-stage ovarian cancer has been considered since long time to increase the rates of postoperative complications. However, improvement of surgical techniques and perioperative management of these patients has lead in the last decade to a safe association of such procedures as part of debulking process. The aim of the current paper was to report our experience regarding the role of diaphragmatic resections as part of debulking surgery for advanced stage ovarian cancer...
March 2018: In Vivo
https://www.readbyqxmd.com/read/29462033/low-dose-epinephrine-plus-tranexamic-acid-reduces-early-postoperative-blood-loss-and-inflammatory-response-a-randomized-controlled-trial
#16
Wei-Nan Zeng, Jun-Li Liu, Fu-You Wang, Cheng Chen, Qiang Zhou, Liu Yang
BACKGROUND: The reductions of perioperative blood loss and inflammatory response are important in total knee arthroplasty. Tranexamic acid reduced blood loss and the inflammatory response in several studies. However, the effect of epinephrine administration plus tranexamic acid has not been intensively investigated, to our knowledge. In this study, we evaluated whether the combined administration of low-dose epinephrine plus tranexamic acid reduced perioperative blood loss or inflammatory response further compared with tranexamic acid alone...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29457391/-analysis-on-related-factors-of-perioperative-total-blood-loss-in-unilateral-total-hip-arthroplasty
#17
Hong Yang, Xi-Bin Li, Jie Tan, Hao Li, Yin-Chu Shao, Feng Shuang
OBJECTIVE: To investigate the influential factors of total blood loss during unilateral artificial total hip arthroplasty (THA). METHODS: From January 2014 to July 2016, 131 patients undergwent primary unilateral total hip arthroplasty, including 55 males and 76 females, ranging in age from 40 to 89 years old, with an average of 64.5 years old. The data of patients with unilateral total hip arthroplasty were collected, and the data of hemodynamics, coagulation function, hemoglobin and hematocrit values were recorded according to the observation data...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29457118/preoperative-elevated-fdp-may-predict-severe-intraoperative-hypotension-after-dural-opening-during-decompressive-craniectomy-of-traumatic-brain-injury
#18
Kei Kamiutsuri, Naoki Tominaga, Shunji Kobayashi
Purpose: Coagulation disorder and intraoperative hypotension are representative complications of traumatic brain injury which cause worse perioperative outcome. The aim of this study was to survey the relation of coagulation disorder and intraoperative hypotension (IH) during decompressive craniectomy. Method: Patients who underwent emergency decompressive craniectomy due to traumatic brain injury were retrospectively surveyed. The relation between preoperative coagulation date and intraoperative hypotension (systolic blood pressure < 60 mmHg after dural opening) was analyzed...
2018: JA Clinical Reports
https://www.readbyqxmd.com/read/29455405/bariatric-surgery-in-patients-on-chronic-anticoagulation-therapy
#19
Gautam Sharma, Zubaidah Nor Hanipah, Ali Aminian, Suriya Punchai, Emre Bucak, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Perioperative management of chronically anti-coagulated patients undergoing bariatric surgery requires a balance of managing hemorrhagic and thromboembolic risks. The aim of this study is to evaluate the incidence of hemorrhagic complications and their management in chronically anticoagulated (CAT) patients undergoing bariatric surgery. METHODS: A retrospective review of CAT patients undergoing bariatric surgery at an academic center from 2008 to 2015 was studied...
February 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29433532/is-there-a-difference-in-bleeding-after-left-ventricular-assist-device-implant-centrifugal-versus-axial
#20
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
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