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Perioperative coagulation

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https://www.readbyqxmd.com/read/28648013/-retrospective-analysis-of-anesthetic-and-perioperative-management-in-patients-of-acute-fatty-liver-of-pregnancy
#1
Y Y Qu, H Zeng, X Y Guo, M Li
Objective: To retrospectively analyze the clinical characteristics of patients with acute fatty liver of pregnancy (AFLP), and to discuss perioperative and anesthetic management. Methods: A retrospective review was conducted on the records of pregnant patients with a diagnosis of acute fatty liver of pregnancy in Peking University Third Hospital from January 2007 to December 2015. 12 cases were identified. The clinical features, preoperative laboratory findings, types of delivery, anesthetic techniques for cesarean section, and the outcomes of parturients and fetus were collected and analyzed...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#2
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28625825/red-blood-cell-transfusion-in-surgical-cancer-patients-targets-risks-mechanistic-understanding-and-further-therapeutic-opportunities
#3
REVIEW
Vassilis L Tzounakas, Jerard Seghatchian, Elissavet Grouzi, Styliani Kokoris, Marianna H Antonelou
Anemia is present in more than half of cancer patients and appears to be an independent prognostic factor of short- and long-term adverse outcomes. It increases in the advanced period of cancer and perioperatively, in patients with solid tumors who undergo surgery. As a result, allogeneic red blood cell (RBC) transfusion is an indispensable treatment in cancer. However, its safety remains controversial, based on several laboratory and clinical data reporting a linkage with increased risk for cancer recurrence, infection and cancer-related mortality...
May 26, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28606160/consumption-coagulopathy-in-acute-aortic-dissection-principles-of-management
#4
Yuyong Liu, Lu Han, Jiachen Li, Ming Gong, Hongjia Zhang, Xinliang Guan
BACKGROUND: The effect of acute aortic dissection itself on coagulopathy or surgery-related coagulopathy has never been specifically studied. The aim of the present study was to perioperatively describe consumption coagulopathy in patients with acute aortic dissection. METHODS: Sixty-six patients with acute type A aortic dissection were enrolled in this study from January 2015 to September 2016. Thirty-six patients with thoracic aortic aneurysms were used as a control group during the same period...
June 12, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28604464/liver-transplantation-in-a-patient-with-antiphospholipid-syndrome-a-case-report
#5
Rachel C Steckelberg, Zarah D Antongiorgi, Randolph H Steadman
Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder characterized by autoantibodies to cell membrane phospholipids. While altered coagulation can complicate end-stage liver disease, there are few reports describing the perioperative management for liver transplantation in recipients with a preexisting hypercoagulable disorder, such as APS. We present a patient with a history of APS, Budd-Chiari syndrome with cirrhosis, hepatopulmonary syndrome, and heparin-induced thrombocytopenia who underwent liver transplantation complicated by hepatic artery thrombosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28601642/comparison-of-citrated-and-fresh-whole-blood-for-viscoelastic-coagulation-testing-during-elective-neurosurgery
#6
E Silverberg, F Tornqvist, T Kander, J Bengzon, C Solomon, J Bonnevier, U Schött
BACKGROUND: Previous viscoelastic haemostatic tests studies have often indicated a hypercoagulative test signal with citrated blood, which could influence clinical decision makings. PURPOSE: The aim of this study was to compare fresh and citrated whole blood using two non-automated viscoelastic ROTEM and Sonoclot tests. Our hypothesis was that citrated blood would demonstrate a hypercoagulative response in this setting, not tested before. METHODS: Perioperative viscoelastic coagulation changes were evaluated with a ROTEM and Sonoclot in 38 patients undergoing elective brain tumor surgery...
June 3, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28587360/the-value-of-sonoclot-detection-technology-to-guide-the-clinical-medication-of-the-perioperative-anticoagulation-and-antiplatelet-therapy-in-patients-with-acute-myocardial-infarction-undergoing-emergent-pci
#7
Wu-Xiao Yang, Chun-Lin Lai, Fu-Heng Chen, Ji-Rong Wang, You-Rui Ji, Dong-Xia Wang
The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28582640/the-causes-of-thrombocytopenia-after-transcatheter-aortic-valve-implantation
#8
Maciej Mitrosz, Remigiusz Kazimierczyk, Bozena Sobkowicz, Ewa Waszkiewicz, Pawel Kralisz, Marek Frank, Jaroslaw Piszcz, Marzenna Galar, Slawomir Dobrzycki, Wlodzimierz J Musial, Tomasz Hirnle, Karol A Kaminski, Agnieszka M Tycinska
INTRODUCTION: Even though thrombocytopenia following transcatheter aortic valve implantation (TAVI) has been described, further investigation of this phenomenon is needed. AIMS: To determine which factors may explain the fall in platelet count that occurs after implantation of a TAVI device, including markers of platelet and blood coagulation activation. MATERIAL AND METHODS: 32 patients without previous indications for dual antiplatelet therapy (mean age 78...
May 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28552297/comparison-between-2-strategies-of-fluid-management-on-blood-loss-and-transfusion-requirements-during-liver-transplantation
#9
Nirmeen A Fayed, Khaled A Yassen, Ayat R Abdulla
OBJECTIVE: To compare the effects of low central venous pressure (LCVP) and transesophageal Doppler (TED)-guided fluid management on blood loss and blood transfusion during liver transplantation (LTx). DESIGN: Retrospective study. SETTING: Single institution, university hospital. PARTICIPANTS: Adult recipients of LTx. INTERVENTIONS: Two groups: control (LCVP G), n=45 with CVP maintained 40% lower than the preoperative value during the preanhepatic phase...
February 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28540073/viscoelastic-testing-inside-and-beyond-the-operating-room
#10
REVIEW
Liang Shen, Sheida Tabaie, Natalia Ivascu
Hemorrhage is a major contributor to morbidity and mortality during the perioperative period. Current methods of diagnosing coagulopathy have various limitations including long laboratory runtimes, lack of information on specific abnormalities of the coagulation cascade, lack of in vivo applicability, and lack of ability to guide the transfusion of blood products. Viscoelastic testing offers a promising solution to many of these problems. The two most-studied systems, thromboelastography (TEG) and rotational thromboelastometry (ROTEM), offer similar graphical and numerical representations of the initiation, formation, and lysis of clot...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523161/the-safety-profile-of-preoperative-administration-of-heparin-for-thromboprophylaxis-in-chinese-patients-intended-for-thoracoscopic-major-thoracic-surgery-a-pilot-randomized-controlled-study
#11
Han-Yu Deng, Chang-Lin Shi, Gang Li, Jun Luo, Zhi-Qiang Wang, Yi-Dan Lin, Lun-Xu Liu, Qing-Hua Zhou
BACKGROUND: Patients undergoing major thoracic surgery especially for cancers are at a high risk of perioperative thromboembolism. Current guidelines recommended either heparin sodium (unfractionated heparin) or low-molecular-weight heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, the rational timing of starting heparin has not yet been well established, because DVT can be caused by not only surgery but also comorbidities as well as prolonged hospital stay, and thoracic surgeons always concerned about heparin-related increased risk of intra- or post-operative bleeding...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515746/veno-arterial-extracorporeal-membrane-oxygenation-as-cardiogenic-shock-therapy-support-in-adult-patients-after-heart-surgery
#12
Robert Musiał, Krystyna Ochońska, Andrzej Proc, Jarosław Stoliński, Dariusz Plicner, Bogusław Kapelak, Rafał Drwiła
INTRODUCTION: The authors present their personal experience in qualifying and treating adult patients using veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in postcardiotomy cardiogenic shock. AIM: The aim of this study was to analyze the results of VA ECMO in patients with postcardiotomy cardiogenic shock. An analysis of the risk factors of postoperative mortality was also performed. MATERIAL AND METHODS: We analyzed the perioperative results of survivors and non-survivors of treatment using VA ECMO...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28509773/perioperative-management-of-antithrombotic-therapies
#13
Timur Yurttas, Patrick M Wanner, Miodrag Filipovic
PURPOSE OF REVIEW: Perioperative coagulation management is becoming increasingly frequent in the daily routine of the anesthesiologist and with the plethora of new substances on the market also increasingly complex. The perioperative setting poses unique challenges requiring an individualized evaluation and management of antithrombotic therapy. This review shall summarize the newest developments in this domain. RECENT FINDINGS: New data in patients with atrial fibrillation have led to a paradigm change in the perioperative management of antithrombotics...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28506049/-laparoscopic-non-ischemic-partial-nephrectomy-using-a-microwave-tissue-coagulator-a-single-institutional-study
#14
Shinji Fukui, Yusuke Iemura, Yoshiaki Matsumura, Yoriaki Kagebayashi, Shoji Samma
We retrospectively investigated the surgical outcomes of renal cell carcinoma (RCC), perioperative complications, and residual renal function in patients receiving laparoscopic non-ischemic partial nephrectomy using a microwave tissue coagulator (MTC). Between January 2002 and December 2015, laparoscopic non-ischemic partial nephrectomy using MTC was performed in 49 patients. The histological diagnosis was RCC in 38 patients, angiomyolipoma in 4, oncocytoma in 2, and others in 5. A histologicallyproven positive surgical margin was observed in 1 (2...
April 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28498944/assessment-of-standard-laboratory-tests-and-rotational-thromboelastometry-for-the-prediction-of-postoperative-bleeding-in-liver-transplantation
#15
T M Dötsch, D Dirkmann, D Bezinover, M Hartmann, J W Treckmann, A Paul, F H Saner
Background.: Perioperative bleeding remains a major challenge in liver transplantation. We aimed to compare standard laboratory tests with thromboelastometry (ROTEM ® ) with regard to their ability to predict postoperative non-surgical bleeding. Methods.: Data from 243 adult liver transplant recipients from January 2012 to May 2014 were evaluated retrospectively. Upon admission to the intensive care unit, coagulation status was assessed using standard laboratory tests [prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, and platelet count] and ROTEM ® whole blood coagulation assays...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28486646/altered-preoperative-coagulation-and-fibrinolysis-are-associated-with-myocardial-injury-after-non-cardiac-surgery
#16
J Górka, K Polok, T Iwaniec, K Górka, A Wludarczyk, J Fronczek, P J Devereaux, J W Eikelboom, J Musial, W Szczeklik
Background: Myocardial injury after non-cardiac surgery (MINS), a complication with unclear pathogenesis, occurs within the first 30 days after surgery and worsens prognosis. Hypercoagulability induced by surgery might contribute to plaque rupture, with subsequent thrombosis and myocardial injury. This study assessed haemostatic markers before surgery and evaluated their association with MINS. Methods: This is a substudy of VISION, a prospective cohort study of perioperative cardiovascular events...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28481998/minimally-invasive-heart-valve-surgery-influence-on-coagulation-and-inflammatory-response%C3%A2
#17
Domenico Paparella, Crescenzia Rotunno, Pietro Guida, Mattia Travascia, Micaela De Palo, Andrea Paradiso, Alessandro Carrozzo, Ruggero Rociola
OBJECTIVES: Minimally invasive valve surgery (MIVS) is associated with improved clinical outcome but longer cardiopulmonary bypass (CPB) time. The aim of the present study is to compare inflammatory and coagulation parameters in patients undergoing minimally invasive or standard valve surgery. METHODS: A prospective non-randomized study was performed enrolling 79 patients undergoing mitral (20 right mini-thoracotomy and 18 standard sternotomy) and aortic valve (20 mini-sternotomy and 21 standard sternotomy) procedures...
May 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28458067/effect-of-liberal-blood-transfusion-on-clinical-outcomes-and-cost-in-spine-surgery-patients
#18
Taylor E Purvis, C Rory Goodwin, Rafael De la Garza-Ramos, A Karim Ahmed, Virginie Lafage, Brian J Neuman, Peter G Passias, Khaled M Kebaish, Steven M Frank, Daniel M Sciubba
BACKGROUND CONTEXT: Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin (Hb) trigger-defined as an intraoperative Hb level of ≥10 g/dL, a postoperative level of ≥8 g/dL, or a whole hospital nadir between 8 and 10 g/dL-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study. PURPOSE: This study aimed to describe the perioperative outcomes and economic cost associated with liberal Hb trigger transfusion among spine surgery patients...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28453901/quasi-static-acoustic-tweezing-thromboelastometry
#19
R G Holt, D Luo, N Gruver, D B Khismatullin
BACKGROUND: Thromboelastography is widely used as a tool to assess the coagulation status of surgical patients. It allows observation of changes in material properties of whole blood, beginning with early stages of clot formation and ending with clot lysis. However, the contact activation of the coagulation cascade at surfaces of thromboelastographic systems leads to inherent variability and unreliability in predicting bleeding or thrombosis risks. OBJECTIVES: To develop acoustic tweezing thromboelastometry as a noncontact method for perioperative assessment of blood coagulation...
April 28, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28449710/effects-of-colloid-pre-loading-on-thromboelastography-during-elective-intracranial-tumor-surgery-in-pediatric-patients-hydroxyethyl-starch-130-0-4-versus-5-human-albumin
#20
Yuanzhi Peng, Jianer Du, Xuan Zhao, Xueyin Shi, Yingwei Wang
BACKGROUND: Volume replacement therapy with colloid is still worth studying in major pediatric surgery with potential risk of bleeding. This study assessed the effects of 6% hydroxyethyl starch (HES) 130/0.4 and 5% Human Albumin (HA) on coagulation tested by thromboelastography (TEG) during elective intracranial tumor surgery in pediatric patients. METHODS: In this randomized controlled trial, 60 patients undergoing intracranial tumor resection under general anesthesia were assigned to HES and HA groups (n = 30), and administered preloads of 20 mL · kg(-1) HES 130/0...
April 27, 2017: BMC Anesthesiology
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