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Perioperative coagulation

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https://www.readbyqxmd.com/read/27928666/utility-of-double-endoscopic-intraluminal-operation-for-esophageal-cancer
#1
Makoto Sohda, Hideyuki Saito, Tomonori Yoshida, Yuji Kumakura, Hiroaki Honjyo, Keigo Hara, Daigo Ozawa, Shigemasa Suzuki, Naritaka Tanaka, Makoto Sakai, Tatsuya Miyazaki, Minoru Fukuchi, Hiroyuki Kuwano
OBJECTIVES: Endoscopic submucosal dissection (ESD) is a more difficult technique for esophageal cancer than for gastric cancer because the working space for esophageal ESD is small. Further, the difficulty level gradually increases depending on the size of the carcinoma. To overcome these difficulties, double endoscopic intraluminal operation (DEILO), which enables the resection of mucosal lesions using two fine endoscopes and monopolar shears, was reported previously. Here, we report the utility of DEILO for esophageal cancer...
December 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27894845/thromboelastography-demonstrates-perioperative-hypercoagulability-in-hepato-pancreato-biliary-patients-and-supports-routine-administration-of-preoperative-and-early-postoperative-venous-thromboembolism-chemoprophylaxis
#2
Anh-Thu Le, Jennifer W Harris, Erin Maynard, Sean P Dineen, Ching-Wei D Tzeng
BACKGROUND: We hypothesized hepato-pancreato-biliary (HPB) surgery patients are more likely to be hypercoagulable than hypocoagulable, and that bleeding risks from VTE chemoprophylaxis are low. This study sought to use thromboelastography (TEG) to compare coagulation profiles with bleeding/thrombotic events in HPB patients receiving standardized perioperative chemoprophylaxis. METHODS: Consecutive patients undergoing HPB resections by three surgeons at one institution (January 2014-December 2015) received preoperative and early postoperative VTE chemoprophylaxis and were evaluated with TEGs...
November 25, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27833495/postoperative-pain-management-of-liver-transplantation-in-cystic-fibrosis-is-it-time-to-start-us-guided-neuraxial-blocks
#3
M Piazza, G Martucci, A Arcadipane
Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27833295/successful-penile-reconstruction-following-prior-arteriovenous-loop-thrombosis-due-to-undiagnosed-protein-s-deficiency-and-exogenous-testosterone
#4
Parameswaran Anoop, Vithal Malmande, M N Prakash Kumar, Naveen Rao
Flap failure from microvascular thrombotic occlusion is a rare but significant cause for unsuccessful reconstructive surgery. We encountered thrombosis of arteriovenous loop in a patient undergoing phallus reconstruction. Further investigations revealed underlying previously asymptomatic hypercoagulable state due to protein-S deficiency in addition to long-term exogenous testosterone administration. Role of thrombophilia testing, thrombogenic potential of testosterone and the need for therapeutic perioperative anti-coagulation in such situations are described here...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27824211/spontaneous-omental-bleeding-in-a-20-year-old-patient-with-hemophilia-a-a-rare-cause-for-emergency-laparotomy
#5
V Aumann, C Chiapponi, F Meyer, C Wybranski, C J Bruns, O Jannasch
Spontaneous intraabdominal hemorrhage is a very rare event even in patients with bleeding disorders like hemophilia. Nevertheless this rare case must be considered in patients with coagulopathies presenting with abdominal pain. Prompt radiologic imaging and surgical consultation are of highest priority. Here we report on a 20-year-old patient with moderate hemophilia A, who underwent emergency laparotomy for a spontaneous idiopathic bleeding of the omentum majus. There are few cases in the literature on this sort of event in patients with hemophilia, who mostly suffer from spontaneous joint bleedings...
November 8, 2016: Hämostaseologie
https://www.readbyqxmd.com/read/27821785/anesthetic-considerations-for-surgery-on-the-aortic-arch
#6
REVIEW
Barbara J Wilkey, Nathaen S Weitzel
Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This review discusses intraoperative management from the anesthesiologist's perspective, with particular emphasis on transesophageal echo evaluation and coagulation management.
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27799175/evaluation-of-clinical-practice-in-perioperative-patient-blood-management
#7
D M Baron, P G H Metnitz, T Fellinger, B Metnitz, A Rhodes, S A Kozek-Langenecker
BACKGROUND: Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. METHODS: An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27785858/a-prospective-diagnostic-accuracy-study-evaluating-rotational-thromboelastometry-and-thromboelastography-in-100-patients-with-von-willebrand-disease
#8
D E Schmidt, A Majeed, M Bruzelius, J Odeberg, M Holmström, A Ågren
INTRODUCTION: Rotational thromboelastometry (ROTEM(®) ) and thromboelastography (TEG(®) ) are increasingly used in the perioperative and emergency assessment of bleeding tendencies. The diagnostic value of ROTEM and TEG for von Willebrand disease (VWD) remains to be established. AIM: To investigate whether ROTEM and TEG can discriminate patients with VWD from healthy controls. METHODS: Rotational thromboelastometry and TEG whole blood coagulation profiles were compared between VWD patients (n = 100) and healthy controls (n = 89)...
October 26, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27777753/coagulative-safety-of-epidural-catheters-after-major-upper-gastrointestinal-surgery-advanced-and-routine-coagulation-analysis-in-38-patients
#9
Owain Thomas, Hampus Rein, Karin Strandberg, Ulf Schött
BACKGROUND: The risk of spinal haematoma in patients receiving epidural catheters is estimated using routine coagulation tests, but guidelines are inconsistent in their recommendations on what to do when results indicate slight hypocoagulation. Postoperative patients are prone to thrombosis, and thromboelastometry has previously shown hypercoagulation in this setting. We aimed to better understand perioperative haemostasis by comparing results from routine and advanced tests, hypothesizing that patients undergoing major upper gastrointestinal surgery would be deficient in vitamin K-dependent coagulation factors because of malnutrition, or hypocoagulative because of accumulation of low molecular weight heparin (LMWH)...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27759648/mechanism-and-early-intervention-research-on-ali-during-emergence-surgery-of-stanford-type-a-aad-study-protocol-for-a-prospective-double-blind-clinical-trial
#10
Yi Cheng, Mu Jin, Xiuhua Dong, Lizhong Sun, Jing Liu, Rong Wang, Yanwei Yang, Peirong Lin, Siyu Hou, Yuehua Ma, Yuefeng Wang, Xudong Pan, Jiakai Lu, Weiping Cheng
BACKGROUND: Stanford type-A acute aortic dissection (AAD) is a severe cardiovascular disease demonstrating the characteristics of acute onset and rapid development, with high morbidity and mortality. The available evidence shows that preoperative acute lung injury (ALI) induced by Stanford type-A AAD is a frequent and important cause for a number of untoward consequences. However, there is no study assessing the incidence of preoperative ALI and its independent determinants before Standford type-A AAD surgery in Chinese adult patients...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27749339/comparison-of-seer-sonorheometry-with-rotational-thromboelastometry-and-laboratory-parameters-in-cardiac-surgery
#11
Julie L Huffmyer, Lucas G Fernandez, Cyrus Haghighian, Abdullah S Terkawi, Danja S Groves
BACKGROUND: The Quantra Hemostasis Analyzer is a novel diagnostic device that uses an ultrasound-based technology, sonic estimation of elasticity via resonance (SEER) sonorheometry, to characterize the dynamic changes in viscoelastic properties of a blood sample during coagulation. Cardiac surgery utilizing cardiopulmonary bypass (CPB) is associated with a significant impact on the coagulation system and can result in perioperative coagulopathy. The aim of this study was to correlate SEER sonorheometry results to corresponding rotational thromboelastometry (ROTEM) and laboratory parameters obtained before, during, and after CPB...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27745616/administration-of-coagulation-altering-therapy-in-the-patient-presenting-for-oral-health-and-maxillofacial-surgery
#12
Thomas M Halaszynski
Oral health care providers are concerned with how to manage patients prescribed coagulation-altering therapy during the perioperative/periprocedural period for dental and oral surgery interventions. Management and recommendation can be based on medication pharmacology and the clinical relevance of coagulation factor levels/deficiencies. Caution should be used with concurrent use of medications that affect other components of the clotting mechanisms; prompt diagnosis and any necessary intervention to optimize outcome is warranted...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27740465/perioperative-management-of-a-bilateral-forearm-allograft
#13
M Clerc, J Prothet, T Rimmelé
Composite tissue allotransplantation (CTA) is a complex procedure requiring a multidisciplinary collaboration between surgeons, anesthetists, and transplantation specialists. We will describe the perioperative management of a bilateral forearm allograft performed at our facility. A 40-year-old man who lost both forearms was registered on the transplant waiting list; a suitable graft was available 11months later. Anesthesia required planning for vascular access, hemodynamic monitoring, fluid therapy management and prevention of deep vein thrombosis...
June 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27729708/perioperative-management-of-a-child-with-hypoplastic-left-heart-syndrome-of-the-jehovah-s-witness-faith-presenting-for-hybrid-comprehensive-stage-ii-procedure
#14
Sathappan Karuppiah, Christopher Mckee, Ashley Hodge, Mark Galantowicz, Joseph Tobias, Aymen Naguib
Over the years, there has been a growing recognition of the potential negative sequelae of allogeneic blood products on postoperative outcomes following cardiac surgery. In addition, followers of the Jehovah's Witness (JW) faith have a religious restriction against receiving blood or blood components. Advances in perioperative care, cardiopulmonary bypass (CPB), and surgical technique have minimized the need for allogeneic blood products. Specific blood conservation strategies include maximizing the preoperative hematocrit and coagulation function as well as intraoperative strategies, such as acute normovolemic hemodilution and adjustments of the technique of CPB...
September 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#15
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27722160/monitoring-and-treatment-of-coagulation-disorders-in-end-stage-liver-disease
#16
REVIEW
Fuat H Saner, Carmen Kirchner
BACKGROUND: Patients with end-stage liver disease (ESLD) are assumed to be at high risk of bleeding when undergoing any kind of invasive intervention (any kind of operation, including transplantation or minimally invasive interventions). Both bleeding and thrombosis are associated with a poor outcome. METHODS: A selective literature research was conducted with the following key words: 'cirrhosis', 'coagulation', 'bleeding', 'INR' (international normalized ratio), 'aPTT' (activated partial thromboplastin time), and 'thrombocytopenia'...
August 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27713677/intraoperative-anaphylactic-reaction-is-it-the-floseal
#17
Brianne Bordes, David Martin, Brian Schloss, Allan Beebe, Walter Samora, Jan Klamar, David Stukus, Joseph D Tobias
When hemodynamic or respiratory instability occurs intraoperatively, the inciting event must be determined so that a therapeutic plan can be provided to ensure patient safety. Although generally uncommon, one cause of cardiorespiratory instability is anaphylactic reactions. During anesthetic care, these most commonly involve neuromuscular blocking agents, antibiotics, or latex. Floseal is a topical hemostatic agent that is frequently used during orthopedic surgical procedures to augment local coagulation function and limit intraoperative blood loss...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27671048/-application-of-temporary-balloon-occlusion-of-the-abdominal-aorta-in-the-treatment-of-complete-placenta-previa-complicated-with-placenta-accreta
#18
S H Cui, Y X Zhi, K Zhang, L D Zhang, L N Shen, Y N Gao
Objective: To investigate the value of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa with placenta accreta. Methods: From January 2015 to February 2016, 24 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the abdominal aorta(the study group)before cesarean, and 24 cases of complete placenta previa with placenta accreta did not receive balloon occlusion(the control group). The operation time, intraoperative blood loss, intraoperative blood transfusion volume, the perioperative hemoglobin level, the hysterectomy rate and the related complications were compared retrospectively...
September 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27668331/efficacy-of-intraoperative-cell-salvage-in-decreasing-perioperative-blood-transfusion-rates-in-first-time-cardiac-surgery-patients-a-retrospective-study
#19
Claudia L Côté, Alexandra M Yip, Jeffrey B MacLeod, Bill O'Reilly, Joshua Murray, Maral Ouzounian, Craig D Brown, Rand Forgie, Marc P Pelletier, Ansar Hassan
BACKGROUND: Evidence regarding the safety and efficacy of intraoperative cell salvage (ICS) in transfusion reduction during cardiac surgery remains conflicting. We sought to evaluate the impact of routine ICS on outcomes following cardiac surgery. METHODS: We conducted a retrospective analysis of patients who underwent nonemergent, first-time cardiac surgery 18 months before and 18 months after the implementation of routine ICS. Perioperative transfusion rates, postoperative bleeding, clinical and hematological outcomes, and overall cost were examined...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27660800/impact-of-platelet-rich-plasma-on-arthroscopic-repair-of-small-to-medium-sized-rotator-cuff-tears-a-randomized-controlled-trial
#20
Richard Holtby, Monique Christakis, Eran Maman, Joy C MacDermid, Tim Dwyer, George S Athwal, Kenneth Faber, John Theodoropoulos, Linda J Woodhouse, Helen Razmjou
BACKGROUND: Increased interest in using platelet-rich plasma (PRP) as an augment to rotator cuff repair warrants further investigation, particularly in smaller rotator cuff tears. PURPOSE: To examine the effectiveness of PRP application in improving perioperative pain and function and promoting healing at 6 months after arthroscopic repair of small- or medium-sized rotator cuff tears. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1...
September 2016: Orthopaedic Journal of Sports Medicine
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