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Perioperative coagulation

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https://www.readbyqxmd.com/read/28922233/endoscopic-versus-open-repair-for-craniosynostosis-in-infants-using-propensity-score-matching-to-compare-outcomes-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#1
Douglas R Thompson, David Zurakowski, Charles M Haberkern, Paul A Stricker, Petra M Meier
BACKGROUND: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28901992/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-elderly
#2
Sibylle Kozek-Langenecker, Christian Fenger-Eriksen, Emmanuel Thienpont, Giedrius Barauskas
: The risk for postoperative venous thromboembolism (VTE) is increased in patients aged more than 70 years and in elderly patients presenting with co-morbidities, for example cardiovascular disorders, malignancy or renal insufficiency. Therefore, risk stratification, correction of modifiable risks and sustained perioperative thromboprophylaxis are essential in this patient population. Timing and dosing of pharmacoprophylaxis may be adopted from the non-aged population. Direct oral anti-coagulants are effective and well tolerated in the elderly; statins may not replace pharmacological thromboprophylaxis...
September 9, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28881707/intratumoral-coagulation-by-radiofrequency-ablation-facilitated-the-laparoscopic-resection-of-giant-hepatic-hemangioma-a-surgical-technique-report-of-two-cases
#3
Shaohong Wang, Jun Gao, Mengmeng Yang, Shan Ke, Xuemei Ding, Jian Kong, Li Xu, Wenbing Sun
BACKGROUND: Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5...
August 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28876572/haemoperitoneum-secondary-to-snake-bite
#4
S Rahim
BACKGROUND: Literature supports that very rarely the venom of "Hemotoxic Snake" (Russell's Vipers) affect haemostasis by secreting thrombin-like enzyme which promotes formation of unstable clots. Such clots could lead to fibrin deposition in micro circulation that in turn consume platelets and coagulation factors (consumption coagulopathy). Clinical presentation is mainly spontaneous bleeding and coagulopathy. In this case the significant effects of altered coagulation were observed in retropetitoneum and the patient presented in casuality as acute abdomen...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28870850/hypoprothrombinemia-and-severe-perioperative-haemorrhagic-complications-in-cardiac-surgery-patients-treated-with-high-dose-cefazolin-for-infective-endocarditis
#5
Emeline Angles, Christine Mouton, Justine Perino, Alain Remy, Alexandre Ouattara
Endocarditis is a serious and common disease that requires prolonged antimicrobial therapy. The recent shortage of oxacillin has led to the use of other antimicrobial agents such as cefazolin to treat endocarditis due to methicillin-sensitive Staphylococcus aureus. We describe four cases of life-threatening haemorrhagic complications (fatal in two cases) in patients treated with high-dose cefazolin. All of these patients with major bleeding presented with hypoprothrombinemia secondary to hypovitaminosis K. This adverse event may be due to inhibition of vitamin K epoxide reductase and/or gamma-glutamyl-carboxylase by the 2-methyl-1,2,3-thiadiazol-5-thiol group of cefazolin...
September 1, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28866059/revascularization-operation-for-moyamoya-disease-with-concurrent-von-willebrand-disease-a-case-report
#6
Kenji Miki, Koichi Arimura, Ataru Nishimura, Koji Yoshimoto, Tetsuro Sayama, Koji Iihara
BACKGROUND: Although extracranial-intracranial (EC-IC) bypass is an effective treatment strategy for symptomatic moyamoya disease, surgeons need to be cautious regarding the possibility of postoperative hemorrhagic complications in patients with a concurrent coagulation disorder. Here, we describe a case of EC-IC bypass for moyamoya disease concurrent with von Willebrand disease (vWD) type 1. CASE DESCRIPTION: Following perioperative replacement of the von Willebrand factor (vWF), the patient showed an uneventful and uncomplicated clinical course...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28856946/spontaneous-hit-syndrome-post-knee-replacement-surgery-with-delayed-recovery-of-thrombocytopenia-a-case-report-and-literature-review
#7
Dilli Ram Poudel, Sushil Ghimire, Rashmi Dhital, Daniel A Forman, Theodore E Warkentin
Recently published reports have established a heparin-induced thrombocytopenia (HIT)-mimicking thromboembolic disorder without proximate heparin exposure, called spontaneous HIT syndrome. Although the pathophysiology remains unclear, anti-platelet factor 4 (PF4)/heparin antibodies possibly triggered by exposure to knee cartilage glycosaminoglycans or other non-heparin polyanions found on bacterial surfaces and nucleic acids have been postulated. We present a 53-year-old female receiving antithrombotic prophylaxis with aspirin following right total knee replacement surgery (without perioperative or any previous lifetime heparin exposure) who acutely presented with high-risk pulmonary embolism (PE) and right great saphenous vein thrombophlebitis on postoperative day (POD) 14; her platelet count at presentation was 13 × 10(9)/L...
September 2017: Platelets
https://www.readbyqxmd.com/read/28853010/coagulation-after-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-a-retrospective-cohort-analysis
#8
Heather Hurdle, Graeme Bishop, Andrew Walker, Afra Moazeni, Elizabeth Oddone Paloucci, Walley Temple, Lloyd Mack, Molly Shing
PURPOSE: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) benefit patients with peritoneal carcinomatosis. Nevertheless, this therapy is associated with considerable postoperative pain due to the extensive abdominal incision. While epidural analgesia offers efficacious pain control, CRS and HIPEC therapy is associated with perioperative coagulopathy that may impact its use. The purpose of this retrospective study is to characterize the postoperative coagulopathy in this patient subset and to develop a model that will help predict those at risk...
August 29, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28844370/technology-is-there-sufficient-evidence-to-change-practice-in-point-of-care-management-of-coagulopathy
#9
REVIEW
Michael Fabbro, Anne M Winkler, Jerrold H Levy
Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evidence that algorithmic transfusion using point-of-care (POC) testing can reduce red cell and platelet transfusions and major bleeding after cardiac surgery. Integrating these tests during cardiac surgery and trauma management is especially important because these groups use the most blood products within a health system and the risks of transfusion are well documented...
May 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28839987/effect-of-huisheng-oral-solution-on-coagulation-function-in-perioperative-period-in-patients-with-primary-lung-cancer
#10
Xiaoguang Yang, Helin Zhang, Fanyi Kong, Guochen Wang, Qianyu Gu, Zheng Zhao, Tiezhi Li, Mingming Ren, Zuosheng Li, Yang Guo
BACKGROUND: The incidence of venous thromboembolism (VTE) is about 4-10% in lung cancer patients. Huisheng oral solution (HSOS) has been previously demonstrated to inhibit carageenan induced acute thrombosis in rats, reduce the incidence of thrombosis in the lungs and mesentery of tumor-bearing mice and inhibit tumor cell metastasis. The purpose of this study was to assess the anticoagulant effect of HSOS in lung cancer patients in the perioperative period. METHODS: This study was a multicenter, randomized, single-blind, blank-controlled clinical trial...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28838728/perioperative-use-of-coagulation-factor-concentrates-in-patients-undergoing-cardiac-surgery
#11
REVIEW
Mark M Smith, Elena Ashikhmina, Nathan J Brinkman, David W Barbara
Coagulopathy and bleeding are common in patients undergoing cardiac surgery, with a perioperative transfusion rate in excess of 50%. The mechanism of coagulopathy associated with cardiac surgery using cardiopulmonary bypass is multifactorial. Historically, coagulation factor-mediated bleeding in such instances has been treated with allogeneic plasma transfusion. Coagulation factor concentrate use for treatment of hemophilia, congenital factor deficiencies and, more recently, emergency warfarin reversal is common...
May 10, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28830476/comparison-of-continuous-infusion-versus-bolus-injection-of-factor-concentrates-for-blood-management-after-total-knee-arthroplasty-in-patients-with-hemophilia
#12
Young Shil Park, Won-Ju Shin, Kang-Il Kim
BACKGROUND: Total knee arthroplasty (TKA) has become the treatment of choice for end-stage hemophilic arthropathy of the knee. Theoretically in hemophilia A, perioperative continuous infusion (CI) of factor VIII (FVIII) would provide a more consistent FVIII level than general bolus injections (BI) in TKA. Current study was designed to evaluate the effectiveness of CI of coagulation factor concentrates during the perioperative period compared to BI. METHODS: A total of 42 TKAs were performed in 31 patients with severe hemophilia A...
August 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28803771/perioperative-management-of-patients-with-end-stage-renal-disease
#13
REVIEW
Hirotsugu Kanda, Yuji Hirasaki, Takafumi Iida, Megumi Kanao-Kanda, Yuki Toyama, Takashi Chiba, Takayuki Kunisawa
End-stage renal disease (ESRD) is associated with significant alterations in cardiovascular function; homeostasis of body fluid, electrolytes, and acid-base equilibrium; bone metabolism, erythropoiesis; and blood coagulation. The prevalence of ESRD is increasing rapidly worldwide, as is the number of patients requiring surgery under general anesthesia. Patients with ESRD have significantly higher risks of perioperative morbidity and mortality due to multiple comorbidities. The perioperative management of patients with ESRD under general anesthesia therefore requires special considerations and a careful multidisciplinary approach...
April 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28795966/the-coagulation-profile-of-end-stage-liver-disease-and-considerations-for-intraoperative-management
#14
Katherine T Forkin, Douglas A Colquhoun, Edward C Nemergut, Julie L Huffmyer
The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging...
August 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28794370/the-successful-prevention-of-thromboembolism-using-rivaroxaban-in-a-patient-with-antithrombin-deficiency-during-the-perioperative-period
#15
Hidetsugu Kawai, Hiromichi Matsushita, Hiroshi Kawada, Yoshiaki Ogawa, Kiyoshi Ando
Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients. We herein report the case of a 90-year-old woman with AT deficiency who was safely and successfully managed using rivaroxaban (a direct oral factor Xa inhibitor) during the perioperative period of surgery for right femur fracture...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28746233/preoperative-thromboelastometry-for-the-prediction-of-increased-chest-tube-output-in-cardiac-surgery-a-retrospective-study
#16
Waldemar Gozdzik, Barbara Adamik, Grzegorz Wysoczanski, Anna Gozdzik, Maciej Rachwalik, Tomasz Skalec, Andrzej Kübler
Bleeding following cardiac surgery is a serious event with potentially life-threatening consequences. Preoperative recognition of coagulation abnormalities and detection of cardiopulmonary bypass (CPB) related coagulopathy could aid in the start of preventive treatment strategies that minimize perioperative blood loss. Most algorithms that analyze thromboelastometry coagulation tests in elective cardiac surgery do not include test results performed before surgery. We evaluated preoperative rotational thromboelastometry test results for their ability to predict blood loss during and after cardiac surgery...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#17
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
October 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28715503/effects-of-preoperative-aspirin-on-perioperative-platelet-activation-and-dysfunction-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-prospective-randomized-study
#18
Jiwon Lee, Chul-Woo Jung, Yunseok Jeon, Tae Kyong Kim, Youn Joung Cho, Chang-Hoon Koo, Yoon Hyeong Choi, Ki-Bong Kim, Ho Young Hwang, Hang-Rae Kim, Ji-Young Park
The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate® analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups...
2017: PloS One
https://www.readbyqxmd.com/read/28700983/intratumoral-coagulation-by-radiofrequency-ablation-facilitated-the-laparoscopic-resection-of-giant-hepatic-hemangioma-a-surgical-technique-report-of-two-cases
#19
Shaohong Wang, Jun Gao, Mengmeng Yang, Shan Ke, Xuemei Ding, Jian Kong, Li Xu, Wenbing Sun
BACKGROUND: Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28683994/the-effects-of-steroids-on-coagulation-dysfunction-induced-by-cardiopulmonary-bypass-a-steroids-in-cardiac-surgery-sirs-trial-substudy
#20
RANDOMIZED CONTROLLED TRIAL
Domenico Paparella, Alessandro Parolari, Crescenzia Rotunno, Jessica Vincent, Veronica Myasoedova, Pietro Guida, Micaela De Palo, Vito Margari, Philip J Devereaux, Andre Lamy, Francesco Alamanni, Salim Yusuf, Richard Whitlock
Cardiopulmonary bypass (CPB) surgery, despite heparin administration, elicits activation of coagulation system resulting in coagulopathy. Anti-inflammatory effects of steroid treatment have been demonstrated, but its effects on coagulation system are unknown. The primary objective of this study is to assess the effects of methylprednisolone on coagulation function by evaluating thrombin generation, fibrinolysis, and platelet activation in high-risk patients undergoing cardiac surgery with CPB. The Steroids In caRdiac Surgery study is a double-blind, randomized, controlled trial performed on 7507 patients worldwide who were randomized to receive either intravenous methylprednisolone, 250 mg at anesthetic induction and 250 mg at initiation of CPB (n = 3755), or placebo (n = 3752)...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
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