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indications of transfusion in surgery

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https://www.readbyqxmd.com/read/29135529/acute-coronary-artery-thrombus-after-tranexamic-acid-during-total-shoulder-arthroplasty-in-a-patient-with-coronary-stents-a-case-report
#1
Kathryn H Bridges, Sylvia H Wilson
Tranexamic Acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29135139/-laparoscopic-transperitoneal-adrenalectomy
#2
B G Guliev, B K Komyakov, D V Semenov
AIM: To analyze the results of laparoscopic adrenalectomy (LAE) in patients with adrenal gland tumors. MATERIALS AND METHODS: From 2011 to 2016, 24 patients (15 men, 9 women), mean age 49.6 +/- 8.2 years, underwent LAE. The right, left and bilateral LAE was performed in 12, 10 and 2 patients, respectively. Indications for surgery were mainly primary and metastatic adrenal tumors. The operations were performed using a transperitoneal 4-port approach. RESULTS: Twenty six LAE were successfully performed in 24 patients...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29130845/restrictive-or-liberal-red-cell-transfusion-for-cardiac-surgery
#3
C David Mazer, Richard P Whitlock, Dean A Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M Carrier, Paul J Young, Juan C Villar, Hilary P Grocott, Manfred D Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M Bagshaw, Nian C Hwang, Chirag Mehta, Thomas W Painter, Colin Royse, Subodh Verma, Gregory M T Hare, Ashley Cohen, Kevin E Thorpe, Peter Jüni, Nadine Shehata
Background The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. Methods In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#4
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29082529/patient-blood-management-knowledge-and-practice-among-clinicians-from-seven-european-university-hospitals-a%C3%A2-multicentre-survey
#5
P M Manzini, A M Dall'Omo, S D'Antico, A Valfrè, K Pendry, A Wikman, D Fischer, D Borg-Aquilina, S Laspina, E C M van Pampus, M van Kraaij, M T Bruun, J Georgsen, J Grant-Casey, P S Babra, M F Murphy, G Folléa, K Aranko
BACKGROUND AND OBJECTIVES: The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. MATERIALS AND METHODS: A web-based questionnaire was sent to 4952 clinicians working in medical, surgery and anaesthesiology disciplines. The responses were analysed, and the overall results as well as a comparison between hospitals are presented...
October 29, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29077977/packed-red-blood-cell-transfusion-in-older-adults-a-systematic-review
#6
Allison R Jones, Gwen McGhan, Jill Deaver
Most packed red blood cell (PRBC) transfusion research focuses on younger patient populations (younger than 65) given the complexity of care and presence of comorbidities in older adults. The purpose of the current study was to critically examine the current evidence related to PRBC transfusion among older adults (age ≥65). PubMed, CINAHL, and Embase were searched for randomized controlled trials that evaluated blood transfusion in any manner (e.g., prevention, associated outcomes). Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the search resulted in 10 studies focused on cardiac, orthopedic, and gastrointestinal surgery patients...
October 27, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29064875/perioperative-patient-blood-management-to-improve-outcomes
#7
Neel Desai, Nick Schofield, Toby Richards
Anemia is common in elective surgery and is an independent risk factor for morbidity and mortality. Historical management of anemia has focused on the use of allogeneic blood transfusion but this in itself is not without risk. It too has been independently associated with morbidity and mortality, let alone the costs and relative shortage of this resource. In recognition of this, patient blood management (PBM) shifts the focus from the product to the patient and views the patient's own blood as a resource that should be conserved and managed appropriately as a standard of care...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29064872/no-differences-in-renal-function-between-balanced-6-hydroxyethyl-starch-130-0-4-and-5-albumin-for-volume-replacement-therapy-in-patients-undergoing-cystectomy-a-randomized-controlled-trial
#8
Tobias Kammerer, Florian Brettner, Sebastian Hilferink, Nikolai Hulde, Florian Klug, Judith Pagel, Alexander Karl, Alexander Crispin, Klaus Hofmann-Kiefer, Peter Conzen, Markus Rehm
BACKGROUND: The use of artificial colloids has declined in critical care, whereas they are still used in perioperative medicine. Little is known about the nephrotoxic potential in noncritically ill patients during routine surgery. The objective of this trial was to evaluate the influences of albumin 5% and balanced hydroxyethyl starch 6% (130/0.4) on renal function and kidney injury. METHODS: One-hundred urologic patients undergoing elective cystectomy were randomly assigned for this prospective, single-blinded, controlled study with two parallel groups to receive either albumin 5% or balanced hydroxyethyl starch 6% (130/0...
October 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29032252/a-comparison-of-industry-leading-energy-devices-for-use-in-gynecologic-laparoscopy-articulating-enseal-versus-ligasure-energy-devices
#9
Linda-Dalal J Shiber, Daniel N Ginn, Ambareen Jan, Jeremy T Gaskins, Shan M Biscette, Resad Pasic
OBJECTIVE: To compare two laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device (ENSEAL® G2, Ethicon) and an electrothermal bipolar vessel sealer (LigasureTM, Covidien) were analyzed for difference in surgeon perception of ease of instrument use and workload using the raw-Task Load Index (RTLX) scale. Secondarily, differences in operative time, estimated blood loss (EBL), and perioperative complication rates between the two devices were examined...
October 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29032064/laparoscopic-and-robotic-assisted-hysterectomy-for-uterine-leiomyomas-a-comparison-of-complications-and-costs
#10
Tin Yan Tina Ngan, Andrew Zakhari, Nicholas Czuzoj-Shulman, Togas Tulandi, Haim Arie Abenhaim
OBJECTIVE: Robotic surgery is increasingly being used for treatment of malignant and benign gynaecologic diseases. The purpose of our study is to compare patient perioperative complications and costs of laparoscopic versus robotic-assisted hysterectomy for uterine leiomyomas. METHODS: A retrospective cohort study using the Nationwide Inpatient Sample database from the United States was conducted, comparing patients who underwent robotic-assisted hysterectomy and laparoscopic hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for uterine fibroids between 2008 and 2012...
October 11, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29027639/robotic-laparoendoscopic-single-site-benign-gynecologic-surgery-a-single-center-experience
#11
J Jayakumaran, K Wiercinski, C Buffington, A Caceres
The da Vinci Xi surgical system was released with several upgrades and modifications compared to the previous robotic generations to facilitate minimal invasive surgery. Herein, we present our preliminary experience of robotic laparoendoscopic single-site gynecologic surgery performed for benign indications with the da Vinci Xi robotic system in a single center. Thirty-five female patients underwent robotic single-site surgery between June 2016 and January 2017. The median console time for hysterectomy with or without salpingo-oophorectomy was 41 min...
October 13, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28991116/incidence-and-operative-factors-associated-with-discretional-postoperative-mechanical-ventilation-after-general-surgery
#12
Juliet J Ray, Meredith Degnan, Krishnamurti A Rao, Jonathan P Meizoso, Charles A Karcutskie, Danielle B Horn, Luis Rodriguez, Richard P Dutton, Carl I Schulman, Roman Dudaryk
BACKGROUND: Mechanical ventilation after general surgery is associated with worse outcomes, prolonged hospital stay, and increased health care cost. Postoperatively, patients admitted to the intensive care unit (ICU) may be categorized into 1 of 3 groups: extubated patients (EXT), patients with objective medical indications to remain ventilated (MED), and patients not meeting these criteria, called "discretional postoperative mechanical ventilation" (DPMV). The objectives of this study were to determine the incidence of DPMV in general surgery patients and identify the associated operative factors...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28975996/laparoscopic-pancreaticoduodenectomy-for-tumors-of-the-head-of-pancreas-10-cases-for-a-single-center-experience
#13
F Caruso, G Alessandri, G Cesana, G Castello, M Uccelli, F Ciccarese, R Giorgi, R Villa, B Scotto, S Olmi
OBJECTIVE: The tumors of the head of the pancreas are one of the leading causes of cancer-related death in Western countries. The current gold standard for these tumors is a Whipple procedure. This procedure did not change in its surgical steps since when it was initially introduced in 1935. More recently, a laparoscopic approach with similar outcomes has been described. The aim of this paper is to describe the laparoscopic surgical technique performed in our unit, reporting single center postoperative outcomes...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28974829/the-influence-of-smoking-on-the-variations-in-carboxyhemoglobin-and-methemoglobin-during-urologic-surgery
#14
Aleksandra Gavrilovska-Brzanov, Mirjana Shosholcheva, Biljana Kuzmanovska, Andrijan Kartalov, Maja Mojsova-Mijovska, Marija Jovanovski-Srceva, Gordana Taleska, Nikola Brzanov, Risto Simeonov, Maja Slaninka Miceska
INTRODUCTION: Surgery is supposed to modulate the production of carbon monoxide by the reduction of heme oxygenase activity or transcriptional regulation of inducible heme oxygenase. On the other hand, the inhalation of tobacco smoke can substantially raise the level of carboxyhemoglobin in the blood. Furthermore, methemoglobin is maintained at a constant level. However, excessive production of methemoglobin relative to total methemoglobin reductase activity results in methemoglobin increase...
June 2017: Medical Archives
https://www.readbyqxmd.com/read/28970690/successful-surgical-procedure-in-a-patient-of-aplastic-anemia-with-platelet-refractoriness-using-cross-match-compatible-platelets
#15
Ritam Chakrabarty, Sudipta Sekhar Das
This case marks the beginning of issuing cross-matched platelet products in Eastern India. A known case of aplastic anemia, on regular transfusion support, now presented with obstructed ventral periumbilical hernia requiring urgent surgical intervention. Platelet count at presentation was 13,000/μL. Platelet cross-matching was done by solid phase method. Ten units of random donor platelets were crossmatched. Five units were compatible and transfused. Counts rose to 84,000/μL after 1 h. Surgery was completed successfully...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28953310/adverse-effects-of-crystalloid-and-colloid-fluids
#16
Robert G Hahn
Guidelines for infusion fluid therapy rarely take into account that adverse effects occur in a dose-dependent fashion. Adverse effects of crystalloid fluids are related to their preferential distribution to the interstitium of the subcutis, the gut, and the lungs. The gastrointestinal recovery time is prolonged by 2 days when more than 2 litres is administered. Infusion of 6-7 litres during open abdominal surgery results in poor wound healing, pulmonary oedema, and pneumonia. There is also a risk of fatal postoperative pulmonary oedema that might develop several days after the surgery...
September 27, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28942541/surgical-site-infections-in-emergency-abdominal-surgery-at-tamale-teaching-hospital-ghana
#17
Stephen Tabiri, Edwin Yenli, Martin Kyere, Theophilus T K Anyomih
BACKGROUND: Surgical site infections (SSIs) result in delayed wound healing, increased use of antibiotics and increased length of hospital stay, putting remarkable physical and financial burden on patients, their relatives and the healthcare facilities. Patient-related factors, such as pre-existing colonization with antibiotic-resistant bacteria, and clinical-related factors, such as adherence to sterile techniques, contribute to the development of SSIs. The objective of this study, therefore, was to determine the SSI rate and risk factors for emergency abdominal surgeries at Tamale Teaching Hospital, Ghana...
September 23, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28938282/efficacy-and-safety-of-tranexamic-acid-in-orthopaedic-fracture-surgery-a-meta-analysis-and-systematic-literature-review
#18
Kamil M Amer, Saqib Rehman, Kamal Amer, Christopher Haydel
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopaedic surgeries. However, the effectiveness of TXA use in orthopaedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28933328/-local-application-of-tranexamic-acid-in-total-hip-arthroplasty-decreases-blood-loss-and-consumption-of-blood-transfusion
#19
J Lošťák, J Gallo, M Večeřa, J Špička, K Langová
PURPOSE OF THE STUDY The primary aim of our study was to identify the effects of local application of tranexamic acid (TXA, Exacyl) on the amount of postoperative blood loss and blood transfusion requirement in primary total hip arthroplasty. We also recorded the levels of postoperative haemoglobin and its drop in early period after surgery. In each patient, we monitored in detail the incidence of early complications (haematoma, wound exudate). Lastly, the economic aspect of TXA administration was also taken into account...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28888685/predictive-factors-of-hospital-stay-mortality-and-functional-recovery-after-surgery-for-hip-fracture-in-elderly-patients
#20
T Pareja Sierra, I Bartolomé Martín, J Rodríguez Solís, L Bárcena Goitiandia, M Torralba González de Suso, M D Morales Sanz, M Hornillos Calvo
OBJECTIVES: Due to its high prevalence and serious consequences it is very important to be well aware of factors that might be related to medical complications, mortality, hospital stay and functional recovery in elderly patients with hip fracture. MATERIAL AND METHODS: A prospective study of a group of 130 patients aged over 75 years admitted for osteoporotic hip fracture. Their medical records, physical and cognitive status prior to the fall, fracture type and surgical treatment, medical complications and functional and social evolution after hospitalization were evaluated...
September 6, 2017: Revista Española de Cirugía Ortopédica y Traumatología
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