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indications of transfusion in surgery

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https://www.readbyqxmd.com/read/28287015/cost-consequence-analysis-of-two-different-active-flowable-hemostatic-matrices-in-spine-surgery-patients
#1
D Makhija, M Rock, S Ikeme, E Kuntze, J D Epstein, G Nicholson, J S Price, V Patel
OBJECTIVES: A recently published retrospective analysis comparing two different active flowable hemostatic matrices (FLOSEAL and SURGIFLO Kit with Thrombin) showed significantly increased resource use and complications (surgery time, risk of blood product transfusion, and amount of matrix used) with SURGIFLO use compared to FLOSEAL in major spine surgery, and also significantly increased surgical time with SURGIFLO use in severe spine surgery. This analysis was developed as a follow-up to this prior analysis, to evaluate the cost-consequence of using FLOSEAL vs SURGIFLO in major and severe spine surgery...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#2
Sarah E Deery, Katie E Shean, Grace J Wang, James H Black, Gilbert R Upchurch, Kristina A Giles, Virendra I Patel, Marc L Schermerhorn
OBJECTIVE: Whereas sex differences in the pathogenesis, presentation, and outcomes of repair for abdominal aortic aneurysms are well studied, less is known about sex differences after thoracic endovascular aortic repair (TEVAR). The goal of this study was to evaluate the association between sex and morbidity and mortality after TEVAR. METHODS: A retrospective review of all TEVARs in the Society for Vascular Surgery Vascular Quality Initiative (VQI) registry from 2011 to 2015 was conducted, excluding those with dissection, trauma, and rupture...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28249586/serum-lipid-profile-as-a-marker-of-liver-impairment-in-hepatitis-b-cirrhosis-patients
#3
Sadia Qamar Arain, Farah Naz Talpur, Naseem Aslam Channa, Muhammad Shahbaz Ali, Hassan Imran Afridi
BACKGROUND: Chronic HBV infection is a major cause of Cirrhosis and an important risk factor to develop hepatocellular carcinoma. The study is conducted to find out the changes in the lipid metabolism of HBV-cirrhosis patients. METHODS: In the present study, serum lipid profiles of patients with HBV-cirrhosis were assessed by utilizing micro-lab and gas chromatography, while risk factors for transmission of HBV-cirrhosis studied through the standard questionnaire...
March 1, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28241695/-clinical-abservations-of-pulmonary-surfactant-s-autologous-transfusion-in-massive-lung-lavage
#4
X Y Xiao, X P Zhang, G Chen, Y Yuan, G X Ma, J Y Duan, Z Q Sun, J H Huang, X Cao, J Zhang
Objective: Investigate the pulmonary surfactant autotransfusion effect on the recovery of respiratory function in patients with whole lung lavage, to provide theoretical basis for the clinical application. Methods: We taken 30 patients of pneumoconiosis treated by whole lung lavage as the subjects. We extracted the pulmonary surfactant from lavage fluid, after single postoperative lung lavage for the first time; after one weeks when the second times of lung lavage were performed to the other side of the lung of patients, we put PS into the right side...
January 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/28241234/laparoscopic-total-pancreatectomy-with-islet-autotransplantation-and-intraoperative-islet-separation-as-a-treatment-for-patients-with-chronic-pancreatitis
#5
Caleb J Fan, Kenzo Hirose, Christi M Walsh, Michael Quartuccio, Niraj M Desai, Vikesh K Singh, Rita R Kalyani, Daniel S Warren, Zhaoli Sun, Marie N Hanna, Martin A Makary
Importance: Pain management of patients with chronic pancreatitis (CP) can be challenging. Laparoscopy has been associated with markedly reduced postoperative pain but has not been widely applied to total pancreatectomy with islet autotransplantation (TPIAT). Objective: To examine the feasibility of using laparoscopic TPIAT (L-TPIAT) in the treatment of CP. Design, Setting, and Participants: Thirty-two patients with CP presented for TPIAT at a tertiary hospital from January 1, 2013, through December 31, 2015...
February 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28238959/superiority-of-robotic-surgery-for-cervical-cancer-in-comparison-with-traditional-approaches-a-systematic-review-and-meta-analysis
#6
REVIEW
Zhongyu Liu, Xiuli Li, Shuang Tian, Tongyu Zhu, Yuanqing Yao, Ye Tao
OBJECTIVES: To review the safety and effectiveness of da Vinci robotic surgery for cervical cancer in comparison with the traditional open surgery and conventional laparoscopic operation. METHODS: Based on Medline, the Cochrane library, Embase, and the Journal of Robotic Surgery prior to December 30st, 2015, we searched for controlled trials and observational studies. A systematic review with meta-analyses was conducted to compare the clinical efficacy between the da Vinci robotic surgery, open surgery, and laparoscopic surgery for cervical cancer...
February 24, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28235532/massive-blood-loss-in-elective-spinal-and-orthopedic-surgery-retrospective-review-of-intraoperative-transfusion-strategy
#7
Demicha Rankin, Alix Zuleta-Alarcon, Suren Soghomonyan, Mahmoud Abdel-Rasoul, Karina Castellon-Larios, Sergio D Bergese
OBJECTIVE: To evaluate the perioperative dynamics of hematologic changes and transfusion ratio in patients undergoing a major spinal surgery accompanied with massive bleeding defined as blood loss >5 liters. DESIGN: Retrospective cohort study. SETTING: Operating room of a university-affiliated hospital. PATIENTS: Adult patients who underwent elective neurosurgical, orthopedic, or combined spinal surgical procedure between 2008 and 2012...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28231649/optimal-timing-for-hemoglobin-concentration-determination-after-total-knee-arthroplasty-day-1-versus-day-2
#8
Mahdi Yacine Khalfaoui, Charles Godavitarne, Michael C P Wilkinson
Purpose: Postoperative hemoglobin (Hb) determination remains an essential parameter for quantifying blood loss following total knee replacement (TKR) surgery and guiding transfusion practice. In this study we aimed to ascertain the optimal timing for Hb determination postoperatively and assess its relationship to serum hematocrit (Hct). Materials and Methods: This was a retrospective cohort analysis of 61 consecutive patients undergoing preoperative, day 1 and day 2 Hb and Hct concentration determination following TKR surgery...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28222991/perioperative-clopidogrel-is-associated-with-increased-bleeding-and-blood-transfusion-at-the-time-of-lower-extremity-bypass
#9
Douglas W Jones, Marc L Schermerhorn, Benjamin S Brooke, Mark F Conrad, Philip P Goodney, Mark C Wyers, David H Stone
OBJECTIVE: Controversy persists surrounding the perceived bleeding risk associated with perioperative clopidogrel use in patients undergoing lower extremity bypass (LEB). The purpose of this study was to examine the LEB bleeding risk and clinical sequelae associated with clopidogrel. METHODS: All LEBs in the Vascular Quality Initiative (VQI) from 2008 to 2014 were studied. The exposure was perioperative clopidogrel. Primary outcomes were blood transfusion, estimated blood loss ≥500 mL, and reoperation for bleeding...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#10
W Nussbaumer, M Amato, H Schennach, M Astl, C Y Chen, J-S Lin, L Corash, R J Benjamin
BACKGROUND: Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients. METHODS: Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation...
February 15, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28193282/preoperative-embolization-in-patients-with-metastatic-spinal-cord-compression-mandatory-or-optional
#11
Chul Gie Hong, Jae Hwan Cho, Dae Chul Suh, Chang Ju Hwang, Dong-Ho Lee, Choon Sung Lee
BACKGROUND: The contribution of preoperative embolization in reducing intraoperative blood loss and its clinical importance are unclear. So, we aimed to compare the perioperative clinical outcomes based on whether preoperative embolization was performed and assess the role and safety of preoperative embolization in metastatic spinal cord compression (MSCC) patients. METHODS: We enrolled 52 patients (men, 37; women, 15) who underwent palliative decompression for MSCC...
February 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28174536/exploring-the-pharmacokinetic-profile-of-remifentanil-in-mid-trimester-gestations-undergoing-fetal-intervention-procedures
#12
Judith A Smith, Roopali V Donepudi, Pedro S Argoti, Anita L Giezentanner, Ranu Jain, Noemi Boring, Elisa Garcia, Kenneth J Moise
Background: Indications for surgery during pregnancy have increased. Specifically fetal interventions have increased from conditions that were considered lethal like twin-twin transfusion syndrome and severe fetal anemia to non-lethal conditions like myelomeningocele. The optimal anesthetic agent for in utero surgery is yet to be determined. Success of the procedure is often dictated by the efficacy of the anesthetic to immobilize the fetus without over-sedating mom. Remifentanil is used as preferred agent due to its short half-life however pharmacokinetics in pregnancy is unknown...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28151454/effects-of-blood-transfusion-on-oxygen-extraction-ratio-and-central-venous-saturation-in-children-after-cardiac-surgery
#13
Bana Nasser, Mohmad Tageldein, Abdulrahman AlMesned, Mohammad Kabbani
BACKGROUND: Red blood cell transfusion is common in critically ill children after cardiac surgery. Since the threshold for hemoglobin (Hb) transfusion need is not well defined, the threshold Hb level at which dependent critical oxygen uptake-to-delivery (VO2-DO2) status compensation is uncertain. OBJECTIVES: To assess the effects of blood transfusion on the oxygen extraction ratio (O2ER) and central venous oxygen saturation (ScvO2) to identify a critical O2ER value that could help us determine the critical need for blood transfusion...
January 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28151388/peri-operative-treatment-of-anaemia-in-major-orthopaedic-surgery-a-practical-approach-from-spain
#14
REVIEW
Elvira Bisbe, Misericordia Basora, María J Colomina
In patients undergoing major orthopaedic surgery, pre-operative anaemia, peri-operative bleeding and a liberal transfusion policy are the main risk factors for requiring red blood cell transfusion (RBCT). The clinical and economic disadvantages of RBCT have led to the development and implementation of multidisciplinary, multimodal, individualised strategies, collectively termed patient blood management, which aim to reduce RBCT and improve patients' clinical outcome and safety. Within a patient blood management programme, low pre-operative haemoglobin is one of the few modifiable risk factors for RBCT...
January 26, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28149547/video-assisted-versus-conventional-thoracotomy-pneumonectomy-a-comparison-of-perioperative-outcomes-and-short-term-measures-of-convalescence
#15
Yuanqi Liu, Yang Gao, Huajun Zhang, Yuanda Cheng, Ruimin Chang, Weixing Zhang, Chunfang Zhang
BACKGROUND: Pneumonectomy is a proven treatment for lung diseases. We sought to present a comparison between video-assisted thoracic surgery pneumonectomy (VATS-P) and conventional thoracotomy pneumonectomy (CP) on perioperative outcomes and short-term measures of convalescence. METHODS: A retrospective cohort study was performed to assess perioperative outcomes among patients underwent VATS-P and CP. A total of 32 patients undergoing VATS-P were matched 2:1 about comorbidity, surgical indication, tumour size and lesion location to a previous cohort of 64 patients who underwent CP...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28148908/the-treatment-evaluation-for-osteoporotic-kummell-disease-by-modified-posterior-vertebral-column-resection-minimum-of-one-year-follow-up
#16
Da-Long Yang, Si-Dong Yang, Qian Chen, Yong Shen, Wen-Yuan Ding
BACKGROUND The aim of this study was to evaluate the clinical efficacy of modified posterior vertebral column resection (MPVCR) in treating osteoporotic Kummell disease. MATERIAL AND METHODS Between January 2013 and January 2015, 10 patients who were diagnosed with Kummell disease underwent MPVCR treatment, and their medical records were retrospectively collected. Every patient had follow-up for at least one year, with an average of 15 months. Clinical efficacy of MPVCR treatment was evaluated by kyphotic Cobb's angle, Oswestry disability index (ODI) and visual analogue scale (VAS) score...
February 2, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28144727/-non-vitamin-k-dependent-oral-anticoagulants-what-is-important-in-intensive-care-medicine
#17
D C Gulba, L Broscaru
Since first used in 2009, non-vitamin K oral anticoagulants (NOAC) have gained world-wide acceptance. Two groups of NOAC are currently used: the direct thrombin antagonist dabigatran and three direct factor  Xa antagonists apixaban, edoxaban, and ricaroxaban. With their increasing use for prevention of thromboembolism, the probability increases that NOAC-pretreated patients are admitted to emergency departments or intensive care units.The clinical challenge in NOAC preanticoagulated patients is to adequately cope with the given anticoagulated status of such patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28144581/tourniquets-do-not-increase-the-total-blood-loss-or-re-amputation-risk-in-transtibial-amputations
#18
Christian Wied, Peter T Tengberg, Gitte Holm, Thomas Kallemose, Nicolai B Foss, Anders Troelsen, Morten T Kristensen
AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#19
Melissa Schwartz, Kristin Powell
Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28125676/determinants-of-indices-of-cerebral-volume-in-former-very-premature-infants-at-term-equivalent-age
#20
Aurelie Naud, Emmanuelle Schmitt, Maelle Wirth, Jean-Michel Hascoet
Conventional magnetic resonance imaging (MRI) at term equivalent age (TEA) is suggested to be a reliable tool to predict the outcome of very premature infants. The objective of this study was to determine simple reproducible MRI indices, in premature infants and to analyze their neonatal determinants at TEA. A cohort of infants born before 32 weeks gestational age (GA) underwent a MRI at TEA in our center. Two axial images (T2 weighted), were chosen to realize nine measures. We defined 4 linear indices (MAfhlv: thickness of lateral ventricle; CSI: cortex-skull index; VCI: ventricular-cortex index; BOI: bi occipital index) and 1 surface index (VS...
2017: PloS One
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