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https://www.readbyqxmd.com/read/29302123/bloodless-repair-for-a-3-6-kilogram-transposition-of-the-great-arteries-with-jehovah-s-witness-faith
#1
Jeffery L Burnside, Todd M Ratliff, Ashley B Hodge, Daniel Gomez, Mark Galantowicz, Aymen Naguib
Achieving pediatric cardiac surgery using cardiopulmonary bypass (CPB) without allogeneic blood transfusion is challenging. There are many clinical and economic factors that point to the importance of avoiding blood transfusions. In some instances, honoring patients or parents beliefs may be the reason for avoiding blood transfusions. For example, patients or parents of the Jehovah's Witness faith refuse blood transfusion based on their religious beliefs. Over the last decade, our institution has seen a steady increase in our pediatric Jehovah's Witness patient population...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29284876/dexmedetomidine-versus-magnesium-sulfate-in-anesthesia-for-cochlear-implantation-surgery-in-pediatric-patients
#2
Passaint Fahim Hassan, Amany Hassan Saleh
Context: Cochlear implantation surgery represents a great advance in ENT surgeries. Special anesthetic managements were required to provide bloodless surgical field and monitoring of the facial nerve. Aims: We aimed to compare both dexmedetomidine and magnesium sulfate as regards their efficacy in inducing deliberate hypotension and providing better quality of the surgical field during cochlear implantation in pediatrics. Settings and Design: Prospective, randomized double-blinded study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29258567/knowledge-of-bloodless-medicine-among-nurses-at-the-medical-surgical-directorate-of-komfo-anokye-teaching-hospital-ghana-a-descriptive-cross-sectional-study
#3
Yaa Obirikorang, Christian Obirikorang, Enoch Odame Anto, Emmanuel Acheampong, Emmanuella Nsenbah Batu, Flora Macaulary, Christopher Kwaku Paavire, Bright Amankwaa
OBJECTIVE: This study assessed the knowledge of bloodless medicine (BM) among nurses at the medical and surgical directorate of Komfo Anokye Teaching Hospital. A paper questionnaire was administered to 322 nurses to obtain information on socio-demographic characteristics and knowledge of BM. RESULTS: More than half (52.1%) of the nurses were aware of BM. The major source of information on BM was from the internet. Out of the study population, 90.1% knew iron therapy as BM strategy...
December 19, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29206488/structural-and-functional-evidence-for-the-scaffolding-effect-of-alveolar-blood-vessels
#4
Barry C Gibney, Willi L Wagner, Alexandra B Ysasi, Janeil M Belle, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
A contribution of pulmonary blood distension to alveolar opening was first proposed more than 100 years ago. To investigate the contribution of blood distension to lung mechanics, we studied control mice (normal perfusion), mice after exsanguination (absent perfusion) and mice after varying degrees of parenchymal resection (supra-normal perfusion). On inflation, mean tracheal pressures were higher in the bloodless mouse (4.0 ± 2.5 cm H2O); however, there was minimal difference between conditions on deflation (0...
December 5, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29199481/the-conversational-position-in-endoscopic-pituitary-surgery
#5
Jinendra Ekanayake, Irene Baudracco, Anjum Quereshi, Tom Vercauteren, Neil L Dorward
We describe a novel patient position for endoscopic transphenoidal surgery - the 'conversational position'. This position is a safe and effective alternative to the standard supine position, incorporating a semi-sitting position with the additional innovation of achieving a 'conversational position' by flexing the neck and turning the patient's head turned to face the surgeon. The 'conversational' position offers improvements in the surgical approach to sellar region, addressing specific intraoperative challenges such as maintaining a bloodless operative field, and enabling more intuitive and ergonomic surgical workflow...
December 4, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29147171/recent-progress-of-bypass-surgery-to-the-dialysis-dependent-patients-with-critical-limb-ischemia
#6
Nobuyoshi Azuma, Shinsuke Kikuchi, Hiroko Okuda, Keisuke Miyake, Atsuhiro Koya
According to expansion of dialysis-dependent population, more than half of patients with critical ischemic limbs are dialysis-dependent in Japan. Although patients with end-staged renal disease are well-known as poor life prognosis, well-managed dialysis patients in Japan can survive much longer compared to dialysis patients in the United States and Europe. Therefore, some dialysis patients can enjoy the long-term benefits of bypass surgery. To decide the indication of bypass surgery, patient's general condition, nutrition status, and vein availability are more important rather than arterial disease anatomy...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29141522/perceived-comfort-during-minor-hand-surgeries-with-wide-awake-local-anaesthesia-no-tourniquet-walant-versus-local-anaesthesia-la-tourniquet
#7
Jayaletchumi Gunasagaran, Ee Soon Sean, Sachin Shivdas, Shams Amir, Tunku Sara Ahmad
PURPOSE: Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28985692/comprehensive-blood-conservation-program-in-a-new-congenital-cardiac-surgical-program-allows-bloodless-surgery-for-the-jehovah-witness-and-a-reduction-for-all-patients
#8
Vincent Olshove, Nicole Berndsen, Veena Sivarajan, Pooja Nawathe, Alistair Phillips
BACKGROUND: Cardiac surgery on Jehovah's Witnesses (JW) can be challenging, given the desire to avoid blood products. Establishment of a blood conservation program involving the pre-, intra- and post-operative stages for all patients may lead to a minimized need for blood transfusion in all patients. METHODS: Pre-operatively, all JW patients were treated with high dose erythropoietin 500 IU/kg twice a week. JW patients were compared to matching non-JW patients from the congenital cardiac database, two per JW to serve as control...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28979046/bloodless-repair-of-aortic-arch-with-dual-aortic-cannulation-in-a-jehovah-s-witness-patient
#9
Melinda S Valleley, Kimberly R Glogowski, Kim F Duncan, Andrea Dutoit, Corinna Hagedorn
Various methods for surgical repair of the aortic arch are described throughout the literature with many focused on cannulation techniques and degree of systemic cooling in an effort to reduce postoperative morbidities. Despite advancements in techniques, this surgery is still often associated with higher levels of blood loss and subsequent allogenic blood transfusions. Although blood products can be safely transfused to the majority of patients undergoing repair of the aortic arch, the complexity and risk is further multiplied when the patient is of Jehovah's Witness faith and refuses blood transfusions...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28970635/basics-of-cardiopulmonary-bypass
#10
REVIEW
Manjula Sarkar, Vishal Prabhu
Cardiopulmonary bypass (CPB) provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump. Team effort between surgeon, perfusionist and anaesthesiologist is paramount for the successful use of CPB. However, it also has its share of complications and strategies to reduce these complications are the area of the current research.
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28878585/selective-upper-body-perfusion-technique-for-removal-of-renal-cell-carcinoma-extending-into-the-inferior-vena-cava-and-right-atrium
#11
Selim Aydin, Bora Cengiz, Banu Vural Gokay, Anar Mammadov, Remzi Emiroglu, Saadettin Eskicorapci, Ersin Erek
Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28865632/back-to-basics-pneumatic-tourniquet-use
#12
Lisa Spruce
Pneumatic tourniquets are commonly used in surgeries involving the limbs to achieve a nearly bloodless surgery and an optimal operating field or when administering regional anesthesia during surgery on a limb. Complications can arise from the use of tourniquets, including nerve injuries, pain, compartment syndrome, pressure injuries, chemical burns, and tissue necrosis. More serious injuries-including deep vein thrombosis, thermal damage to tissues, severe ischemic injuries, and rhabdomyolysis-also can occur...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#13
REVIEW
Carlton D Scharman, Debora Burger, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of perioperative and intraoperative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
December 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28789655/efficacy-and-safety-of-a-new-elastic-tourniquet-cuff-in-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#14
O-Sung Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA)...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28742506/bioimpedance-analysis-vs-dexa-as-a-screening-tool-for-osteosarcopenia-in-lean-overweight-and-obese-caucasian-postmenopausal-females
#15
Melpomeni Peppa, Charikleia Stefanaki, Athanasios Papaefstathiou, Dario Boschiero, George Dimitriadis, George P Chrousos
BACKGROUND-OBJECTIVES: We aimed at evaluating the efficiency of a newly developed, advanced Bioimpedance Analysis (BIA-ACC®) device as a screening tool for determining the degree of obesity and osteosarcopenia in postmenopausal women with normal or decreased bone density determined by Dual-Energy X-Ray absorptiometry (DEXA) in a representative sample of Greek postmenopausal women. METHODS: This is a single-gate cross-sectional study of body composition measured by BIA-ACC® and DEXA...
April 2017: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28706378/soft-tissue-damage-during-total-knee-arthroplasty-focus-on-tourniquet-induced-metabolic-and-ionic-muscle-impairment
#16
REVIEW
Constantin Mayer, Alexander Franz, Jan-Frieder Harmsen, Fina Queitsch, Michael Behringer, Johannes Beckmann, Rüdiger Krauspe, Christoph Zilkens
PURPOSE: Advantages of tourniquet use in TKA include benefits for surgeons and patients, varying from a bloodless operation site to a reduced intervention time. The time under ischemia and the reperfusion period are crucial phases for affected soft-tissue, most commonly the extensor mechanism. CASE REPORTS: documented its impact on soft-tissue, ranging from necrotic muscle damage to systemic inflammation. Recently, research regarding tourniquet application patterns discuss clinical outcome parameters in the context of soft-tissue damage, excluding the underlying pathophysiological mechanisms...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28705097/transfusion-refusal-and-the-shifting-limits-of-multicultural-accommodation
#17
Carey DeMichelis
The refusal of blood products by Jehovah's Witness patients has provoked court proceedings, social science research, and contemporary fiction, all of which emphasize a seemingly intractable conflict between religious and secular ways of being. This article takes a different approach, focusing instead on the space that Witness patients have carved out for their accommodation in a major pediatric research hospital. Using discourse analysis and interview data, I map the way moralizing discourses surrounding Witness families have shifted over the past 70 years alongside advancements in bloodless medicine...
July 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28688475/adolf-lorenz-the-bloodless-surgeon-of-vienna
#18
Ahmadreza Afshar, Robert A Kyle, David P Steensma
No abstract text is available yet for this article.
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28580218/cryotherapy-as-a-conservative-treatment-modality-for-gingival-enlargement-in-a-patient-with-sturge-weber-syndrome
#19
Vikender Singh Yadav, Souvik Chakraborty, Shikha Tewari, Nitesh Tewari, Tuhina Ghosh
This case report describes a case of Sturge-Weber syndrome reported for unilateral gingival enlargement and bleeding from gingiva in maxillary left region. Initial treatment in the form of scaling and root planing was done but recurrence was observed after one year of follow up. Instead of performing conventional surgery, an alternative conservative treatment was planned in the form of cryotherapy with the help of closed nitrous oxide probe. Seeing the satisfactory results obtained, cryotherapy can be suggested as an atraumatic, bloodless and effective chair side procedure for treating vascular gingival enlargement...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28560111/clonidine-or-remifentanil-for-adequate-surgical-conditions-in-patients-undergoing-endoscopic-sinus-surgery-a-randomized-study
#20
Laurent Bairy, Marie Vanderstichelen, Jacques Jamart, Edith Collard
BACKGROUND: Deliberate hypotension is one way to achieve a bloodless surgical field in endoscopic sinus surgery (ESS). We compared two anaesthesia regimens to induce deliberate hypotension and attempted to determine the most efficient one. METHODS: Fifty-nine patients undergoing ESS were minimized into two groups. In the CLO group, patients received I.V. sufentanil 0.15 µg/kg together with I.V. clonidine 2-3 µg/kg. In the REMI group, patients received remifentanil at a rate of up to 1 µg/kg/min...
2017: PeerJ
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