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Perioperative bleeding

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https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#1
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28314985/the-role-of-new-oral-anticoagulants-in-orthopaedics-an-update-of-recent-evidence
#2
REVIEW
Dimitrios V Papadopoulos, Ioannis Kostas-Agnantis, Ioannis Gkiatas, Andreas G Tsantes, Panagiota Ziara, Anastasios V Korompilias
Rivaroxaban, dabigatran, apixaban and edoxaban are the four available new oral anticoagulants (NOAC) which are currently approved for venous thromboembolism prophylaxis after total hip and knee replacement. Large phase 3 and phase 4 studies comparing NOAC with low molecular weight heparins have shown similar results regarding the efficacy and safety of these two categories of anticoagulants. Management of bleeding complications is a matter of great significance. Three reversal agents have been developed: idarucizumab, andexanet alfa and ciraparantag...
March 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28298793/perioperative-considerations-in-a-patient-with-hemophilia-a-a-case-report-and-review-of-literature
#3
Tuhin Mistry, Neelam Dogra, Kanchan Chauhan, Jigyasa Shahani
Classic hemophilia or hemophilia A is a congenital bleeding diathesis in which the affected individual may present with spontaneous hemorrhage or persistent bleeding even after minor trauma. Knowledge about the disease process, multidisciplinary team approach, and timely management can lead to favorable outcome in these patients. We report management of a child with hemophilia A for suturing of lacerated upper lip mucosa following trauma. A review of literature with recommendations for perioperative management, especially in the setting of emergency surgery, is also provided...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296069/thrombotic-and-bleeding-outcomes-following-perioperative-interruption-of-direct-oral-anticoagulants-in-patients-with-venous-thromboembolic-disease
#4
J Shaw, C de Wit, G Le Gal, M Carrier
BACKGROUND: Direct Oral Anticoagulants (DOACs) are increasingly being used in the setting of venous thromboembolic disease (VTE). There is little evidence to guide the peri-procedural interruption of DOACs in this patient population. A number of studies have evaluated the perioperative interruption of DOACs based on half-life of the anticoagulant and the underlying procedural bleeding risk in patient with atrial fibrillation, but it remains unclear whether these findings can be extended to patients with VTE...
March 12, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28295573/therapeutic-plasma-exchange-for-perioperative-management-of-patients-with-congenital-factor-xi-deficiency
#5
Mohamed S Alsammak, Aneel A Ashrani, Jeffrey L Winters, Rajiv K Pruthi
BACKGROUND: Factor XI (FXI) deficiency (hemophilia C [HEM-C]) is a bleeding disorder with unpredictable severity that correlates poorly with FXI coagulation activity (FXI:C). It poses a perioperative hemostatic management challenge. For US patients with severe disease, fresh frozen plasma (FFP) or, in current use, thawed plasma is the most readily available option but comes with risk of volume overload. We report our experience of using therapeutic plasma exchange (TPE) as an alternative perioperative management strategy...
March 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#6
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28289542/complications-after-pancreaticoduodenectomy-are-associated-with-higher-amounts-of-intra-and-postoperative-fluid-therapy-a-single-center-retrospective-cohort-study
#7
Birte Kulemann, Marianne Fritz, Torben Glatz, Goran Marjanovic, Olivia Sick, Ulrich T Hopt, Jens Hoeppner, Frank Makowiec
BACKGROUND: Perioperative mortality after pancreaticoduodenectomy has decreased significantly in high-volume centers, but morbidity remains high. Restrictive perioperative fluid management may contribute to reduced complication rates after various surgical procedures. The aim of this study was to determine whether there is a correlation between the amount of fluid administered and postoperative complications. We hypothesized that higher amounts of intra- and total fluid is associated with greater postoperative morbidity...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28288056/ottawa-criteria-for-appropriate-transfusions-in-hepatectomy-using-the-rand-ucla-appropriateness-method
#8
Sean Bennett, Alan Tinmouth, Daniel I McIsaac, Shane English, Paul C Hébert, Paul J Karanicolas, Alexis F Turgeon, Jeffrey Barkun, Timothy M Pawlik, Dean Fergusson, Guillaume Martel
OBJECTIVE: Create practice guidelines for the appropriate use of red blood cell transfusions in hepatectomy. BACKGROUND: Hepatectomy is associated with a high prevalence of transfusions. A transfusion can be life-saving, but can be associated with important adverse effects. Given the prevalence, the potential for benefit and harm, and the difficulty in conducting clinical trials, transfusion in hepatectomy is well-suited for a study of appropriateness. METHODS: Using the RAND/UCLA appropriateness method, an international, multidisciplinary expert panel in hepatobiliary surgery, anesthesia, transfusion medicine, and critical care rated a series of 468 perioperative scenarios for transfusion appropriateness...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28283268/perioperative-management-of-vitamin-k-antagonists-in-patients-with-low-thromboembolic-risk-undergoing-elective-surgery-a-prospective-experience
#9
Ana Florencia Becerra, María Teresita Cornavaca, José Ignacio Revigliono, Alejandro Contreras, Ricardo Albertini, Aldo Hugo Tabares
BACKGROUND AND OBJECTIVES: To quantify thromboembolic and bleeding events in patients with low thromboembolic risk, who were chronically receiving vitamin K antagonists and undergoing elective surgery. MATERIAL AND METHODS: A descriptive, prospective, single-center study was conducted between December 2010 and July 2014. Patients aged over 18 years old, chronically anticoagulated with vitamin K antagonists and admitted for elective surgery were included in the study...
March 7, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28283237/duodenal-ulcers-are-a-major-cause-of-gastrointestinal-bleeding-after-cardiac-surgery
#10
Frances Krawiec, Andrew Maitland, Qiuli Duan, Peter Faris, Paul J Belletrutti, William D T Kent
OBJECTIVE: To determine the incidence of gastrointestinal (GI) bleeding in patients after cardiac surgery, assess the perioperative risk factors, and determine the type of GI tract pathology associated with bleeding events. METHODS: At a tertiary referral hospital, all cardiac surgery patients having a postoperative GI bleed from April 2002 to March 2012 were identified. To determine bleeding etiology, only patients requiring endoscopy were included in the analysis...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28282002/the-efficacy-of-dextran-40-as-a-venous-thromboembolism-prophylaxis-strategy-in-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#11
Jason M Foster, Richard Sleightholm, Duncan Watley, Steven Wahlmeier, Asish Patel
The incidence of venous thromboembolism (VTE) in peritoneal malignancies can approach 30 to 50 per cent without prophylaxis. Prophylaxis in cytoreductive surgeries (CRS) presents a challenge to preoperative heparin-based therapy because of an increased risk of coagulopathy and potential for bleeding. Herein, we report the large series of CRS and hyperthermic intraperitoneal chemotherapy receiving dextran-40 prophylaxis. Retrospective chart review of peritoneal malignancies patients undergoing CRS at University of Nebraska Medical Center identified 69 individuals who received dextran-40 between 2010 and 2013...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28281737/early-and-mid-term-results-of-coronary-endarterectomy-influence-of-cardiopulmonary-bypass-and-surgical-techniques
#12
Jae Hang Lee, Cheong Lim, Jun Sung Kim, Kay-Hyun Park
BACKGROUND: Coronary endarterectomy (CE) may be a good option for complete revascularization of diffuse coronary artery diseases, but it has not been widely used because the outcomes have not been definitively identified. This study aims to evaluate the mid-term clinical results of CE and compare the outcomes according to the use of cardiopulmonary bypass (CPB) and the surgical technique used. METHODS: Between 2004 and 2014, 69 cases of coronary endarterectomy were performed in 64 patients...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28277419/complications-after-continuous-posterior-lumbar-plexus-blockade-for-total-hip-arthroplasty-a-retrospective-cohort-study
#13
Catherine W Njathi, Rebecca L Johnson, Ruple S Laughlin, Darrell R Schroeder, Adam K Jacob, Sandra L Kopp
BACKGROUND AND OBJECTIVES: While benefits of regional anesthesia in total hip arthroplasty (THA) are well documented, data describing the incidence of complications related to the use of posterior lumbar plexus blockade for THA remain limited. Our primary aim was to evaluate the incidence of infectious, bleeding, and neurological complications related specifically to the use of continuous posterior lumbar plexus block for elective THA. METHODS: We reviewed the electronic medical records of all adult patients who underwent elective THA with continuous posterior lumbar plexus blockade between December 1, 2004, and April 30, 2015, using the Mayo Clinic Total Joint Registry...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28265728/impact-of-comorbidity-and-prescription-drugs-on-haemorrhage-in-cholecystectomy
#14
J Strömberg, G Sandblom
BACKGROUND: The purpose of the present study was to analyse the impact of patient-related risk factors and medication drugs on haemorrhagic complications following cholecystectomy. METHODS: All cholecystectomies registered in the Swedish population-based Register for Gallstone Surgery and ERCP (GallRiks) were identified. Risk factors for bleeding were assessed by linking data in the GallRiks to the National Patient Register and the Prescribed Drug Register, respectively...
March 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28262568/a-bleeding-assessment-tool-correlates-with-intraoperative-blood-loss-in-children-and-adolescents-undergoing-major-spinal-surgery
#15
Jennifer M Anadio, Peter F Sturm, Johan M Forslund, Sunil Agarwal, Adam Lane, Cristina Tarango, Joseph S Palumbo
Screening laboratory studies for bleeding disorders are of little predictive value for operative bleeding risk in adults. Predicting perioperative bleeding in pediatric patients is particularly difficult as younger patients often have not had significant hemostatic challenges. This issue is distinctly important for high bleeding risk surgeries, such as major spinal procedures. The aim of this study was to determine if the score of a detailed bleeding questionnaire (BQ) correlated with surgical bleeding in pediatric patients undergoing major spinal surgery...
February 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262456/preoperative-use-of-clopidogrel-does-not-affect-outcomes-for-femoral-neck-fractures-treated-with-hemiarthroplasty
#16
Elie S Ghanem, Raveesh D Richard, Nathaniel C H Wingert, James R Gotoff, Jove H Graham, Thomas R Bowen
BACKGROUND: The antiplatelet effect of clopidogrel on blood loss and perioperative complications after surgical intervention remains ambiguous. The purpose of this study was to determine if patients on clopidogrel before hemiarthroplasty for femoral neck fracture are predisposed to greater surgical bleeding and perioperative complications compared with those not taking clopidogrel before surgery. METHODS: We conducted a review of our electronic medical record from 2006-2013 and identified 602 patients who underwent 623 hemiarthroplasty procedures for displaced femoral neck fracture, of which 54 cases (9%) were taking clopidogrel before hospital admission...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28261878/hemodynamic-and-perioperative-management-in-two-different-preclinical-pig-to-baboon-cardiac-xenotransplantation-models
#17
Tanja Mayr, Andreas Bauer, Bruno Reichart, Sonja Guethoff, Uwe Schoenmann, Matthias Längin, Alessandro Panelli, Alexander Kind, Paolo Brenner, Jan-Michael Abicht
BACKGROUND: The perioperative phase of preclinical cardiac xenotransplantations significantly affects the experimental outcome. Moderate or even severe hemodynamic and respiratory impairment occurs frequently in baboons after receiving a cardiac transplant. The perioperative management of such postoperative instability is very demanding, especially in the experimental setting. We compared perioperative changes of hemodynamic and laboratory findings during orthotopic and heterotopic thoracic cardiac xenotransplantations and describe our monitoring, treatment and intensive care...
March 5, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28261426/is-intraoperative-use-of-quikclot-combat-gauze-effective-for-hemostasis-after-total-knee-arthroplasty
#18
Jung Ho Noh, Jae Woo Lee, Young Joon Nam, Ki Yong Choi
BACKGROUND: To assess the hemostatic effect of QuikClot Combat Gauze (QCG) compared to that of standard gauze during cruciate-retaining total knee arthroplasty (TKA). METHODS: Sixty knees underwent TKA using a pneumatic tourniquet in this prospective randomized study. After implantation of the femoral and tibial components and hardening of the bone cement, the tourniquet was deflated and QCG (group 1) or standard gauze (group 2) was packed into the joint cavity for 5 minutes for hemostasis...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28259574/a-comparison-of-results-of-carotid-endarterectomy-in-octogenarians-and-nonagenarians-to-younger-patients-from-the-mid-america-vascular-study-group-and-the-society-for-vascular-surgery-vascular-quality-initiative
#19
Joseph R Schneider, Cheryl R Jackson, Irene B Helenowski, Michael J Verta, Julia B Wilkinson, Stanley Kim, Andrew W Hoel
OBJECTIVE: Carotid endarterectomy (CEA) reduces stroke risk in selected patients. However, CEA risk profile may be different in older patients. We compared characteristics and outcomes of octogenarians and nonagenarians with those of younger patients. METHODS: Deidentified data from CEA patients were obtained from the Society for Vascular Surgery Vascular Quality Initiative (VQI) database. Prior CEA, carotid artery stent, or combined CEA and coronary artery bypass were excluded, yielding 7390 CEAs in octogenarians and nonagenarians (≥80 years of age) and 35,303 CEAs in younger patients (<80 years of age)...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28258021/sartorius-muscle-flaps-perioperative-outcomes-based-on-surgical-specialty
#20
Tammam Obeid, Satinderjit Locham, Isibor Arhuidese, Besma Nejim, Hanaa D Aridi, Mahmoud Malas
OBJECTIVE: Complicated groin wounds often require repair by Sartorius Muscle Flap (SMF). Operating surgical specialty differs based on SMF indication, hospital, and operating surgeon preference. We aim to assess the effect of operating surgical specialty, indication for SMF, and other patient-level factors on 30-day outcomes. METHODS: We collected data on all patients undergoing SMF performed at our institution from 2005-2015, including age, sex, body mass index, comorbidity index (hypertension, diabetes, dyslipidemia, peripheral arterial disease, coronary artery disease), smoking status, history of malignancy, indication for SMF (infection, non-infectious complication, prophylaxis), and operating surgeon's specialty (vascular, plastic, general, other)...
February 28, 2017: Annals of Vascular Surgery
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