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https://www.readbyqxmd.com/read/28062865/-poor-outcome-factors-associated-to-patients-with-lower-digestive-bleeding-in-a-public-hospital
#1
Jorge Luis Rojas-Domínguez, Alvaro Carvallo-Michelena, Alejandro Piscoya, Edson Guzmán
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is an event that has shown an increase in complications and mortality rates in the last decades. Although some factors associated with poor outcome have been identified, there are several yet to be evaluated. OBJECTIVE: To identify risk factors for poor outcome in patients with LGIB in the Hospital Edgardo Rebagliati Martins of Lima, Peru. MATERIAL AND METHODS: A prospective analytic observational cohort study was made, and a census was conducted with all patients with acute LGIB between January 2010 and December 2013...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/27993880/providing-hemostatic-and-blood-conservation-options-for-jehovah-s-witness-patients-in-a-large-medical-system
#2
Yu Bai, Brian S Castillo, Amanda Tchakarov, Miguel A Escobar, Bryan A Cotton, John B Holcomb, Robert E Brown
People of the Jehovah's Witness faith believe that they shall "abstain from blood." Because of this belief, we encounter the challenges from Jehovah's Witness patients who actively seek medical care for themselves and their children, but refuse the transfusion of blood products, which may result in increased morbidity and mortality in this patient population. With the development/availability of new hemostatic/coagulation products and the advances in medical technology, we, in collaboration with our clinical colleagues and our local Jehovah's Witness leadership, have developed a clinical guideline comprising medical protocol and surgical strategy for patients refusing blood products...
December 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27987348/conservative-management-of-post-partum-hemorrhage-secondary-to-placenta-previa-accreta-with-hypogastric-artery-ligation-and-endo-uterine-hemostatic-suture
#3
Melekoglu Rauf, Celik Ebru, Eraslan Sevil, Buyukkurt Selim
AIM: The aim of this study was to investigate maternal and neonatal outcomes of conservative management of post-partum hemorrhage due to placenta previa-accreta using hypogastric artery ligation and endo-uterine hemostatic suture to lower uterine segment. METHODS: The records of 38 patients who were managed conservatively with hypogastric artery ligation and endo-uterine hemostatic suture to control post-partum hemorrhage secondary to placenta previa-accreta between April 2014 and January 2016, were reviewed retrospectively...
December 17, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27938373/pre-hospital-transfusion-of-plasma-in-hemorrhaging-trauma-patients-independently-improves-hemostatic-competence-and-acidosis
#4
Hanne H Henriksen, Elaheh Rahbar, Lisa A Baer, John B Holcomb, Bryan A Cotton, Jacob Steinmetz, Sisse R Ostrowski, Jakob Stensballe, Pär I Johansson, Charles E Wade
BACKGROUND: The early use of blood products has been associated with improved patient outcomes following severe hemorrhage or traumatic injury. We aimed to investigate the influence of pre-hospital blood products (i.e. plasma and/or RBCs) on admission hemostatic properties and patient outcomes. We hypothesized that pre-hospital plasma would improve hemostatic function as evaluated by rapid thrombelastography (rTEG). METHODS: We conducted a prospective observational study recruiting 257 trauma patients admitted to a Level I trauma center having received either blood products pre-hospital or in-hospital within 6 hours of admission...
December 9, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27925685/in-vitro-characterization-of-synthoplate-%C3%A2-synthetic-platelet-technology-and-its-in-vivo-evaluation-in-severely-thrombocytopenic-mice
#5
Meenal Shukla, Ujjal D S Sekhon, Venkaiah Betapudi, Wei Li, DaShawn A Hickman, Christa L Pawlowski, Mitchell R Dyer, Matthew D Neal, Keith R McCrae, Anirban Sen Gupta
BACKGROUND: Platelet transfusion applications face severe challenges due to the limited availability and portability, high risk of contamination and short shelf-life of platelets. Therefore there is significant interest in synthetic platelet substitutes that can render hemostasis while avoiding these issues. Platelets promote hemostasis by injury site-selective adhesion and aggregation, and propagation of coagulation reactions on their membrane. Based on these mechanisms, we have developed a synthetic platelet technology (SynthoPlate(™) ) that integrates platelet-mimetic site-selective 'adhesion' and 'aggregation' functionalities via heteromultivalent surface-decoration of lipid vesicles with Von Willebrand Factor-binding, collagen-binding and active platelet integrin GPIIb-IIIa-binding peptides...
December 7, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27913736/additional-effects-of-topical-tranexamic-acid-in-on-pump-cardiac-surgery
#6
Noppon Taksaudom, Sophon Siwachat, Apichat Tantraworasin
OBJECTIVE: Postoperative bleeding after cardiac surgery is commonly associated with hyperfibrinolysis. This study was designed to evaluate the efficacy of topical tranexamic acid in addition to intravenous tranexamic acid in reducing bleeding in cardiac surgery cases. METHODS: From July 1, 2014 to September 30, 2015, 82 patients who underwent elective on-pump cardiac surgery were randomized into a tranexamic acid group and a placebo group. In the tranexamic acid group, 1 g of tranexamic acid dissolved in 100 mL of normal saline solution was poured into the pericardium during sternal closure; the placebo group had 100 mL of saline only...
December 2, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27901294/performance-of-functional-fibrinogen-thromboelastography-in-children-undergoing-congenital-heart-surgery
#7
Nischal K Gautam, Chunyan Cai, Olga Pawelek, Muhammad B Rafique, Davide Cattano, Evan G Pivalizza
BACKGROUND: Functional Fibrinogen assay of the Thromboelastography (FFTEG), a whole blood viscoelastic hemostatic assay, has been used to estimate fibrinogen levels in adult patients undergoing major surgery but its performance in pediatric patients undergoing cardiac surgery requires evaluation. In this study, we evaluate the correlation between FFTEG parameters and standard laboratory tests for fibrinogen and platelet counts before and after cardiopulmonary bypass in children undergoing repair for congenital heart disease...
November 30, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27895932/coagulation-complications-following-trauma
#8
REVIEW
Wenjun Z Martini
Traumatic injury is one of the leading causes of death, with uncontrolled hemorrhage from coagulation dysfunction as one of the main potentially preventable causes of the mortality. Hypothermia, acidosis, and resuscitative hemodilution have been considered as the significant contributors to coagulation manifestations following trauma, known as the lethal triad. Over the past decade, clinical observations showed that coagulopathy may be present as early as hospital admission in some severely injured trauma patients...
2016: Military Medical Research
https://www.readbyqxmd.com/read/27871586/comparative-effectiveness-of-epsilon-aminocaproic-acid-and-tranexamic-acid-on-postoperative-bleeding-following-cardiac-surgery-during-a-national-medication-shortage
#9
Kevin P Blaine, Christopher Press, Ken Lau, Jan Sliwa, Vidya K Rao, Charles Hill
STUDY OBJECTIVE: The aim of this study was to compare the effectiveness of epsilon-aminocaproic acid (εACA) and tranexamic acid (TXA) in contemporary clinical practice during a national medication shortage. DESIGN: A retrospective cohort study. SETTING: The study was performed in all consecutive cardiac surgery patients (n=128) admitted to the cardiac-surgical intensive care unit after surgery at a single academic center immediately before and during a national medication shortage...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27843336/treatment-of-bleeding-in-acquired-hemophilia-a-with-the-proper-administration-of-recombinant-activated-factor-vii-single-center-study-of-7-cases
#10
Makoto Saito, Minoru Kanaya, Koh Izumiyama, Akio Mori, Tatsuro Irie, Masanori Tanaka, Masanobu Morioka, Masahiro Ieko
Recombinant activated factor VII (rFVIIa) is the bypassing agent used in the first-line hemostatic therapy for acquired hemophilia A (AHA); however, the occurrence of thrombotic complications in rFVIIa-treated AHA patients was recently reported to be 2.9-6.5%. Therefore, the investigation of the proper administration of rFVIIa for AHA is needed. In the present study, we retrospectively investigated the clinical features of AHA with regards to the use of rFVIIa (presence or absence of use and total amount) in 7 AHA patients encountered in our department for 7 years between January 2008 and December 2014...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/27830459/comparison-of-radial-brachial-and-femoral-accesses-using-hemostatic-devices-for-percutaneous-coronary-intervention
#11
Masaya Otsuka, Nobuo Shiode, Yasuhisa Nakao, Yuki Ikegami, Yusuke Kobayashi, Arinori Takeuchi, Ayako Harima, Tadanao Higaki, Kuniomi Oi, Kazuoki Dai, Tomoharu Kawase, Yasuharu Nakama, Kazuyoshi Suenari, Kenji Nishioka, Koyu Sakai, Yuji Shimatani, Yoshiko Masaoka, Ichiro Inoue
Some studies have suggested that radial access (RA) for percutaneous coronary intervention (PCI) reduces vascular complications and bleeding compared to femoral access (FA). The purpose of this study was to investigate the routine use of hemostatic devices and bleeding complications among RA, brachial access (BA), and FA. Between January 2015 and December 2015, 298 patients treated for PCI with RA were compared with 158 patients using BA and 206 patients using FA. The radial sheath was routinely removed with ADAPTY, the brachial sheath with BLEED SAFE, and the femoral sheath with Perclose ProGlide...
November 9, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27825746/comparative-study-of-hybrid-laparoendoscopic-single-site-less-partial-nephrectomy-and-conventional-multiport-laparoscopy
#12
C Redondo, C Esquinas, E Meilán, A García-Tello, I Arance, J C Angulo
OBJECTIVE: To investigate the surgical and oncological outcomes of hybrid laparoendoscopic single-site (LESS) in partial nephrectomy with reusable components compared with multiport laparoscopy. MATERIAL AND METHOD: Hybrid LESS technique with auxiliary 3.5mm trocar (n=20) was compared with conventional multiport laparoscopy (n=26) by a prospective, paired, nonrandomized, and comparative study in partially nephrectomized patients. RESULTS: Follow-up average was 31±18...
November 5, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27805995/rapid-thrombelastography-thresholds-for-goal-directed-resuscitation-of-patients-at-risk-for-massive-transfusion
#13
Peter M Einersen, Ernest E Moore, Michael P Chapman, Hunter B Moore, Eduardo Gonzalez, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Uncontrolled hemorrhage is a leading cause of mortality after trauma accounting for up to 40% of deaths. Massive transfusion protocols offer a proven benefit in resuscitation of these patients. Recently, the superiority of thrombelastography (TEG)-guided resuscitation over strategies guided by conventional clotting assays has been established. We seek to determine optimal thresholds for rapid (r)-TEG driven resuscitation. METHODS: The r-TEG data were reviewed for 190 patients presenting to our level 1 trauma center from 2010 to 2015...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27800187/the-use-of-thrombopoietin-receptor-agonists-for-correction-of-thrombocytopenia-prior-to-elective-procedures-in-chronic-liver-diseases-review-of-current-evidence
#14
REVIEW
Kamran Qureshi, Shyam Patel, Andrew Meillier
Patients with chronic liver diseases (CLD) undergo a range of invasive procedures during their clinical lifetime. Various hemostatic abnormalities are frequently identified during the periprocedural work-up; including thrombocytopenia. Thrombocytopenia of cirrhosis is multifactorial in origin, and decreased activity of thrombopoietin has been identified to be a major cause. Liver is an important site of thrombopoietin production and its levels are decreased in patients with cirrhosis. Severe thrombocytopenia (platelet counts < 60-75,000/µL) is associated with increased risk of bleeding with invasive procedures...
2016: International Journal of Hepatology
https://www.readbyqxmd.com/read/27757554/thromboelastometry-guided-fibrinogen-replacement-therapy-in-cardiac-surgery-a-retrospective-observational-study
#15
Francesco Vasques, Luca Spiezia, Alberto Manfrini, Vincenzo Tarzia, Dario Fichera, Paolo Simioni, Gino Gerosa, Carlo Ori, Guido Di Gregorio
This retrospective, observational study compared the impact of a point-of-care rotational thromboelastometry (ROTEM(®)) method versus conventional bleeding management in terms of postoperative (24-h) blood loss, intraoperative and postoperative (24-h) transfusion requirement and length of stay in the postoperative intensive care unit (ICU) in patients undergoing cardiac surgery. Forty consecutive patients undergoing cardiac surgery under ROTEM(®)-guided hemostatic management were enrolled; the control population included 40 selected patients undergoing similar interventions without ROTEM(®) monitoring...
October 18, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27756373/dieulafoy-lesion-in-a-two-year-old-boy-a-case-report
#16
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27745621/damage-control-resuscitation-for-catastrophic-bleeding
#17
REVIEW
Chase L Andreason, Timothy H Pohlman
The timely recognition of shock secondary to hemorrhage from severe facial trauma or as a complication of complex oral and maxillofacial surgery presents formidable challenges. Specific hemostatic disorders are induced by hemorrhage and several extreme homeostatic imbalances may appear during or after resuscitation. Damage control resuscitation has evolved from massive transfusion to a more complex therapeutic paradigm that includes hemodynamic resuscitation, hemostatic resuscitation, and homeostatic resuscitation...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27743710/is-one-size-fits-all-strategy-adequate-for-platelet-storage
#18
Ibrahim Eker, Soner Yilmaz, Rıza Aytac Cetinkaya, Aytekin Unlu, Aysel Pekel, Cengizhan Acikel, Sebahattin Yilmaz, Orhan Gursel, İsmail Yaşar Avci
BACKGROUND: Platelet suspensions (PSs) are stored at room temperature. However, recent reports show that PSs stored at 4 °C possess superior hemostatic properties. We compared the viabilities and thrombin generation capacities of PSs stored either at 4 °C or 22 °C hours. MATERIALS AND METHODS: Twenty units of apheresis derived platelets (ADPs) from 20 male donors and 20 units of random platelet suspensions (RPSs) from another 20 male donors were obtained...
December 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27718296/which-type-of-placenta-previa-requires-blood-transfusion-more-frequently-a-new-concept-of-indiscernible-edge-total-previa
#19
Yosuke Baba, Hironori Takahashi, Akihide Ohkuchi, Rie Usui, Shigeki Matsubara
AIM: During cesarean section (CS) for placenta previa (PP), the size/area/portion of the lower uterine segment occupied by the placenta may affect the bleeding amount and the subsequent need for a blood transfusion (BT). We propose a new concept, indiscernible edge total PP (IEPP), when vaginal ultrasound does not discern the lower placental edge because the placenta covers the visible lower segment. We characterized IEPP, focusing on its allogeneic BT requirement. METHODS: We classified PP (n = 307) into four types: marginal, partial, discernible edge total PP (DEPP) and IEPP: internal ostium (os)-placental edge distance measurable or unmeasurable on vaginal ultrasound in DEPP or IEPP, respectively...
November 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27716278/a-systematic-review-on-the-rotational-thrombelastometry-rotem%C3%A2-values-for-the-diagnosis-of-coagulopathy-prediction-and-guidance-of-blood-transfusion-and-prediction-of-mortality-in-trauma-patients
#20
REVIEW
Precilla V Veigas, Jeannie Callum, Sandro Rizoli, Bartolomeu Nascimento, Luis Teodoro da Luz
INTRODUCTION: Viscoelastic assays have been promoted as an improvement over traditional coagulation tests in the management of trauma patients. Rotational thromboelastometry (ROTEM®) has been used to diagnose coagulopathy and guide hemostatic therapy in trauma. This systematic review of clinical studies in trauma investigates the ROTEM® parameters thresholds used for the diagnosing coagulopathy, predicting and guiding transfusion and predicting mortality. METHODS: Systematic literature search was performed using MEDLINE, EMBASE and Cochrane databases...
October 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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