keyword
https://read.qxmd.com/read/38310045/bloodless-management-of-significantly-elevated-transcranial-doppler-velocity-value-in-a-jehovah-s-witness-child-with-sickle-cell-disease-a-tertiary-centre-experience-a-case-report
#1
Chisom Adaobi Nri-Ezedi, Thomas Ulasi, Chilota Chibuife Efobi, John Chinawaeze Aneke, Nwanneka Ugwu, Chinekwu Nwosu
BACKGROUND: Effective management of complications in sickle cell disease (SCD), such as stroke prevention, often necessitates the use of blood transfusions. However, individuals who adhere to the religious tenets of Jehovah's Witnesses strictly abstain from accepting blood transfusions, thereby presenting a formidable challenge in clinical decision-making. CASE REPORT: This is a case of a 3 year old child Jehovah's Witness who was found to have significantly elevated transcranial Doppler (TCD) velocity values between 193 and 203 cm/s, following routine screening...
February 2, 2024: Journal of the National Medical Association
https://read.qxmd.com/read/38175737/clinical-outcomes-blood-utilization-and-ethical-considerations-for-pediatric-patients-in-a-bloodless-medicine-and-surgery-program
#2
JOURNAL ARTICLE
Brian D Lo, Andrew Pippa, Ish'shah Sherd, Andrew V Scott, Ananda J Thomas, Elizabeth A Hendricks, Paul M Ness, Shruti Chaturvedi, Linda M S Resar, Steven M Frank
BACKGROUND: Pediatric patients requesting bloodless care represent a challenging clinical situation, as parents cannot legally refuse lifesaving or optimal interventions for their children. Here, we report clinical outcomes for the largest series of pediatric inpatients requesting bloodless care and also discuss the ethical considerations. METHODS: We performed a single-institution retrospective cohort study assessing 196 pediatric inpatients (<18 years of age) who requested bloodless care between June 2012 and June 2016...
January 2, 2024: Anesthesia and Analgesia
https://read.qxmd.com/read/38144674/major-abdominal-surgery-for-jehovah-s-witnesses-challenge-while-practicing-bloodless-medicine-in-a-middle-income-country
#3
Aleksandra Gavrilovska-Brzanov, Darko Gjambaz, Filip Naumovski, Nikola Brzanov, Marija Jovanovski Srceva, Atanas Sivevski, Kuzmanovska Biljana
We present a 59-year-old female Jehovah's Witness patient transferred from another facility to our tertiary center as an emergency case owing to anemia due to gastrointestinal bleeding. A computed tomography scan and gastroscopy confirmed an invasion of the duodenum by a malignant process. The patient underwent a Whipple procedure and a right hemicolectomy refusing blood transfusion. On the 17th postoperative day, the patient was discharged following a successful surgery. This article's objectives are to first highlight the moral and ethical quandary and then share our surgical experiences with this particular patient population...
2023: SAGE Open Medical Case Reports
https://read.qxmd.com/read/38088615/-re-criminalizing-abortion-returning-to-the-political-with-stories
#4
JOURNAL ARTICLE
George J Annas
Abortion stories have always played a powerful role in advancing women's rights. In the abortion sphere particularly, the personal is political. Following the Court's reversal of Roe v. Wade , abortion politics, and abortion storytelling, take on an even deeper political role in challenging the bloodless judicial language of Dobbs with the lived experience of women.
2023: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://read.qxmd.com/read/37640464/wafer-trial-a-study-protocol-for-a-feasibility-randomised-controlled-trial-comparing-wide-awake-local-anaesthesia-no-tourniquet-walant-to-general-and-regional-anaesthesia-with-tourniquet-for-flexor-tendon-repair
#5
JOURNAL ARTICLE
Muholan Kanapathy, Ryan Faderani, Juliette Bray, Hakim-Moulay Dehbi, Monica Panca, Cecilia Vindrola-Padros, Anjana Prasad, Nicola Burr, Norman R Williams, Yazan Al-Ajam, Waseem Bhat, Jason Wong, Afshin Mosahebi, Dariush Nikkhah
INTRODUCTION: Flexor tendons are traditionally repaired under either general anaesthesia (GA) or regional anaesthesia (RA), allowing for the use of an arm tourniquet to minimise blood loss and establish a bloodless surgical field. However, the use of tourniquets exposes the patient to certain risks, including skin, muscle and nerve injuries. A recent advancement in anaesthesia delivery involves the use of a wide-awake approach where no sedation nor tourniquets are used (wide-awake local anaesthesia no tourniquet (WALANT))...
August 28, 2023: BMJ Open
https://read.qxmd.com/read/37624779/management-and-clinical-outcomes-for-patients-with-gastrointestinal-bleeding-who-decline-transfusion
#6
JOURNAL ARTICLE
Jessica O Asiedu, Ananda J Thomas, Nicolas C Cruz, Ryan Nicholson, Linda M S Resar, Mouen Khashab, Steven M Frank
BACKGROUND: The national blood shortage and growing patient population who decline blood transfusions have created the need for bloodless medicine initiatives. This case series describes the management of gastrointestinal bleed patients who declined allogeneic blood transfusion. Understanding the effectiveness of bloodless techniques may improve treatment for future patients while avoiding the risks and cost associated with transfusion. STUDY DESIGN AND METHODS: A retrospective chart review identified 30 inpatient encounters admitted between 2016 to 2022 for gastrointestinal hemorrhage who declined transfusion due to religious or personal reasons...
2023: PloS One
https://read.qxmd.com/read/37534100/simultaneous-control-of-venous-reservoir-level-and-arterial-flow-rate-in-cardiopulmonary-bypass-with-a-centrifugal-pump
#7
JOURNAL ARTICLE
Hidenobu Takahashi, Takuya Kinoshita, Zu Soh, Shigeyuki Okahara, Satoshi Miyamoto, Shinji Ninomiya, Toshio Tsuji
Cardiopulmonary bypass (CPB) is an indispensable technique in cardiac surgery, providing the ability to temporarily replace cardiopulmonary function and create a bloodless surgical field. Traditionally, the operation of CPB systems has depended on the expertise and experience of skilled perfusionists. In particular, simultaneously controlling the arterial and venous occluders is difficult because the blood flow rate and reservoir level both change, and failure may put the patient's life at risk. This study proposes an automatic control system with a two-degree-of-freedom model matching controller nested in an I-PD feedback controller to simultaneously regulate the blood flow rate and reservoir level...
2023: IEEE Journal of Translational Engineering in Health and Medicine
https://read.qxmd.com/read/37512033/virtually-wall-less-versus-standard-thin-wall-venous-cannula-in-the-minimally-invasive-mitral-valve-surgery-single-center-experience
#8
JOURNAL ARTICLE
Fabrizio Ceresa, Liborio Francesco Mammana, Aurora Leonardi, Augusto Palermo, Francesco Patanè
Background and Objectives : Minimally invasive cardiac surgery (MICS) has been developing since 1996. Peripheral cannulation is required to perform MICS, and good venous drainage and a bloodless field are crucial for the success of this procedure. We assessed the benefits of using a virtually wall-less cannula in comparison with the standard thin-wall cannula in clinical practice. Materials and Methods : Between January 2021 and December 2022, we evaluated 65 elective patients, who underwent isolated minimally invasive mitral valve surgery...
June 29, 2023: Medicina
https://read.qxmd.com/read/37462258/tourniquet-use-for-people-with-peripheral-arterial-disease-undergoing-major-lower-limb-amputations
#9
REVIEW
Ryan Laloo, Madlen Dewi, Brenig L Gwilym, Owen J Richards, Alexander D McLain, Dave Bosanquet
BACKGROUND: At least 7000 major lower limb amputations (MLLAs) are performed in the UK each year, 80% of which are due to peripheral arterial disease (PAD). Intraoperative blood loss can have a deleterious effect on patient outcomes, and its replacement with transfused blood is not without risk. Tourniquets can be used in lower limb surgical procedures to provide a bloodless surgical field, minimise intraoperative blood loss, and reduce perioperative blood transfusion requirements. Although their safety has been demonstrated in certain orthopaedic operations, their use among people with PAD undergoing MLLA remains controversial...
July 18, 2023: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/37363562/lipectomy-for-madelung-disease-using-tumescent-technique-a-cross-sectional-study
#10
JOURNAL ARTICLE
Nguyen Quang Duc, Nguyen Phuong Tien, Nguyen Thanh Tu, Hoang Ngoc Huynh, Le Diep Linh
UNLABELLED: Madelung's disease is a rare disfiguring disorder that affects both function and esthetic appearance in the head and/or shoulder, neck, and arms regions. Lipectomy is typically necessary but such treatment can encounter difficulties due to the large sizes of the tumors, interspersed with important organs in the surrounding region. In this report, the authors evaluate the effectiveness of using tumescent solution in lipectomy to provide a dual treatment of tissue removal for Madelung disease in the head-and-neck region...
June 2023: Annals of Medicine and Surgery
https://read.qxmd.com/read/37334974/comprehensive-management-of-jehovah-s-witness-in-pregnancy
#11
JOURNAL ARTICLE
Fei San Pang, Elvin Yee Fan Liaw, Somsubhra De
Jehovah's Witness (JW) is a denomination of Christianity which has many-fold higher morbidity and mortality compared to the general population as they refuse blood transfusion. Information is scanty regarding guidelines on the optimal approach to pregnant ladies of JW faith. In this review we have attempted to analyse the ways and techniques available which can be used to reduce the morbidity and mortality of these women. In antenatal care, haematological status can be optimised to reduce modifiable risk factors, namely anaemia by parenteral iron therapy from the second trimester onwards especially in patients who do not respond to oral iron therapy...
June 19, 2023: Postgraduate Medical Journal
https://read.qxmd.com/read/37095385/cinnamon-roll-technique-with-walant-for-nipple-reduction
#12
JOURNAL ARTICLE
Jo-Yun Sun, Ching-Hsuan Hu
BACKGROUND: Nipple hypertrophy is a common esthetic problem in Asian women. Many patients are uncomfortable and seek plastic surgeons for correction. Although several reduction methods have been published, the new nipple size is not always decided by patients under conventional anesthesia. We describe a novel cinnamon roll technique with wide-awake local anesthesia no tourniquet (WALANT) to decrease pain, provide a bloodless field and allow on-table discussion of the ideal nipple size during surgery...
April 24, 2023: Aesthetic Plastic Surgery
https://read.qxmd.com/read/37092636/are-italian-nurses-ready-for-patient-blood-management-program-a-national-social-media-survey
#13
JOURNAL ARTICLE
Chiara Barchielli, Sara Landriscina, Sabrina Claudia Castelluzzo, Marco Alaimo
BACKGROUND AND AIM: Blood transfusion is one of the five most overused procedures in healthcare. Patient Blood Management (PBM) is a multimodal and multidisciplinary strategy that aims to properly manage the patient blood. In 2015 the Italian National Blood Centre explicitly mentioned the need for the identification of dedicated nursing staff to implement this approach. The purpose of this study is to investigate if Italian nurses are prepared and willing to implement the PBM. METHODS: We conducted a social media survey that registered 235 respondents from the whole Italian territory over a one-month period (15th of May-15th of June 2020)...
April 24, 2023: Acta Bio-medica: Atenei Parmensis
https://read.qxmd.com/read/37091753/efficient-bloodless-mechanical-thrombectomy-for-massive-dural-sinus-thrombosis-associated-with-covid-19-using-the-12-french-penumbra-lightning-intelligent-aspiration-system
#14
Bradley Bernard, Taylor Maloney, Gregg Shalan, Mougnyan Cox, Ike Thacker
Endovascular treatment for dural sinus thrombosis is typically reserved for a small subset of patients who fail medical management. Conventional neurovascular aspiration catheters are suboptimal for use in dural sinus thrombosis given their relatively small caliber with respect to the large dural sinuses and risk of significant blood loss if continuous suction is applied through the catheter as it traverses patent portions of the large veins. We present a case where the Penumbra Lightning aspiration system, currently approved for thrombectomy in the peripheral and pulmonary vasculature, was successfully used for dural sinus thrombectomy with rapid clinical improvement of the patient...
2023: Proceedings of the Baylor University Medical Center
https://read.qxmd.com/read/36984445/extracorporeal-circulation-and-optic-nerve-ultrasound-a-pilot-study
#15
JOURNAL ARTICLE
Öztürk Taşkın, Ufuk Demir
Background and Objectives : Cardiopulmonary bypass (CPB) is an extracorporeal circuit that provides surgical access to an immobile and bloodless area, allowing for technical and procedural advances in cardiothoracic surgery. CBP can alter the integrity of the blood-brain barrier and cause changes in intracranial pressure (ICP) postoperatively. Optical nerve sheath diameter (ONSD) measurement is among the alternative non-invasive methods for ICP monitoring. In this study, we aimed to evaluate the optic nerve sheath diameter measurements under the guidance of ultrasonography for ICP changes during the extracorporeal circulation process...
February 23, 2023: Medicina
https://read.qxmd.com/read/36930481/the-effect-of-elbow-position-at-the-time-of-tourniquet-inflation-on-clinical-outcomes
#16
JOURNAL ARTICLE
M Ç Engin, Ö Ayik
OBJECTIVE: The aim of this study was to prospectively investigate the effects of elbow position on perioperative and postoperative clinical outcomes during tourniquet inflation. PATIENTS AND METHODS: The patients were divided into two groups based on their elbow position during tourniquet inflation: patients with elbows extended group E (30 patients), patients with flexed elbows group F (30 patients). Both groups were compared in terms of perioperative bloodless surgical field, tourniquet pain, time to onset of pain, and pain in the tourniquet area on the first postoperative day, plus elbow-forearm range of motion deficit on both the perioperative and postoperative first day...
March 2023: European Review for Medical and Pharmacological Sciences
https://read.qxmd.com/read/36907838/a-comparative-study-of-the-hemodynamic-and-clinical-effects-of-using-or-not-tourniquet-in-total-knee-arthroplasty
#17
JOURNAL ARTICLE
Shih-Hsin Hung, Fang-Yao Chiu, Ming Fai Cheng
BACKGROUND: Pneumatic tourniquet is widely used in lower limb surgery to provide a bloodless operating field. Previous studies on total knee arthroplasty (TKA) in which tourniquets have been applied during surgery have reported some vascular and soft tissue complications. Nevertheless, it is still not well known exactly how use of tourniquets contributes to hemodynamics of the lower limb and its clinical relevance following TKA. In this prospective study, we wished to determine whether tourniquet affects the hemodynamics and postoperative healing of the lower limb in the first few weeks and its clinical relevancies following TKA...
March 13, 2023: Journal of the Chinese Medical Association: JCMA
https://read.qxmd.com/read/36852856/effect-of-a-patient-blood-management-program-on-the-appropriateness-of-red-blood-cell-transfusion-and-clinical-outcomes-in-elderly-patients-undergoing-hip-fracture-surgery
#18
JOURNAL ARTICLE
Jong Hun Kim, Hyeon Ju Shin, Hae Sun You, Yoonsun Park, Ki Hoon Ahn, Jae Seung Jung, Seung-Beom Han, Jong Hoon Park
BACKGROUND: Elderly patients with hip fractures frequently receive perioperative transfusions, which are associated with increased morbidity and mortality. This study aimed to evaluate the impact of a patient blood management (PBM) program on the appropriateness of red blood cell (RBC) transfusion and clinical outcomes in geriatric patients undergoing hip fracture surgery. METHODS: In 2018, the revised PBM program was implemented at the Korea University Anam Hospital, Seoul, Republic of Korea...
February 27, 2023: Journal of Korean Medical Science
https://read.qxmd.com/read/36557057/a-brief-history-of-cardiothoracic-surgical-critical-care-medicine-in-the-united-states
#19
JOURNAL ARTICLE
Rafal Kopanczyk, Nicolas Kumar, Amar M Bhatt
Cardiothoracic surgical intensive care has developed in response to advances in cardiothoracic surgery. The invention of the cardiopulmonary bypass machine facilitated a motionless and bloodless surgical field and made operations of increasing complexity feasible. By the mid-1950s, the first successful procedures utilizing cardiopulmonary bypass took place. This was soon followed by the establishment of postoperative recovery units, the precursors to current cardiothoracic surgical intensive care units. These developments fostered the emergence of a new medical specialty: the discipline of critical care medicine...
December 16, 2022: Medicina
https://read.qxmd.com/read/36512958/utilization-and-cost-of-cell-salvage-in-minimally-invasive-myomectomy
#20
JOURNAL ARTICLE
Harold Wu, Bhuchitra Singh, Ting-Tai Yen, Jacqueline Maher, Shreetoma Datta, Katherine Chaves, Brandyn D Lau, Steven Frank, Khara Simpson, Kristin Patzkowsky, Karen Wang
OBJECTIVE: To assess the utilization and cost of intraoperative cell salvage (ICS) in minimally invasive myomectomy. STUDY DESIGN: Retrospective cohort study of patients who underwent minimally invasive myomectomy at a quaternary care academic hospital. Patients were classified into: ICS setup vs no ICS setup, ICS setup with reinfusion vs ICS setup without reinfusion. RESULTS: Of 382 patients who underwent minimally invasive myomectomy, 67 (17...
January 2023: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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