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Perioperative anticoagulation

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https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#1
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#2
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28618708/re-impact-of-anticoagulant-and-antiplatelet-drugs-on-perioperative-outcomes-of-robotic-assisted-partial-nephrectomy
#3
Jeffrey A Cadeddu
No abstract text is available yet for this article.
July 2017: Journal of Urology
https://www.readbyqxmd.com/read/28617694/the-spectrum-of-general-surgery-interventions-in-pediatric-patients-with-ventricular-assist-devices
#4
Fady Kamel, Holger Buchholz, Bryan Dicken, Jennifer Conway
Ventricular assist devices (VADs) have positively impacted the management of heart failure. However, they come with a range of complications. Although general surgical complications have been assessed in adults with VADs, there is no study to date that has assessed general surgery intervention in the pediatric population. Fifty-two patients who received VADs from 2005 to 2015 at the Stollery Children's Hospital were assessed for general surgery intervention and anticoagulation status at the time of intervention...
June 13, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28604464/liver-transplantation-in-a-patient-with-antiphospholipid-syndrome-a-case-report
#5
Rachel C Steckelberg, Zarah D Antongiorgi, Randolph H Steadman
Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder characterized by autoantibodies to cell membrane phospholipids. While altered coagulation can complicate end-stage liver disease, there are few reports describing the perioperative management for liver transplantation in recipients with a preexisting hypercoagulable disorder, such as APS. We present a patient with a history of APS, Budd-Chiari syndrome with cirrhosis, hepatopulmonary syndrome, and heparin-induced thrombocytopenia who underwent liver transplantation complicated by hepatic artery thrombosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28601642/comparison-of-citrated-and-fresh-whole-blood-for-viscoelastic-coagulation-testing-during-elective-neurosurgery
#6
E Silverberg, F Tornqvist, T Kander, J Bengzon, C Solomon, J Bonnevier, U Schött
BACKGROUND: Previous viscoelastic haemostatic tests studies have often indicated a hypercoagulative test signal with citrated blood, which could influence clinical decision makings. PURPOSE: The aim of this study was to compare fresh and citrated whole blood using two non-automated viscoelastic ROTEM and Sonoclot tests. Our hypothesis was that citrated blood would demonstrate a hypercoagulative response in this setting, not tested before. METHODS: Perioperative viscoelastic coagulation changes were evaluated with a ROTEM and Sonoclot in 38 patients undergoing elective brain tumor surgery...
June 3, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28589690/perioperative-management-of-new-oral-anticoagulants-in-patients-undergoing-elective-surgery-at-a-tertiary-hospital
#7
Henry Wamala, Ian A Scott, Xenia Caney
BACKGROUND: Increasing numbers of patients receiving new oral anticoagulants (NOACs) are undergoing elective surgery. The extent to which perioperative interruption of NOAC therapy and use of bridging heparin are concordant with best evidence is uncertain. METHODS: Retrospective study of consecutive adult patients undergoing elective surgery at a tertiary hospital between January 1(st) 2014 and June 30(th) 2015 and were receiving NOACs for at least 3 months prior to surgery...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28587360/the-value-of-sonoclot-detection-technology-to-guide-the-clinical-medication-of-the-perioperative-anticoagulation-and-antiplatelet-therapy-in-patients-with-acute-myocardial-infarction-undergoing-emergent-pci
#8
Wu-Xiao Yang, Chun-Lin Lai, Fu-Heng Chen, Ji-Rong Wang, You-Rui Ji, Dong-Xia Wang
The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28584363/new-anticoagulants-and-antiplatelet-agents-in-perioperative-period-recommendations-and-controversies
#9
Abhijit S Nair, Basanth Kumar Rayani
No abstract text is available yet for this article.
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28580867/impact-of-perioperative-anticoagulation-on-artificial-urinary-sphincter-device-survival
#10
Andrew T Blackburne, Brian J Linder, Daniel S Elliott
OBJECTIVE: The aim of this study was to evaluate the impact of perioperative anticoagulation on artificial urinary sphincter (AUS) device outcomes. METHODS: Following institutional review board approval, patients undergoing AUS surgery from 1983 to 2014 were evaluated to assess device survival in patients with warfarin use compared to individuals without warfarin use. Hazard regression analysis was used to determine the association between warfarin use and device outcomes...
June 5, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28576519/pediatric-post-tonsillectomy-hemorrhage-in-the-setting-of-post-transplantation-immunosuppression
#11
Lourdes Quintanilla-Dieck, Sivakumar Chinnadurai, Christopher Wootten, Steven L Goudy, Frank W Virgin
INTRODUCTION: Long-term immunosuppressants form an integral part of therapy for post-transplantation patients. Immunosuppressants may also have an anticoagulant effect, and little is known about their effects on bleeding risk after adenotonsillectomy. Our objective was to investigate whether there is an increased observed rate of post-tonsillectomy hemorrhage in a population of pediatric patients on long-term immunosuppressants after solid organ transplantation, compared to healthy controls...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28570011/effect-of-transcervical-arterial-ligation-on-the-severity-of-postoperative-hemorrhage-after-transoral-robotic-surgery
#12
Mark Kubik, Rajarsi Mandal, William Albergotti, Umamaheswar Duvvuri, Robert L Ferris, Seungwon Kim
BACKGROUND: The value of transcervical arterial ligation during transoral robotic surgery (TORS) as a measure to decrease postoperative bleeding incidence or severity is unclear. METHODS: A retrospective single institution study was performed to identify risk factors for hemorrhage after TORS for oropharyngeal squamous cell carcinoma (SCC). RESULTS: Overall, 13.2% of patients (35/265) experience postoperative hemorrhage. T classification, perioperative use of anticoagulants, surgeon experience >50 cases, and tumor subsite were not predictors of postoperative hemorrhage...
June 1, 2017: Head & Neck
https://www.readbyqxmd.com/read/28561148/-preoperative-preparation-patient-blood-management-what-is-optimal
#13
Patrick Meybohm, Markus M Müller, Kai Zacharowski
Patient Blood Management (PBM) focusses on anemia management, the minimization of (unnecessary) iatrogenic blood loss and the exhaustion of natural tolerance to anemia with rational use of red blood cell transfusion. The focus of the current review article is now the preoperative phase with the following PBM components: management of anemia, pre-transfusion analytics and management of anticoagulants. Preoperative anemia is an independent risk factor for increased perioperative morbidity and mortality. In elective surgery, the causes of anemia should be diagnosed prior to surgery as early as possible, and if indicated, a specific treatment for treatable causes should be initiated...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28549416/management-of-intra-operative-acute-pulmonary-embolism-during-general-anesthesia-a-case-report
#14
Yuanyuan Mao, Shuai Wen, Gezi Chen, Wei Zhang, Yanqiu Ai, Jingjing Yuan
BACKGROUND: Acute pulmonary embolism (APE) can be life-threatening. Early detection is even more difficult for patients under general anesthesia as common symptoms are not available and the pathophysiological course of intra-operative APE is influenced by procedures of surgery and anesthesia, which makes patients under general anesthesia a distinctive group. CASE PRESENTATION: We report a case of APE during orthopedic surgery under general anesthesia. A 64-year-old female with atrial fibrillation and surgical history of varicosity underwent total right hip replacement surgery under general anesthesia...
May 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28544292/perioperative-adverse-events-in-patients-on-continued-anticoagulation-undergoing-photoselective-vaporisation-of-the-prostate-with-the-180-w-greenlight-lithium-triborate-laser
#15
Georgia L Knapp, Venu Chalasani, Henry H Woo
OBJECTIVES: To compare perioperative factors and adverse events (AEs) in men undergoing photoselective vaporisation of the prostate (PVP) with or without continued anticoagulation therapy. PATIENTS AND METHODS: Retrospective review of a PVP database of men treated with the 180-W lithium triborate (LBO) laser from 2010 to 2016. Of 373 men, 59 underwent PVP with continued anticoagulant therapy, which was defined as treatment with heparin, warfarin, clopidogrel, dipyridamol or new oral anticoagulant drugs...
May 2017: BJU International
https://www.readbyqxmd.com/read/28540073/viscoelastic-testing-inside-and-beyond-the-operating-room
#16
REVIEW
Liang Shen, Sheida Tabaie, Natalia Ivascu
Hemorrhage is a major contributor to morbidity and mortality during the perioperative period. Current methods of diagnosing coagulopathy have various limitations including long laboratory runtimes, lack of information on specific abnormalities of the coagulation cascade, lack of in vivo applicability, and lack of ability to guide the transfusion of blood products. Viscoelastic testing offers a promising solution to many of these problems. The two most-studied systems, thromboelastography (TEG) and rotational thromboelastometry (ROTEM), offer similar graphical and numerical representations of the initiation, formation, and lysis of clot...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28526151/novel-anticoagulant-agents-in-the-perioperative-setting
#17
REVIEW
Allyson Lemay, Alan D Kaye, Richard D Urman
An increasing number of oral anticoagulants have become available over the past decade. Each of these agents has differing implications on both regional and neuraxial anesthetic techniques. This article describes the pharmacology, pharmacokinetics, and pharmacodynamics of the most commonly used novel oral anticoagulants (NOACs). It also outlines recent guidelines for the use of NOACs in the perioperative setting, especially with regard to neuraxial anesthesia.
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28520941/risk-factors-for-in-hospital-shunt-thrombosis-and-mortality-in-patients-weighing-less-than-3%C3%A2-kg-with-functionally-univentricular-heart-undergoing-a-modified-blalock-taussig-shunt%C3%A2
#18
Voravit Chittithavorn, Pongsanae Duangpakdee, Chareonkiat Rergkliang, Napat Pruekprasert
OBJECTIVES: To determine the association between several perioperative variables and in-hospital shunt thrombosis and mortality in patients weighing less than 3 kg with functional univentricular heart (UVH) who underwent modified Blalock-Taussig shunt. METHODS: Between January 2006 and February 2016, 85 patients who weighed less than 3 kg with functional UVH and underwent modified Blalock-Taussig shunt were reviewed. In-hospital shunt thrombosis and mortality were the primary outcomes...
May 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28515674/perioperative-management-of-patients-on-direct-oral-anticoagulants
#19
REVIEW
Virginie Dubois, Anne-Sophie Dincq, Jonathan Douxfils, Brigitte Ickx, Charles-Marc Samama, Jean-Michel Dogné, Maximilien Gourdin, Bernard Chatelain, François Mullier, Sarah Lessire
Direct oral anticoagulants (DOACs) have been licensed worldwide for several years for various indications. Each year, 10-15% of patients on oral anticoagulants will undergo an invasive procedure and expert groups have issued several guidelines on perioperative management in such situations. The perioperative guidelines have undergone numerous updates as clinical experience of emergency management has increased and perioperative studies including measurement of residual anticoagulant levels have been published...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28509773/perioperative-management-of-antithrombotic-therapies
#20
Timur Yurttas, Patrick M Wanner, Miodrag Filipovic
PURPOSE OF REVIEW: Perioperative coagulation management is becoming increasingly frequent in the daily routine of the anesthesiologist and with the plethora of new substances on the market also increasingly complex. The perioperative setting poses unique challenges requiring an individualized evaluation and management of antithrombotic therapy. This review shall summarize the newest developments in this domain. RECENT FINDINGS: New data in patients with atrial fibrillation have led to a paradigm change in the perioperative management of antithrombotics...
May 15, 2017: Current Opinion in Anaesthesiology
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