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https://www.readbyqxmd.com/read/29752920/direct-heart-procurement-following-donation-after-circulatory-death-with-ex-situ-reperfusion
#1
Hassiba Smail, Diana Garcia Saez, Ulrich Stock, Hesham Ahmed Hassan, Christopher Bowles, Barlomiej Zych, Prashant N Mohite, Olaf Maunz, Andre R Simon
The most extended technique of Heart procurement from donors after circulatory death (DCD)involves direct procurement and reperfusion in ex situ normothermic platform using Organ Care System (OCS). We describe a modified technique at our institution with rapid donor blood drainage using a cell saver and synchronised perfusion on the OCS.
May 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29734574/sensorineural-hearing-loss-after-spine-surgery-treated-with-hyperbaric-oxygen-therapy-two-case-reports
#2
Eric Goodrich, Richard P Goodrich, Charles A Reese
Acute idiopathic sudden sensorineural hearing loss (ISSNHL) following lumbar spinal surgery is an exceedingly rare phenomenon. This paper presents a case of ISSNHL presenting acutely after lumbar spine decompression and fusion treated with transtympanic steroids and hyperbaric oxygen (HBO₂) therapy. It also presents the ironic case of SSNHL secondary to presumed viral pathology sustained by the patient's operative surgeon who was treated with transtympanic steroids and HBO₂ as well. Proposed etiologies of the patient's ISSNHL include: hypotension, prone operative position, malfitted/malpositioned headrest, microemboli from a cell-saver, and nitrous oxide anesthesia...
March 2018: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29706445/reoperative-complications-following-pediatric-liver-transplantation
#3
Dor Yoeli, Ruth L Ackah, Rohini R Sigireddi, Michael L Kueht, N Thao N Galvan, Ronald T Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
BACKGROUND: The aim of this study is to describe the incidence and impact of reoperation following pediatric liver transplantation, as well as the indications and risk factors for these complications. METHODS: All primary pediatric liver transplants performed at our institution between January 2012 and September 2016 were reviewed. A reoperative complication was defined as a complication requiring return to the operating room within 30 days or the same hospital admission as the transplant operation, excluding retransplantation...
April 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29652744/clinical-pearls-part-3-anaesthetic-management-of-abnormally-invasive-placentation
#4
Vinod Patil, Gamunu Ratnayake, Galina Fastovets, D S Wijayatilake
PURPOSE OF REVIEW: Abnormal placentation is a clinical condition seen increasingly in the pregnant population. It is associated with significant morbidity and mortality, which may be mitigated through robust multidisciplinary care for these patients. The role of maternal critical care for these patients has largely been ignored in the literature. RECENT FINDINGS: Advances in pharmacological management of bleeding with recent publications of large multicentre trials in addition to new technologies in the management of massive obstetric haemorrhage (MOH) have revolutionized the management of abnormal placentation...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29629584/improving-quality-and-safety-in-paediatric-spinal-surgery
#5
F Miyanji, B Greer, S Desai, J Choi, J Mok, M Nitikman, A Morrison
Aims The aim of this study was to evaluate improvements in the quality and safety of paediatric spinal surgery following the implementation of a specialist Paediatric Spinal Surgical Team (PSST) in the operating theatre. Patients and Methods A retrospective consecutive case study of paediatric spinal operations before (between January 2008 and December 2009), and after (between January 2012 and December 2013) the implementation of PSST, was performed. A comparative analysis of outcome variables including surgical site infection (SSI), operating time (ORT), blood loss (BL), length of stay (LOS), unplanned staged procedures (USP) and transfusion rates (allogenic and cell-saver) was performed between the two groups...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29625899/safety-and-feasibility-of-elective-liver-resection-in-adult-jehovah-s-witnesses-the-henri-mondor-hospital-experience
#6
Chetana Lim, Chady Salloum, Francesco Esposito, Alexandros Giakoustidis, Toufic Moussallem, Michael Osseis, Eylon Lahat, Marc Lanteri-Minet, Daniel Azoulay
BACKGROUND: Elective liver resection (LR) in Jehovah's Witness (JW) patients, for whom transfusion is not an option, involves complex ethical and medical issues and surgical difficulties. METHODS: Consecutive data from a LR program for liver tumors in JWs performed between 2014 and 2017 were retrospectively reviewed. A systematic review of the literature with a pooled analysis was performed. RESULTS: Ten patients were included (median age = 61 years)...
April 3, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29616523/short-term-outcome-of-cardiac-surgery-under-cardiopulmonary-bypass-in-patients-who-refuse-transfusion-a-controlled-study
#7
Antonio Reyes Garcia, Gema Vega González, Ricardo Andino Ruiz
BACKGROUND: Although bloodless cardiac surgery has been successfully performed for many years, studies with controls permitting transfusion are few and their results inconclusive. This study compares the outcome of cardiac surgery on Jehovah's Witnesses (JW) refusing transfusion, with that of controls permitting transfusion if required. METHODS: Data from 172 operations in 162 JW were compared with 172 matched controls. Risk factors, preoperative, operative, 48 hour postoperative variables, outcome data and transfusions were recorded...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29602707/neutrophil-extracellular-traps-were-released-during-intraoperative-blood-salvage-in-posterior-lumbar-surgery
#8
Li Zheng, Ming Tian, Ye Zhang, Peng Dong, He Yang
The formation of neutrophil extracellular traps (NETs) has been associated with endothelial damage and severe pulmonary dysfunction. The present study aimed to investigate whether this NETosis occurs during intraoperative blood salvage (IBS), and whether the washing procedures before re-transfusion of autologous blood could remove the NET components, including DNA, histones, and myeloperoxidase. The study was performed using blood samples from 20 patients who underwent posterior lumbar surgery at the Beijing Friendship Hospital...
March 14, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29582746/intraoperative-cell-salvage-with-autologous-transfusion-in-elective-right-or-repeat-hepatectomy-a-propensity-score-matched-case-control-analysis
#9
Thomas Zacharias, Erich Ahlschwede, Nicole Dufour, Florence Romain, Odile Theissen-Laval
BACKGROUND: Liver resection may be associated with substantial blood loss, and cell saver use has been recommended for patients at high risk. We performed a study to compare the allogenic erythrocyte transfusion rate after liver resection between patients who had intraoperative cell salvage with a cell saver device versus patients who did not. Our hypothesis was that cell salvage with autologous transfusion would reduce the allogenic blood transfusion rate. METHODS: Cell salvage was used selectively in patients at high risk for intraoperative blood loss based on preoperatively known predictors: right and repeat hepatectomy...
April 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29575610/a-red-cell-preservation-strategy-reduces-postoperative-transfusions-in-pediatric-heart-surgery-patients
#10
Meena Nathan, Brielle Tishler, Kimberlee Gauvreau, Gregory S Matte, Robert J Howe, Linda Durham, Sharon Boyle, Derek Mathieu, Francis Fynn-Thompson, James A DiNardo, Juan C Ibla
BACKGROUND: Blood transfusion has well-documented adverse effects. As part of a blood conservation initiative at our center, we began routine use of cell saver for all congenital heart surgery performed on cardiopulmonary bypass since 2014. AIMS: This study aimed to compare transfusion rates prior to, and in the first and second year after this initiative. We hypothesized that cell saver use would decrease transfusion requirements in second year after use of the cell saver compared to the pre cell saver group...
March 25, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29528878/hidden-blood-loss-in-posterior-lumbar-fusion-surgery-an-analysis-of-risk-factors
#11
Longfei Wen, Daxiang Jin, Weixing Xie, Yue Li, Weijian Chen, Jinyong Ding, Jixi Xu, Dongcheng Ren
STUDY DESIGN: Descriptive study. OBJECTIVES: This study aimed to evaluate the hidden blood loss (HBL) of patients who underwent lumbar fusion surgery for degenerative spine and to analyze its risk factors. SUMMARY OF BACKGROUND DATA: When planning transfusion strategies, blood loss calculation is important. However, in clinical practice, spine surgeons usually ignore the possibility that a large amount of HBL may occur after lumbar fusion surgery...
May 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29521937/intraoperative-traction-may-be-a-viable-alternative-to-anterior-surgery-in-cerebral-palsy-scoliosis-%C3%A2-100-degrees
#12
Taylor J Jackson, Burt Yaszay, Joshua M Pahys, Anuj Singla, Firoz Miyanji, Suken A Shah, Paul D Sponseller, Peter O Newton, John M Flynn, Patrick J Cahill
BACKGROUND: For large scoliosis, 2 strategies to maximize correction include intraoperative traction and/or anterior release. It is unclear which patients will benefit the most form either approach. The purpose of our study is to compare the radiographic, perioperative clinical outcomes, and health-related quality of life (HRQoL) outcomes of 2 approaches when used in severe neuromuscular scoliosis in the setting of cerebral palsy (CP). METHODS: In total, 23 patients with minimum 2-year follow-up, major curves ≥100 degrees, and in whom treatment included posterior spinal fusion were evaluated...
May 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29504337/red-cell-alloimmunization-in-multitransfused-thalassaemia-major-patients
#13
Shazia Moeen, Nazish Farooq, Romana Irshad, Muhammad Ashfaq, Umer Farooq, Muhammad Idris
BACKGROUND: Lifelong transfusions are life savers for thalassaemia patients but are associated with many complications. Alloimmunization is a major problem for blood banks. Antigens of foreign red blood cells induce the formation of antibodies in patients suffering from thalassaemia. The purpose of this study was to examine the frequency of red cell alloantibodies and to express the type of these antibodies in thalassaemia patients. METHODS: Patients that have received multiple transfusions were included in this study...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29465551/sirolimus-alternative-to-blood-transfusion-as-a-life-saver-in-blue-rubber-bleb-nevus-syndrome-a-case-report
#14
Ke-Ling Wang, Shu-Fang Ma, Ling-Yu Pang, Meng-Na Zhang, Lin-Yan Hu, Meng-Jia Liu, Li-Ping Zou
RATIONALE: Blue rubber bleb nevus syndrome (BRBNS) is a rare disease characterized by multiple venous malformations. The gastrointestinal bleeding and secondary iron deficiency anemia are the most common complications. There are currently no effective treatments for BRBNS. Here, we report a case of successful treatment with a small dose of sirolimus of a BRBN patient with a de novo gene mutation. PATIENT CONCERNS: A 12-year-old female was admitted to our hospital with multiple hemangiomas for 12 years...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29448990/open-abdomen-in-liver-transplantation
#15
T Chan, M S Bleszynski, D S Youssef, M Segedi, S Chung, C H Scudamore, A K Buczkowski
INTRODUCTION: Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared to primary abdominal closure (PAC) at the index transplant operation. METHODS: Retrospective review of all adults undergoing deceased donor liver transplantation (2007-2011) at a single center tertiary care institution...
May 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29439283/replacement-therapy-for-coronary-artery-bypass-surgery-in-patients-with-hemophilia-a-and-b
#16
REVIEW
Theoni Kanellopoulou, Efrosyni Nomikou
There are only a few cases of patients with hemophilia A and B who have undergone coronary artery bypass surgery. High levels of replacement therapy with factor concentrate either with bolus or continuous infusion are usually required pre-operatively and during the first post-operative days in order to maintain the coagulation deficient factor levels greater than 80% of normal. Heparinization during cardiopulmonary bypass appears to be safe and intra-operative blood salvage using cell saver techniques reduce the need for transfusions...
February 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29435595/-blood-management-in-complex-reconstructive-spine-surgery-in-asd-patients-do-effective-measures-to-reduce-bleeding-exist
#17
REVIEW
V Bullmann, M Granitzka
BACKGROUND: Blood management in reconstructive spine surgery is a challenge and must be managed interdisciplinarily. An experienced team of anesthesiologists and spine surgeons needs to work closely together. THERAPY: After optimal preoperative preparation, the patient is given an initial dose of 1000 mg tranexamic acid. The most adequate medium blood pressure is about 80 mm Hg during surgery. The surgeon must watch for subperiosteal preparation and subtle stypsis...
April 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29335900/hypercomplex-pedicle-subtraction-osteotomies-definition-early-clinical-and-radiological-results-and-complications
#18
Pedro Berjano, Andrea Zanirato, Domenico Compagnone, Andrea Redaelli, Marco Damilano, Claudio Lamartina
PURPOSE: To describe hypercomplex pedicle subtraction osteotomies (HyC-PSO) for adult spine deformity with sagittal imbalance in terms of preoperative, intraoperative and postoperative outcomes and complications. METHODS: From a prospective single centre database, patients undergoing PSO between January 2016 and May 2017 were reviewed. HyC-PSO were defined as those in patients with one of the following conditions: sagittal correction > 45° needed at a single level or at 1-3 consecutive vertebrae, more than 60° of total sagittal correction needed and PSO on segments of the spine with congenital deformities...
February 2018: European Spine Journal
https://www.readbyqxmd.com/read/29214459/the-role-of-intraoperative-cell-salvage-system-on-blood-management-in-major-orthopedic-surgeries-a-cost-benefit-analysis
#19
Altuğ Duramaz, Mustafa Gökhan Bilgili, Berhan Bayram, Nezih Ziroğlu, Erdem Edipoğlu, Halil Nadir Öneş, Cemal Kural, Mustafa Cevdet Avkan
INTRODUCTION: The aim of this study was to compare the efficiency and cost of cell salvage systems with allogeneic blood transfusions in patients who had major elective orthopedic surgeries. MATERIALS AND METHODS: Consecutive 108 patients who had intraoperative cell saver (CS) performed routinely constitute the study group. In control group, consecutive 112 patients who were operated without intraoperative CS were investigated. Hemoglobin (Hb) level less than 8 mg/dL was regarded as the absolute transfusion indication...
December 6, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29209789/-novel-aspects-of-the-guidelines-for-hemotherapy-2017-implications-for-anesthesiology
#20
REVIEW
I Pekrul, G Wittmann, P Möhnle
Based on the German Transfusion Law, the periodically updated guidelines "Richtlinien zur Gewinnung von Blut und Blutbestandteilen und zur Anwendung von Blutprodukten" ("Hämotherapierichtlinien") are intended to provide the current knowledge and state of the art of blood transfusion practice in Germany. The novel update 2017 contains relevant changes for blood donation, especially the extension of the exclusion period of persons at risk for sexually transmitted HBV, HCV and HIV diseases to 12 months...
January 2018: Der Anaesthesist
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