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aneurysm blood transfusion

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https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#1
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28183559/factors-associated-with-blood-transfusion-during-intracranial-aneurysm-surgery
#2
Jessica N Yee, Antoun Koht, Robert J McCarthy, John F Bebawy
STUDY OBJECTIVE: The purpose of this study was to identify risk factors associated with intraoperative blood transfusions in patients presenting for intracranial aneurysm surgery in the current era of more restrictive transfusion guidelines. DESIGN: Retrospective observational cohort study with stepwise, multivariate binary logistic regression analysis. SETTING: Tertiary care university teaching hospital. PATIENTS: Four hundred seventy-one consecutive patients undergoing intracranial aneurysm surgery at Northwestern Memorial Hospital (Chicago, IL) from 2006 to 2012...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28169942/rbc-transfusion-improves-cerebral-oxygen-delivery-in-subarachnoid-hemorrhage
#3
Rajat Dhar, Allyson R Zazulia, Colin P Derdeyn, Michael N Diringer
OBJECTIVES: Impaired oxygen delivery due to reduced cerebral blood flow is the hallmark of delayed cerebral ischemia following subarachnoid hemorrhage. Since anemia reduces arterial oxygen content, it further threatens oxygen delivery increasing the risk of cerebral infarction. Thus, subarachnoid hemorrhage may constitute an important exception to current restrictive transfusion practices, wherein raising hemoglobin could reduce the risk of ischemia in a critically hypoperfused organ...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28121282/how-to-identify-patients-at-risk-of-abdominal-compartment-syndrome-after-surgical-repair-of-ruptured-abdominal-aortic-aneurysms-in-the-operating-room-a-pilot-study
#4
Betty Leclerc, Lucie Salomon Du Mont, Guillaume Besch, Simon Rinckenbach
Objectives Abdominal compartment syndrome (ACS) is poorly identified in surgery for ruptured abdominal aortic aneurysm and an early management is crucial. The aim of this study was to validate how many risk factors were needed to predict ACS. Secondary objectives were to assess its prevalence and the 30-day mortality. Methods All patients operated for ruptured abdominal aortic aneurysm during 5 years were included. An independent committee performed a retrospective diagnosis of ACS. Eight criteria were selected from the literature, and corresponded to pre- and intraoperative period: anemia (hemoglobin lower than 10 g/dL), prolonged shock (systolic blood pressure <90 mmHg more than 18 min), preoperative cardiac arrest, obesity (body mass index > 30), massive fluid resuscitation (≥3500 mL per hour for at least 1 h) and transfusions (>10 units packed blood red cell since the beginning of the treatment), severe hypothermia (≤33℃), acidosis (pH < 7...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28089084/predicting-the-need-for-intra-operative-large-volume-blood-transfusions-during-thoraco-abdominal-aortic-aneurysm-repair
#5
M Pieri, P Nardelli, M De Luca, G Landoni, S Frassoni, G Melissano, A Zangrillo, R Chiesa, F Monaco
OBJECTIVE: Thoraco-abdominal aortic aneurysm (TAAA) repair is a complex procedure performed in patients at high cardiovascular risk. High volume intra-operative bleeding is often recorded, and the amount of intra-operative blood product transfusion is associated with relevant morbidity and mortality. The aim of the study was to identify pre-operative predictors of intra-operative large volume blood transfusions (LVBT) to stratify patients pre-operatively. METHODS: This was a retrospective analysis of prospectively collected data of all patients who underwent open TAAA surgery at San Raffaele Scientific Institute from January 2009 to December 2015...
January 6, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28069418/splenic-artery-aneurysm-rupture-in-pregnancy
#6
Joshua Jacobson, Chad Gorbatkin, Stacey Good, Scott Sullivan
CASE PRESENTATION: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Subsequent CT obtained noted the rare but life-threatening diagnosis of ruptured splenic artery aneurysm that resulted in emergent transfer to the operating room with OB/GYN and general surgery...
December 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040750/a-minimally-invasive-approach-for-open-surgical-thoracoabdominal-aortic-replacement-experimental-concept-for-a-novel-surgical-procedure
#7
Terézia B Andrási, Violetta Kékesi, Béla Merkely, Marius Grossmann, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVES: We aimed to develop a simple, reliable, and timesaving technique for the therapy of thoracoabdominal aortic (TAA) aneurysms that are not suitable for endovascular repair. METHODS: In this pilot study, we sought to combine the advantages of classic open vascular procedure with the use of endoscopic surgical tools and small skin incisions to develop a minimally invasive approach for TAA replacement. The following procedures were used: endoscopic exposure and closure of the lower intercostal arteries; small posterolateral thoracotomy and left retroperitoneal incisions to expose the anastomotic regions of the aorta; partial anticoagulation; passive bypass and sequential aortic clamping; tunnelling of the graft through the native aortic lumen (endoaneurysmorrhaphy) and open performance of vascular anastomosis...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28031651/spontaneous-retroperitoneal-hematoma-simulating-ruptured-infrarenal-aortic-aneurysm-in-a-patient-with-end-stage-renal-disease
#8
Jyy Li, Y C Chan, K X Qing, S W Cheng
We reported a case of spontaneous retroperitoneal hematoma (SRH) simulating a ruptured infrarenal aortic aneurysm. A 72-year-old man with a history of infrarenal aortic aneurysm and end-stage renal disease on hemodialysis presented with malaise and nonspecific central abdominal pain and left loin discomfort. An emergency computed tomography scan showed a large retroperitoneal hematoma and clinical suspicion of ruptured infrarenal aortic aneurysm. However, the hematoma was discontinuous with the aneurysm sac and raised the clinical suspicion on dual pathology...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27927658/aneurysmal-subarachnoid-hemorrhage-red-blood-cell-transfusion-and-outcome-sahara-a-pilot-randomised-controlled-trial-protocol
#9
Shane W English, D Fergusson, M Chassé, A F Turgeon, F Lauzier, D Griesdale, A Algird, A Kramer, A Tinmouth, C Lum, J Sinclair, S Marshall, D Dowlatshahi, A Boutin, G Pagliarello, L A McIntyre
INTRODUCTION: Anaemia is common in aneurysmal subarachnoid haemorrhage (aSAH) and is a potential critical modifiable factor affecting secondary injury. Despite physiological evidence and management guidelines that support maintaining a higher haemoglobin level in patients with aSAH, current practice is one of a more restrictive approach to transfusion. The goal of this multicentre pilot trial is to determine the feasibility of successfully conducting a red blood cell (RBC) transfusion trial in adult patients with acute aSAH and anaemia (Hb ≤100 g/L), comparing a liberal transfusion strategy (Hb ≤100 g/L) with a restrictive strategy (Hb ≤80 g/L) on the combined rate of death and severe disability at 12 months...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27785789/red-blood-cell-transfusion-transmitted-acute-hepatitis-e-in-an-immunocompetent-subject-in-europe-a-case-report
#10
Mar Riveiro-Barciela, Silvia Sauleda, Josep Quer, Fernando Salvador, Josep Gregori, María Pirón, Francisco Rodríguez-Frías, Maria Buti
BACKGROUND: Acute hepatitis E in industrialized countries is usually related to intake or manipulation of undercooked or raw meat. Cases of transfusion-transmitted hepatitis E have rarely been documented in immunosuppressed patients, mainly after receiving frozen plasma. STUDY DESIGN AND METHODS: A 61-year-old man was admitted to hospital for jaundice. His personal history included disseminated bacillus Calmette-Guerin infection treated with antituberculous drugs...
October 26, 2016: Transfusion
https://www.readbyqxmd.com/read/27649014/endovascular-treatment-of-aortic-aneurysms-and-blood-transfusion-what-do-we-need
#11
Rui Machado, Luís Loureiro, Inês Antunes, Jorge Coutinho, Rui Almeida
INTRODUCTION: Comparatively to open repair, endovascular aneurysm repair has reduced transfusion rates but thereâs no recommendation about number of red blood cells units to be crossmatched preoperatively. Our aim is contribute to the analysis of red blood cells units needs in endovascular and hybrid aortic aneurysm repair and developing a protocol for maximum surgical blood orders schedule. MATERIAL AND METHODS: We retrospectively analyzed our prospective database of elective endovascular aneurysm repair from 2001 to 2012...
May 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27605360/massive-blood-transfusion-in-patients-with-ruptured-abdominal-aortic-aneurysm
#12
C Montan, U Hammar, A Wikman, E Berlin, J Malmstedt, J Holst, C M Wahlgren
OBJECTIVES: The aim was to study blood transfusions and blood product ratios in massively transfused patients treated for ruptured abdominal aortic aneurysms (rAAAs). METHODS: This was a registry based cohort study of rAAA patients repaired at three major vascular centres between 2008 and 2013. Data were collected from the Swedish Vascular Registry, hospitals medical records, and local transfusion registries. The transfusion data were analysed for the first 24 h of treatment...
November 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27556307/institutional-impact-of-evar-s-incorporation-in-the-treatment-of-abdominal-aortic-aneurysm-a-12-years-experience-analysis
#13
Rui Machado, Inês Lopes Antunes, Pedro Oliveira, Carlos Pereira, Rui de Almeida
INTRODUCTION: Endovascular aneurysm repair (EVAR) was introduced as a less aggressive treatment of abdominal aortic aneurysms (AAA) for patients ineligible for open repair (OR). OBJECTIVE: To analyze EVAR's incorporation impact in the treatment of infra-renal abdominal aortic aneurysms in our institution. METHODS: A retrospective study of the patients with diagnostic of infra-renal AAA treated between December 2001 and December 2013 was performed...
April 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27530692/elevated-red-cell-distribution-width-is-associated-with-cerebral-infarction-in-aneurysmal-subarachnoid-hemorrhage
#14
James E Siegler, Christy Marcaccio, Kelsey Nawalinski, Francis Quattrone, Danielle K Sandsmark, Eileen Maloney-Wilensky, Suzanne Frangos, Joshua M Levine, Sherman C Stein, Scott E Kasner, Monisha A Kumar
BACKGROUND: Elevated red blood cell distribution width (RDW) has been associated with thrombotic disorders including myocardial infarction, venous thromboembolism, and ischemic stroke, independent of other inflammatory and coagulation biomarkers. The purpose of this study was to determine whether elevated RDW is associated with cerebral infarction and poor outcome after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: In this retrospective single-center cohort of aSAH patients (October 2009-September 2014), elevated RDW was defined as a mean RDW >14...
August 16, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27498532/chemotherapy-analysis-in-massive-transfusion-syndrome
#15
Bratislav Stanković, Goran Stojanović
INTRODUCTION: Massive transfusion is defined as blood transfusion in quantities equal to or greater than the estimated patients' blood volume over a relatively short period of time (3-4 hours). The study was aimed at analyzing the application of chemotherapy in treatment of patients with acute massive bleeding and evaluating the results of hemostasis and platelet counts screening tests in the patients receiving massive transfusions. MATERIAL AND METHODS: Attempts were made to fully compensate hemostatic factors in 24 patients (14 male and 10 female, aged 23 to 76 years) with acute massive and uncontrolled surgical bleeding (polytrauma, abdominal aortic aneurysm, digestive tract bleeding as a result of a farina overdose, mortus fetus) over the five-year period, wherein a circulating patients' blood volume was compensated over a relatively short period of time...
January 2016: Medicinski Pregled
https://www.readbyqxmd.com/read/27495841/complications-in-endovascular-neurosurgery-critical-analysis-and-classification
#16
Vijay M Ravindra, Marcus D Mazur, Min S Park, Craig Kilburg, Christopher J Moran, Rulon L Hardman, William T Couldwell, Philipp Taussky
BACKGROUND: Precisely defining complications, which are used to measure overall quality, is necessary for critical review of delivery of care and quality improvement in endovascular neurosurgery, which lacks common definitions for complications. Furthermore, in endovascular interventions, events that may be labeled complications may not always negatively affect outcome. Our objective is to provide precise definitions for quality evaluation within endovascular neurosurgery. Thus, we propose an endovascular-specific classification system of complications based on our own patient series...
November 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27429809/not-all-acute-abdomen-cases-in-early-pregnancy-are-ectopic-expect-the-unexpected-renal-angiomyolipoma-causing-massive-retroperitoneal-haemorrhage
#17
Muhammad Asim Rana, Ahmed F Mady, Nagesh Jakaraddi, Shahzad A Mumtaz, Habib Ahmad, Kamal Naser
Retroperitoneal haemorrhage (or retroperitoneal haematoma) refers to an accumulation of blood found in the retroperitoneal space. It is a rare clinical entity with variable aetiology including anticoagulation, ruptured aortic aneurysm, acute pancreatitis, malignancy, and bleeding from renal aneurysm. Diagnosis of retroperitoneal bleed is sometimes missed or delayed as presentation is often nonspecific. Multislice CT and arteriography are important for diagnosis. There is no consensus about the best management plan for patients with retroperitoneal haematoma...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27421194/endovascular-versus-open-repair-for-ruptured-abdominal-aortic-aneurysms-in-a-chinese-population
#18
Baolei Guo, Zhihui Dong, Weiguo Fu, Daqiao Guo, Xin Xu, Bin Chen, Junhao Jiang, Zhenyu Shi
BACKGROUND: The aim of this study was to compare the perioperative outcomes and midterm survival rate between open surgical repair (OSR) and endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs) in a Chinese population. METHODS: A retrospective review was performed of the demographic characteristics and perioperative outcomes from 59 RAAA patients (mean 66.6 ± 13.3 years of age; 49 men) undergoing OSR or EVAR at our center between January 2003 and November 2014...
October 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27364946/abdominal-aortic-aneurysm-repair-in-octogenarians-is-associated-with-higher-mortality-compared-with-nonoctogenarians
#19
Caitlin W Hicks, Tammam Obeid, Isibor Arhuidese, Umair Qazi, Mahmoud B Malas
OBJECTIVE: Age is a well-known independent risk factor for death after abdominal aortic aneurysm (AAA) repair. However, there is significant debate about the utility of AAA repair in older patients. In this study, mortality outcomes after endovascular AAA repair (EVAR) and open AAA repair (OAR) in octogenarians (aged ≥80 years) were compared with younger patients (aged <80 years). METHODS: All patients recorded in the Vascular Quality Initiative database (2002-2012) who underwent infrarenal AAA repair were included...
October 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27330545/correlations-of-perioperative-coagulopathy-fluid-infusion-and-blood-transfusions-with-survival-prognosis-in-endovascular-aortic-repair-for-ruptured-abdominal-aortic-aneurysm
#20
Yohei Kawatani, Yoshitsugu Nakamura, Hirotsugu Kurobe, Yuji Suda, Takaki Hori
BACKGROUND: Factors associated with survival prognosis among patients who undergo endovascular aortic repair (EVAR) for ruptured abdominal aortic aneurysms (rAAA) have not been sufficiently investigated. In the present study, we examined correlations between perioperative coagulopathy and 24-h and 30-day postoperative survival. Relationships between coagulopathy and the content of blood transfusions, volumes of crystalloid infusion and survival. METHODS: This was a retrospective study of the medical records of all patients who underwent EVAR for rAAA at Chiba-Nishi General Hospital during the period from October 2013 to December 2015...
2016: World Journal of Emergency Surgery: WJES
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