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Massive Blood Loss

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https://www.readbyqxmd.com/read/28933334/-damage-control-surgery-in-polytrauma-patients-with-pelvic-fractures-is-it-possible-to-use-internal-fixation
#1
L Havlůj, V Džupa, R Gürlich
Current polytrauma management is multidisciplinary, with Damage Control Surgery (DCS), Damage Control Orthopaedics (DCO) and Damage Control Resuscitation (DCR) being applied in the first few hours after injury. The most severe group of polytrauma patients are those with circulatory instability and massive blood loss as a consequence of unstable pelvic fractures. In treating these patients, of crucial importance is the speed and quality of stabilisation of pelvic fracture fragments. The authors present two case reports of polytrauma patients with unstable pelvic fractures, in whom open reduction and internal fixation was performed on the anterior fracture segment through extended laparotomy in order to stop bleeding into the abdominopelvic cavity as part of the DCS approach...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28924528/near-fatal-gastrointestinal-hemorrhage-in-a-child-with-medulloblastoma-on-high-dose-dexamethasone
#2
Derek Yecies, Daniel Tawfik, Jennifer Damman, Chad Thorson, David S Hong, Gerald A Grant, Rachel Bensen, Mihaela Damian
A four-year-old female was admitted to a university-based children's hospital with a newly-diagnosed posterior fossa tumor. She was started on famotidine and high-dose dexamethasone and underwent gross total resection of a medulloblastoma. She was continued on dexamethasone and famotidine. She exhibited postoperative posterior fossa syndrome and was started on enteral feeds via the nasoduodenal tube. She had small gastrointestinal bleeds on postoperative days eight, 11, and 18, and was found to have a well-circumscribed posterior duodenal ulcer...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28916408/robot-assisted-kidney-transplantation-the-european-experience
#3
Alberto Breda, Angelo Territo, Luis Gausa, Volkan Tuğcu, Antonio Alcaraz, Mireia Musquera, Karel Decaestecker, Liesbeth Desender, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Giampaolo Siena, Sergio Serni, Luis Guirado, Carma Facundo, Nicolas Doumerc
BACKGROUND: Robot-assisted kidney transplantation (RAKT) has recently been introduced to reduce the morbidity of open kidney transplantation (KT). OBJECTIVE: To evaluate perioperative and early postoperative RAKT outcomes. DESIGN, SETTING AND PARTICIPANTS: This was a multicenter prospective observational study of 120 patients who underwent RAKT, predominantly with a living donor kidney, in eight European institutions between July 2015 and May 2017, with minimum follow-up of 1 mo...
September 12, 2017: European Urology
https://www.readbyqxmd.com/read/28887236/iatrogenic-major-venous-injury-is-associated-with-increased-morbidity-of-aortic-reconstruction
#4
Sachinder S Hans, Steven Vang, Gul Sachwani-Daswani
BACKGROUND: Major venous injury during open aortic reconstruction though uncommon often result in sudden and massive blood loss resulting in increased morbidity and mortality. This study details the etiology, management, and outcome of such injuries. METHODS: A retrospective review of 945 patients (1981-2017) undergoing aortic reconstruction from 2 mid-sized (350 bed teaching hospitals). Seven hundred twenty-three patients (76.5%) underwent open abdominal aortic aneurysm (AAA) repair/iliac aneurysm repair, 222 patients (23...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885969/the-use-of-the-abdominal-aortic-and-junctional-tourniquet-during-cardiopulmonary-resuscitation-following-traumatic-cardiac-arrest-in-swine
#5
Jason Rall, Jennifer M Cox, Joseph Maddry
BACKGROUND: Standard cardiopulmonary resuscitation (CPR) is ineffective in treating traumatic cardiac arrest (TCA) following hemorrhagic shock despite fluid resuscitation. CPR adjuncts, including abdominal compressions and external counter pressure, have shown some success in laboratory settings. The Abdominal Aortic and Junctional Tourniquet (AAJT) is a device that occludes both venous and arterial blood at the level of the aortic bifurcation and likely increases thoracic pressure when applied to the abdomen...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885411/improvement-in-outcomes-of-major-obstetric-hemorrhage-through-systematic-change
#6
Daniel W Skupski, David Brady, Isaac P Lowenwirt, Jason Sample, Stephanie N Lin, Rahul Lohana, Gary S Eglinton
OBJECTIVE: To report the outcomes over 14 years of sustained systematic institutional focus on the care of women with major obstetric hemorrhage, defined as estimated blood loss greater than 1,500 mL. METHODS: A retrospective cohort study of women with major obstetric hemorrhage at our hospital from 2000 to 2014 compares baseline conditions (age, multiparity, prior cesarean delivery, morbidly adherent placenta), morbidity (lowest mean temperature, lowest mean pH, coagulopathy, hysterectomy), and mortality among three time periods (period 1=January 2000 to December 2001, period 2=January 2002 to August 2005, period 3=September 2005 to December 2014)...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28878000/dissecting-hematopoietic-and-renal-cell-heterogeneity-in-adult-zebrafish-at-single-cell-resolution-using-rna-sequencing
#7
Qin Tang, Sowmya Iyer, Riadh Lobbardi, John C Moore, Huidong Chen, Caleb Lareau, Christine Hebert, McKenzie L Shaw, Cyril Neftel, Mario L Suva, Craig J Ceol, Andre Bernards, Martin Aryee, Luca Pinello, Iain A Drummond, David M Langenau
Recent advances in single-cell, transcriptomic profiling have provided unprecedented access to investigate cell heterogeneity during tissue and organ development. In this study, we used massively parallel, single-cell RNA sequencing to define cell heterogeneity within the zebrafish kidney marrow, constructing a comprehensive molecular atlas of definitive hematopoiesis and functionally distinct renal cells found in adult zebrafish. Because our method analyzed blood and kidney cells in an unbiased manner, our approach was useful in characterizing immune-cell deficiencies within DNA-protein kinase catalytic subunit (prkdc), interleukin-2 receptor γ a (il2rga), and double-homozygous-mutant fish, identifying blood cell losses in T, B, and natural killer cells within specific genetic mutants...
September 6, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28856861/high-intensity-focused-ultrasound-combined-with-hysteroscopic-resection-for-the-treatment-of-placenta-accreta
#8
M Ye, Z Yin, M Xue, X Deng
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of a combination of high-intensity focused ultrasound (HIFU) and hysteroscopic resection while treating placenta accreta (PA). DESIGN: A retrospective study. SETTING: A university teaching hospital in China. METHODS: This study included 25 patients diagnosed with PA who underwent HIFU followed by hysteroscopic resection in our hospital between January 2014 and December 2015...
August 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28852530/multidisciplinary-approach-to-manage-antenatally-suspected-placenta-percreta-updated-algorithm-and-patient-outcomes
#9
Paula S Lee, Samantha Kempner, Michael Miller, Jennifer Dominguez, Chad Grotegut, Jessie Ehrisman, Rebecca Previs, Laura J Havrilesky, Gloria Broadwater, Sarah C Ellestad, Angeles Alvarez Secord
BACKGROUND: Due to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percreta. The purpose of this study is to present our current strategy, maternal morbidity and outcomes of patients treated by our approach. METHODS: From 2005 to 2014, a retrospective cohort study of patients with suspected placenta percreta at an academic tertiary care institution was performed...
2017: Gynecologic Oncology Research and Practice
https://www.readbyqxmd.com/read/28817822/predictors-of-postoperative-non-chylous-massive-discharge-after-pancreaticoduodenectomy-for-pancreatic-ductal-adenocarcinoma
#10
Kyoji Ito, Yoshikuni Kawaguchi, Yoshihiro Sakamoto, Junichi Arita, Kiyoshi Hasegawa, Norihiro Kokudo
BACKGROUND: Pancreaticoduodenectomy (PD) is performed for pancreatic ductal adenocarcinoma (PDA) located at the pancreas head/body. Non-chylous massive discharge after PD is frequently encountered and can cause a vicious cycle of complications associated with severe dehydration and protein loss. METHODS: From August 2008 to June 2015, 102 patients who underwent PD for PDA were retrospectively reviewed. High non-chylous discharge was defined as postoperative daily serous discharge exceeding 10 mL/kg...
August 18, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28810606/aspergillus-niger-bloodstream-infection-in-gastric-cancer-after-common-hepatic-artery-embolization-a-case-report
#11
Li Lin, Chuan-Hua Zhao, Xiu-Yun Yin, Yu-Ling Chen, Hong-Yan Zhai, Chun-Wei Xu, Yan Wang, Fei-Jiao Ge, Jian-Ming Xu
The present case study reported on a 62-year-old male patient with gastric cancer-associated Aspergillus (A.) niger bloodstream infection. The patient presented with massive hemorrhage in the gastrointestinal tract 3 months after total gastrectomy for gastric cancer. Conservative treatment consisting of blood transfusion to supplement blood volume loss was ineffective. Digital subtraction angiography indicated gastroduodenal artery bleeding. The first attempt of performing arterial embolization using gelatin sponges failed, while the second attempt of performing common hepatic artery embolization using gelatin sponges and micro-coil springs stopped the bleeding...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28807540/necessity-of-preoperative-activated-partial-thromboplastin-time-test-as-a-predictor-for-surgical-hemorrhage-in-obstetric-and-gynecological-patients-in-china
#12
Zhang Ge, Zhang Xia, Wang Yuefang, Ma Zhigui
BACKGROUND: On an international scale, the necessity of preoperative coagulation screen remains controversial, yet in China, coagulation screen is still a routine test before surgery required by the Ministry of Health of China. METHODS: A retrospective review of 26,807 patients >18y presenting with problems related to the areas of gynecology and obstetrics from March 2013 to July 2015 was performed, and the rate of major bleeding and the amount of blood lost during surgery were compared among groups of patients grouped according to the values of preoperative APTT, the departments the patients belonged to, or the measures for intervention...
October 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28799827/laparoscopic-splenectomy-for-massive-splenomegaly-does-size-matter
#13
Levan Tsamalaidze, John A Stauffer, Samantha L Permenter, Horacio J Asbun
BACKGROUND: Laparoscopic splenectomy (LS) has become the most common approach for elective splenectomy, but use of LS for patients with massive splenomegaly (MS) remains controversial. By the 2008 European guidelines, LS for MS (spleen size >20 cm) is generally not recommended. METHODS: We performed a retrospective analysis of 229 consecutive patients undergoing LS, hand-assist (HALS), and open splenectomy (OS) at our institution from January 1, 1995 to December 2016...
August 11, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28794530/retrospective-analysis-of-post-operative-coagulopathy-after-major-hepatic-resection-at-a-tertiary-care-centre-in-northern-india
#14
Shweta A Singh, P Vivekananthan, Ankur Sharma, Sandeep Sharma, Kishore Gs Bharathy
BACKGROUND AND AIMS: Hepatic resection is a major surgery associated with intraoperative massive fluid shifts, blood loss, haemodynamic instability and risk of development of post-hepatectomy liver failure. Hepatic resection predisposes the patient to coagulopathy as well as venous thrombosis. However, due to the development of deranged coagulation profile post-operatively, there is a dilemma in starting thromboprophylaxis. Our aim in this study was to determine the incidence of coagulopathy in patients undergoing major hepatectomy...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794525/utility-of-non-invasive-haemoglobin-monitoring-in-oncosurgery-patients
#15
Namrata Gupta, Anita Kulkarni, A K Bhargava, Aditya Prakash, Nitika Gupta
BACKGROUND AND AIMS: Oncosurgeries may incur massive blood loss demanding frequent blood sampling to assess blood loss and the need for intraoperative blood transfusions. Accuracy of non-invasive spectrophotometric haemoglobin (hereafter to be referred as SpHb) monitoring has been studied in various perioperative settings. The intraoperative use of Radical-7(®), Masimo Corp., (Radical-7(®)) for SpHb monitoring may be useful during cancer surgery. The aim of this study is to evaluate the intraoperative utility of SpHb monitoring by the Radical-7(®) to guide intraoperative transfusion in oncosurgeries...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28758557/thromboelastometry-versus-rotational-thromboelastography-in-cardiac-surgery
#16
Ahmed Zaky
Evidence exists on the morbiduty and mortality associated with both massive blood loss and transfusion in cardiac surgical patients. Monitoring of the vesicoelastic properties of blood using rotational thromboelastometry and thromboelsatography (TEG) has been a major step towards ameliorating the risks associated with these 2 evils by providing trageted goal-directed blood product resuscitation. Point of care ROTEM and TEG overcome many of the current limitatons of conventional laboratory coagulation testing...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28745251/-using-thromboelastography-to-measure-coagulation-following-massive-blood-loss
#17
M C A Müller, G A E Ponjee
Thromboelastography is becoming increasingly important for diagnosing coagulation disorders in patients with massive blood loss. This whole-blood measurement provides information about the speed of clot formation, clot strength, and degree of fibrinolysis. The result can be used as a basis for making a faster and better choice of a suitable blood product for the patient with severe blood loss. This technique can be carried out simply and quickly as a rapid test ('point-of-care test') or in a central laboratory...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28740840/bicytopenia-and-leukoerythroblastosis-a-rare-initial-presentation-of-signet-ring-cell-gastric-adenocarcinoma
#18
REVIEW
Vilma Takayasu, Edna Harumi Goto, Mayra Zanon Casagrande, Paulo Guilherme de Arruda Miranda, Gabriela Bezerra de Freitas Diniz, Micaela Frasson Monteiro, Aloisio Felipe-Silva
Gastric adenocarcinoma is a common neoplasia and is responsible for up to 30% of the overall deaths due to cancer. Advanced disease is mostly characterized by peritoneum, liver, and lung involvement. The spread of the disease to the bone is rare, and bone marrow dissemination is even rarer. In this setting, leukoerythroblastosis may be the initial manifestation of the disease. The authors report the case of a 64-year-old Caucasian man who sought medical care complaining of back pain, weakness, and weight loss...
April 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28740434/a-global-quantitative-survey-of-hemostatic-assessment-in-postpartum-hemorrhage-and-experience-with-associated-bleeding-disorders
#19
Andra H James, David L Cooper, Michael J Paidas
PURPOSE: Coagulopathy may be a serious complicating or contributing factor to postpartum hemorrhage (PPH), and should be promptly recognized to ensure proper bleeding management. This study aims to evaluate the approaches of obstetrician-gynecologists worldwide towards assessing massive PPH caused by underlying bleeding disorders. METHODS: A quantitative survey was completed by 302 obstetrician-gynecologists from 6 countries (the UK, France, Germany, Italy, Spain, and Japan)...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28738080/effects-of-exogenous-glucagon-like-peptide-2-and-distal-bowel-resection-on-intestinal-and-systemic-adaptive-responses-in-rats
#20
Sarah W Lai, Elaine de Heuvel, Laurie E Wallace, Bolette Hartmann, Jens J Holst, Mary E Brindle, Prasanth K Chelikani, David L Sigalet
OBJECTIVE: To determine the effects of exogenous glucagon-like peptide-2 (GLP-2), with or without massive distal bowel resection, on adaptation of jejunal mucosa, enteric neurons, gut hormones and tissue reserves in rats. BACKGROUND: GLP-2 is a gut hormone known to be trophic for small bowel mucosa, and to mimic intestinal adaptation in short bowel syndrome (SBS). However, the effects of exogenous GLP-2 and SBS on enteric neurons are unclear. METHODS: Sprague Dawley rats were randomized to four treatments: Transected Bowel (TB) (n = 8), TB + GLP-2 (2...
2017: PloS One
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