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Massive Blood Loss

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https://www.readbyqxmd.com/read/28640786/a-standardized-approach-for-transfusion-medicine-support-in-patients-with-morbidly-adherent-placenta
#1
Anil K Panigrahi, Amanda Yeaton-Massey, Sara Bakhtary, Jennifer Andrews, Deirdre J Lyell, Alexander J Butwick, Lawrence Tim Goodnough
BACKGROUND: The incidence of placenta accreta (PA) has increased from 0.8 to 3.0 in 1000 pregnancies, driven by increased rates of cesarean deliveries (32.2% in 2014) of births in the United States. The average blood loss for a delivery complicated by PA ranges from 2000 to 5000 mL, frequently requiring substantial transfusion medicine support. We report our own institutional multidisciplinary approach for managing such patients, along with transfusion medicine outcomes, in this setting over a 5-year period...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28638007/-re-operations-in-patients-with-heart-wounds
#2
Yu A Radchenko, M M Abakumov, E S Vladimirova, A N Pogodina, O V Nikitina
AIM: To define the risk factors of complications which are followed by re-operations in patients with cardiac and pericardial wounds and to prevent these complications. MATERIAL AND METHODS: Retrospective and prospective analysis of 1072 victims with cardiac and pericardial injuries for 35 years was performed. Overall mortality was 17.2%. 98 patients died during surgery. Postoperative bleeding was observed in 38 (3.9%) cases. RESULTS: In 28 cases re-operations were performed for bleeding-related complications...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28629440/incidence-management-and-outcome-of-women-requiring-massive-transfusion-after-childbirth-in-the-netherlands-secondary-analysis-of-a-nationwide-cohort-study-between-2004-and-2006
#3
Paul I Ramler, Thomas van den Akker, Dacia D C A Henriquez, Joost J Zwart, Jos van Roosmalen
BACKGROUND: Postpartum hemorrhage remains the leading cause of maternal morbidity and mortality worldwide. Few population-based studies have examined the epidemiology of massive transfusion for postpartum hemorrhage. The aim of this study was to determine the incidence, management, and outcomes of women with postpartum hemorrhage who required massive transfusion in the Netherlands between 2004 and 2006. METHODS: Data for all women from a gestational age of 20 weeks onwards who had postpartum hemorrhage requiring eight or more red blood cell concentrates were obtained from a nationwide population-based cohort study including all 98 hospitals with a maternity unit in the Netherlands...
June 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28601987/the-association-of-snp276g-t-at-adiponectin-gene-with-insulin-resistance-and-circulating-adiponectin-in-morbid-obese-patients-after-a-biliopancreatic-diversion-surgery
#4
Daniel Antonio de Luis, David Pacheco, D Primo, Olatz Izaola, R Aller
BACKGROUND: The effects of rs1501299 variant of ADIPO gene on weight loss after bariatric surgery have not been evaluated. We decided to investigate the role of this genetic variant on anthropometric and biochemical outcomes such as serum adiponectin levels after biliopancreatic diversion (BPD) surgery in morbidly obese patients during 3 years. MATERIAL AND METHODS: A sample of 64 patients with morbid obesity without diabetes mellitus was operated. Biochemical and anthropometric evaluation were realized at basal visit and at each visit during 3 years (1, 2, and 3 years)...
June 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28590380/surgical-treatment-for-hemophilic-pseudotumor-twenty-three-cases-with-an-average-follow-up-of-5-years
#5
Jiliang Zhai, Xisheng Weng, Baozhong Zhang, Yong Liu, Peng Gao, Yan-Yan Bian
BACKGROUND: Hemophilic pseudotumor (HPT) is a rare disease with many challenges. Only a few reports on surgical treatment for HPT have been published. METHODS: The cases of 23 patients with HPT who had surgical treatment from July 1996 to December 2014 were retrospectively reviewed. Demographic data, blood loss and transfusion during surgery, outcomes, and complications after surgery were analyzed. RESULTS: Eleven patients underwent HPT resection; 4 underwent HPT excision, allograft transplantation, and absorbable screw fixation; 3 had HPT resection and metallic internal fixation; 2 had HPT resection, autogenous fibular grafting, and absorbable screw fixation; 2 underwent curettage and bone-grafting; and 1 patient received above-the-knee amputation...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28571287/surgical-management-of-a-rare-case-of-massive-compound-odontome-associated-with-missing-primary-tooth
#6
Elengkumaran Sankaran, Sangeetha Narasimhan, K S Sabitha, Punit Chitlangia
Odontomes are considered to be the most common odontogenic tumours of the jaws. They are benign, mixed tumours arising from the remnants of both odontogenic epithelium and the ectomesenchyme resulting in the deposition of varied propotions of enamel, dentin, cementum and pulp tissues. As these lesions show deficiency only in structural arrangement, some authors consider odontomes as hamartomas or tumour like malformations. Though these lesions are more common in children, very few cases have been reported in less than five years age group...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28557286/incidence-and-predictors-of-massive-bleeding-in-children-undergoing-liver-transplantation-a-single-center-retrospective-analysis
#7
Benjamin Kloesel, Pete G Kovatsis, David Faraoni, Vanessa Young, Heung Bae Kim, Khashayar Vakili, Susan M Goobie
BACKGROUND: Liver transplantation represents a major surgery involving a highly vascular organ. Reports defining the scope of bleeding in pediatric liver transplants are few. AIMS: We conducted a retrospective analysis of liver transplants performed at our pediatric tertiary care center to quantify blood loss, blood product utilization, and to determine predictors for massive intraoperative bleeding. METHODS: Pediatric patients who underwent isolated liver transplantation at Boston Children's Hospital between 2011 and 2016 were included...
July 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28549439/anesthetic-management-of-cesarean-section-in-cases-of-placenta-accreta-with-versus-without-abdominal-aortic-balloon-occlusion-study-protocol-for-a-randomized-controlled-trial
#8
Qinjun Chu, Dan Shen, Long He, Hongwei Wang, Xianlan Zhao, Zhimin Chen, Yanli Wang, Wei Zhang
BACKGROUND: Placenta accreta (PA), a severe complication during delivery, is closely linked with massive hemorrhage which could endanger the lives of both mother and baby. Moreover, the incidence of PA has increased dramatically with the increasing rate of cesarean deliveries in the past few decades. Therefore, studies evaluating the effects of different perioperative managements based on different modalities in the treatment of PA are necessary. Among the numerous treatment measures, prophylactic abdominal aortic balloon occlusion (AABO) in combination with cesarean section for PA seems to be more advantageous than others...
May 26, 2017: Trials
https://www.readbyqxmd.com/read/28541859/emergency-cholecystectomy-for-patients-on-antiplatelet-therapy
#9
Keiichi Akahoshi, Takanori Ochiai, Ayumi Takaoka, Takuya Kitamura, Daisuke Ban, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe
The use of antiplatelet therapy (APT) and/or anticoagulant therapy (ACT) continues to increase due to the aging population. Because the management of patients with acute cholecystitis receiving APT/ACT is still unclear, surgeons are sometimes faced with the difficult decision to delay surgery. We aimed to analyze characteristics and surgical risks of patients who underwent emergency cholecystectomy for acute cholecystitis without discontinuing APT. We conducted a retrospective review of 113 patients between 2006 and 2014...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28532047/porous-chitosan-microspheres-for-application-as-quick-in-vitro-and-in-vivo-hemostat
#10
Jixiang Li, Xiaowei Wu, Yanqing Wu, Zonghao Tang, Xun Sun, Meng Pan, Yufeng Chen, Juanjuan Li, Rongdong Xiao, Zhengchao Wang, Haiqing Liu
Controlling massive hemorrhage is of great importance to lower transfusional medical cost, and to reduce death and mobility rate in battlefield and civilian accidents. We reported the fabrication of porous chitosan microspheres (CSMS) with tunable surface pore size by microemulsion combined with thermally induced phase separation technique, and its application as a quick hemostat. Their hemostatic property was characterized by blood clotting kinetics, adherence interaction between red blood cells/platelets and CSMS, in vitro and in vivo hemostasis by rat tail amputation and liver laceration models, and histological analysis...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28501265/an-algorithm-for-the-management-of-coagulopathy-from-postpartum-hemorrhage-using-fibrinogen-concentrate-as-first-line-therapy
#11
S Seto, A Itakura, R Okagaki, M Suzuki, O Ishihara
BACKGROUND: We constructed an algorithm for the management of coagulopathy from massive postpartum hemorrhage. Fibrinogen concentrate was administered preferentially, and the dose of both fibrinogen concentrate and fresh frozen plasma given was determined by the plasma fibrinogen concentration and prothrombin time. The efficacy of the algorithm and the amount of fibrinogen concentrate and fresh frozen plasma transfused were determined. METHODS: The study was conducted in a single teaching perinatal center...
April 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28492488/redistribution-of-cerebral-blood-flow-during-severe-hypovolemia-and-reperfusion-in-a-sheep-model-critical-role-of-%C3%AE-1-adrenergic-signaling
#12
René Schiffner, Sabine Juliane Bischoff, Thomas Lehmann, Florian Rakers, Sven Rupprecht, Juliane Reiche, Georg Matziolis, Harald Schubert, Matthias Schwab, Otmar Huber, Martin Schmidt
BACKGROUND: Maintenance of brain circulation during shock is sufficient to prevent subcortical injury but the cerebral cortex is not spared. This suggests area-specific regulation of cerebral blood flow (CBF) during hemorrhage. METHODS: Cortical and subcortical CBF were continuously measured during blood loss (≤50%) and subsequent reperfusion using laser Doppler flowmetry. Blood gases, mean arterial blood pressure (MABP), heart rate and renal blood flow were also monitored...
May 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28489924/neonatal-and-maternal-outcomes-of-successful-manual-rotation-to-correct-malposition-of-the-fetal-head-a-retrospective-and-prospective-observational-study
#13
Nicola Tempest, Naomi McGuinness, Steven Lane, Dharani K Hapangama
OBJECTIVE: To evaluate the neonatal and maternal outcomes associated with successful operative vaginal births assisted by manual rotation. DESIGN: Prospective and retrospective observational study. SETTING: Delivery suite in a tertiary referral teaching hospital in England. POPULATION: A cohort of 2,426 consecutive operative births, in the second stage of labour, complicated with malposition of the fetal head during 2006-2013...
2017: PloS One
https://www.readbyqxmd.com/read/28473920/posterior-reversible-encephalopathy-syndrome-pres
#14
Sreenivasa Rao Sudulagunta, Mahesh Babu Sodalagunta, Monica Kumbhat, Aravinda Settikere Nataraju
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterized by a headache, seizures, altered mental status and visual loss and characterized by white matter vasogenic edema affecting the posterior occipital and parietal lobes of the brain predominantly. This clinical syndrome is increasingly recognized due to improvement and availability of brain imaging specifically magnetic resonance imaging (MRI). A 35-year-old female with the history of unsafe abortion and massive blood transfusion 10 days ago was brought to the emergency room with three episodes of generalized tonic-clonic seizures, urinary incontinence and altered sensorium since 3 hours...
April 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28470638/-management-of-massive-intraoperative-blood-loss-using-a-case-study
#15
Andreas Pape, Angelo Ippolito, Joanna Warszawska, Florian Raimann, Kai Zacharowski
Massive intraoperative bleeding is a major and potentially life-threatening complication during surgical procedures. The lethal triade of hemorrhagic shock with metabolic acidosis, hypothermia and coagulopathy enhances bleeding tendency. Avoiding this vitious circle requires a well-structured and standardized procedure. Primary goals include the maintenance of adequate tissue oxygenation, restauration of proper coagulatory function, normothermia and homeostasis of acid-base and electrolyte balance. In the present article, these therapeutic goals and their pathophysiological background are illustrated with a clinical case example...
April 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28467584/the-geriatric-polytrauma-risk-profile-and-prognostic-factors
#16
Holger Rupprecht, Hans Jürgen Heppner, Kristina Wohlfart, Alp Türkoglu
BACKGROUND: In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. METHODS: Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS)...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28441942/rare-antibody-associated-hemolytic-transfusion-reaction-and-transfusion-related-acute-lung-injury-a-case-report
#17
Tim N Beck, Natalee G Young, Michelle L Erickson, Ignacio Prats
BACKGROUND: Hemolytic transfusion reactions and transfusion-related acute lung injury (TRALI) are life-threatening complications associated with the transfusion of blood products. Hemorrhage is one of the most common surgical complications and the risk of bleeding is particularly acute in patients with hematologic deficiencies. Management of surgical bleeding can be divided into two phases. The first phase centers on immediate control of acute bleeding and the second phase focuses on keeping the patient stable and on reducing the sequelae associated with blood transfusions and blood loss...
April 26, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28436465/the-clinical-efficacy-of-fibrinogen-concentrate-in-massive-obstetric-haemorrhage-with-hypofibrinogenaemia
#18
Shigetaka Matsunaga, Yasushi Takai, Eishin Nakamura, Sumiko Era, Yoshihisa Ono, Koji Yamamoto, Hiroo Maeda, Hiroyuki Seki
Massive obstetric haemorrhage remains a major cause of maternal death attributable to hypofibrinogenaemia. Transfusion of large volumes of fresh frozen plasma (FFP) is required to normalise fibrinogen levels. We compared the efficacy of FFP (F group) with that of FFP plus fibrinogen concentrate (F + F group) in massive obstetric haemorrhage. In this retrospective study, we compared the medical charts (2004-2016) of 137 patients with <150 mg/dl fibrinogen treated with F + F (n = 47; after August 2009) or F (n = 56; before August 2009)...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28432428/tranexamic-acid-for-treatment-and-prophylaxis-of-bleeding-and-hyperfibrinolysis
#19
Ingrid Pabinger, Dietmar Fries, Herbert Schöchl, Werner Streif, Wolfgang Toller
Uncontrolled massive bleeding with subsequent derangement of the coagulation system is a major challenge in the management of both surgical and seriously injured patients. Under physiological conditions activators and inhibitors of coagulation regulate the sensitive balance between clot formation and fibrinolysis. In some cases, excessive and diffuse bleeding is caused by systemic activation of fibrinolysis, i. e. hyperfibrinolysis (HF). Uncontrolled HF is associated with a high mortality. Polytrauma patients and those undergoing surgical procedures involving organs rich in plasminogen proactivators (e...
May 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28420496/the-value-of-hysteroscopic-management-of-cesarean-scar-pregnancy-a-report-of-44-cases
#20
Ying Pan, Mu-Biao Liu
OBJECTIVE: With the incidence of cesarean scar pregnancy (CSP) rising, the reports of serious adverse outcomes of it have increased gradually. The management of CSP remains an inadequately explored clinical field, and there is no consensus on it presently. The present study was performed to investigate the efficacy and safety of operative hysteroscopy in the diagnosis and treatment of CSP. MATERIALS AND METHODS: Forty-four patients with CSP underwent operative hysteroscopy for removal of scar ectopic pregnancy in our institution...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
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