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https://www.readbyqxmd.com/read/29792721/-use-of-viscoelastic-methods-in-surgery
#1
D Šmíd, J Zatloukal, T Kural, J Fichtl, V Opatrný, J Moláček
INTRODUCTION: Major liver resections are associated with high morbidity and mortality. The main causes of this fact include a significant blood loss which may be associated with this surgical procedure. Hemocoagulation disorder, diagnosed by standard laboratory tests, is very frequent in the postoperative period and often requires the administration of blood derivatives. Several recent studies, however, have questioned the presence of such coagulopathy when viscoelastic methods are used to assess the coagulation process...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29792090/procedural-and-clinical-outcomes-of-endovascular-recanalization-therapy-in-patients-with-cancer-related-stroke
#2
Seunguk Jung, Cheolkyu Jung, Jae Hyoung Kim, Byung Se Choi, Yun Jung Bae, Leonard Sunwoo, Ho Geol Woo, Jun Young Chang, Beom Joon Kim, Moon-Ku Han, Hee-Joon Bae
Objective Embolism due to coagulopathy might be the main pathomechanism underlying cancer-related stroke (CRS). CRS patients with a large artery occlusion could be candidates for endovascular recanalization therapy (ERT), although its procedural and clinical outcomes are not well known. This study aimed to investigate the procedural and clinical outcomes of ERT in CRS patients and the characteristics associated with outcomes compared with those of conventional stroke patients. Methods A registry of consecutive acute ischemic stroke patients who underwent ERT between January 2011 and October 2015 was retrospectively reviewed...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29791173/-rotational-thromboelastometry-in-therapy-of-life-threatening-bleeding
#3
Miroslav Durila
Bleeding and coagulopathy is a common problem in the fields of internal medicine. In case of life-threatening bleeding, rotational thromboelastometry (ROTEM) has critical role in diagnosis and therapy of coagulopathy. In contrast to commonly used tests such as prothrombin time and activated partial thromboplastin time, ROTEM evaluates coagulation of the whole blood as a bedside method. The use of ROTEM for rapid diagnosis and targeted therapy of coagulopathy leads to reduction in bleeding and thus to reduction in administration of blood transfusion products...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29790796/in-vitro-coagulation-triggers-anti-aspergillus-fumigatus-neutrophil-response
#4
Emilie Fréalle, Philippe Gosset, Sophie Leroy, Claire Delattre, Agnès Wacrenier, Christoph Zenzmaier, Christophe Zawadzki, El Moukhtar Aliouat, Susanne Perkhofer
AIM: To explore Aspergillus interactions with platelets in the blood, especially during clot formation. MATERIALS & METHODS: Aspergillus fumigatus resting or swollen conidia, germlings or hyphae were inoculated into blood sampled into tubes with or without anticoagulant. Interactions were explored using microscopy, and chemokine levels were determined. RESULTS: Anatomopathological examination of the clot revealed conidia and germlings colocalization with platelet aggregates, and neutrophil recruitment around aggregates...
May 23, 2018: Future Microbiology
https://www.readbyqxmd.com/read/29788811/central-ecmo-for-circulatory-failure-following-pediatric-liver-transplantation
#5
John P Scott, Johnny C Hong, Nathan E Thompson, Ronald K Woods, George M Hoffman
We describe the case of a 4-year-old male with a past medical history significant for nephrotic syndrome, short-bowel syndrome and fulminant hepatic failure status post (s/p) liver transplant (LT) who developed early post-transplant allograft dysfunction (hyperbilirubinemia, coagulopathy) and septic shock requiring central extracorporeal membrane oxygenation (ECMO). He remained on ECMO for 85 hours before he was decannulated without event and later underwent repeat LT. This case highlights the potential of central ECMO to provide the circulatory output necessary to reverse distributive shock physiology in patients with sepsis and hepatic dysfunction following LT...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29786890/thrombotic-and-hemorrhagic-complications-during-visceral-transplantation-risk-factors-and-association-with-intraoperative-disseminated-intravascular-coagulation-like-thromboelastographic-qualities-single-center-retrospective-study
#6
Yehuda Raveh, Yiliam Rodriguez, Ernesto Pretto, Fouad Souki, Vadim Shatz, Behrouz Ashrafi, Vinaya Manmohansigh, Michael Demos, Joshua Livingstone, Georges Nasrallah, David Andrews, Thiago Beduschi, Rodrigo Vianna, Ramona Nicolau-Raducu
This study describes the risk of thrombotic and hemorrhagic complications, both intraoperatively, and up to 1-month following visceral transplantation. Data from 48 adult visceral transplants performed between 2010-2017 were retrospectively studied (32 multivisceral (MVTx); 10 isolated intestine; 6 modified-MVTx). Intraoperatively, intracardiac thrombosis (ICT)/pulmonary embolism (PE) occurred in 25%, 0% and 0% of MVTx, isolated intestine and modified MVTx, respectively, and was associated with 50% (4/8) mortality...
May 22, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29778610/a-decade-of-tevar-in-new-york-state-volumes-outcomes-and-implications-for-the-dissemination-of-endovascular-technology
#7
Jordan R Stern, Tianyi Sun, Jialin Mao, Art Sedrakyan, Andrew J Meltzer
INTRODUCTION: /Objectives: The purpose of this study was to characterize utilization and outcomes of TEVAR in New York State during the first decade of commercial availability, with respect to evolving indications, results, and costs. Of specific interest was evaluation of the volume-outcome relationship for this relatively uncommon procedure. METHODS: The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried to identify patients undergoing TEVAR from 2005-2014 for aortic dissection (AD), non-ruptured aneurysm (NRA), and ruptured aneurysm (RA)...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29776837/evaluation-of-massive-transfusion-protocol-practices-by-type-of-trauma-at-a-level-i-trauma-center
#8
Roshan Givergis, Swapna Munnangi, Katayoun Fayaz M Fomani, Anthony Boutin, Luis Carlos Zapata, Ld George Angus
PURPOSE: To evaluate massive transfusion protocol practices by trauma type at a level I trauma center. METHODS: A retrospective analysis was performed on a sample of 76 trauma patients with MTP activation between March 2010 and January 2015 at a regional trauma center. Patient demographics, transfusion practices, and clinical outcomes were compared by type of trauma sustained. RESULTS: Penetrating trauma patients who required MTP activation were significantly younger, had lower injury severity score (ISS), higher probability of survival (POS), decreased mortality, and higher Glasgow Coma scale (GCS) compared to blunt trauma patients...
April 18, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29774760/safety-of-nonsteroidal-anti-inflammatory-drugs-in-copperhead-snakebite-patients
#9
Hoang X Pham, Michael E Mullins
INTRODUCTION: Current management guidelines for pit viper envenomations recommend against the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control due to concern for platelet dysfunction and resulting coagulopathy. However, prior research suggests that copperhead snakes generally do not cause coagulopathy and they are responsible for most of the venomous snakebites in the USA. Thus, we compared the occurrences of clinically apparent bleeding and most abnormal laboratory values of coagulation between copperhead envenomation patients who received NSAIDs and those who did not...
May 18, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29773783/cholesteryl-ester-storage-disease-fatal-outcome-without-causal-therapy-in-a-female-patient-with-the-preventable-sequelae-of-progressive-liver-disease-after-many-years-of-mild-symptoms
#10
Ali Canbay, Meike N Müller, Stathis Philippou, Guido Gerken, Andreas Tromm
BACKGROUND Cholesteryl ester storage disease (CESD), also known as lysosomal acid lipase deficiency (LAL-D), is a rare autosomal-recessive inheritable lysosomal storage disease. Since 2015, a causal treatment with sebelipase alfa, which replaces the missing LAL enzyme, has been approved. We report a fatal course of LAL-D in a female patient. CASE REPORT In 1979, CESD was first diagnosed in a 13-year-old female with marked hepatomegaly. At that time, no specific treatment for CESD was available and the spontaneous course of the disease had to be awaited...
May 18, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29772364/pathophysiology-and-non-surgical-treatment-of-chronic-subdural-hematoma-from-past-to-present-to-future
#11
REVIEW
Dana C Holl, Victor Volovici, Clemens M F Dirven, Wilco C Peul, Fop van Kooten, Korné Jellema, Niels A van der Gaag, Ishita P Miah, Kuan H Kho, Heleen M den Hertog, Hester F Lingsma, Ruben Dammers
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the more frequent pathological entities in daily neurosurgical practice. Historically, CSDH was considered a progressive, recurrent bleeding with a traumatic etiology. However, recent evidence suggests a complex intertwined pathway of inflammation, angiogenesis, local coagulopathy, recurrent microbleeds and exudates. The aim of the present review is to collect existing data on pathophysiology of CSDH in order to direct further research questions aiming to optimize treatment for the individual patient...
May 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29771870/hyperfibrinolysis-is-an-important-cause-of-early-hemorrhage-in-patients-with-acute-promyelocytic-leukemia
#12
Yu-Hua Song, Chun Qiao, Li-Chan Xiao, Run Zhang, Hua - Lu
BACKGROUND The objective of the current study was to guide the early clinical treatment strategies by assessing the recovery of abnormal coagulation in acute promyelocytic leukemia (APL) patients during induction therapy. MATERIAL AND METHODS Retrospective analysis was performed in 112 newly-diagnosed patients with APL during induction treatment. RESULTS The early death (ED) rate in our study was 5.36% and the main cause was fetal hemorrhage. The presence of bleeding symptoms was significantly correlated with low platelet and fibrinogen levels...
May 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29766777/administering-riastap-for-congenital-afibrinogenemia-during-liver-transplant
#13
Chris Giordano, Chris Johnson, Janice Lawson, Anita Rajasekhar, Elizabeth Thomas
Liver transplant has occasionally been performed in the presence of congenital afibrinogenemia and has been rarely used to treat it. Historically, to safely manage coagulopathy during transplant, these patients have been administered a combination of fresh frozen plasma and cryoprecipitate. In this case report, we discuss the first reported use of recombinant fibrinogen to treat such a patient and the decision-making process considered to balance the thrombotic and hemorrhagic risks.
May 16, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29766129/is-thromboelastography-teg-based-resuscitation-better-than-empirical-1-1-transfusion
#14
Isaac W Howley, Elliott R Haut, Lenwoth Jacobs, Jonathan J Morrison, Thomas M Scalea
Thomboelastography (TEG) is a whole blood measure of coagulation which was originally described in the 1950s. However, it has only been in the last few decades that assays have become accessible and viable as a point-of-care test. Following the observation that hemorrhagic shock is associated with an intrinsic coagulopathy, TEG has been used as a method of diagnosing specific coagulation defects in order to direct individualized blood products resuscitation. An alternative transfusion strategy is the administration of fixed ratio products, a paradigm borne out of military experience...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#15
Edgar A Samaniego, Aldo A Mendez, Thanh N Nguyen, Vladimir Kalousek, Waldo R Guerrero, Sudeepta Dandapat, Guilherme Dabus, Italo Linfante, Ameer E Hassan, Alexander Drofa, Evgueni Kouznetsov, David Leedahl, David Hasan, Alberto Maud, Santiago Ortega-Gutierrez
Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29754142/cholestatic-jaundice-a-unique-presentation-leading-to-the-diagnosis-of-hlh-with-hodgkin-lymphoma-hiv-and-ebv
#16
Hira Shaikh, Soorih Shaikh, Amir Kamran, Prerna Mewawalla
Haemophagocytic lymphohistiocytosis (HLH) is a syndrome of dysregulated immune activity with macrophage activation that can manifest as pancytopenia, coagulopathy and other laboratory abnormalities, usually progressing to multiorgan failure and death. This report documents the rarely reported association between HLH and Hodgkin's lymphoma (HL) with simultaneous HIV and Epstein-Barr virus (EBV) and complete resolution with chemotherapy. The patient initially presented with cholestatic jaundice. He was then found to have HL associated with HLH with coexistent HIV and EBV viraemia...
May 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29752769/systematic-review-on-ureteral-access-sheaths-facts-and-myths
#17
REVIEW
Vincent De Coninck, Etienne Xavier Keller, María Rodríguez-Monsalve, Marie Audouin, Steeve Doizi, Olivier Traxer
OBJECTIVES: To review literature on all available ureteral access sheaths (UASs) with their indications, limitations, risks, advantages and disadvantages in current modern endourological practice. PATIENTS AND METHODS: Two authors searched Medline, Scopus, Embase and Web of Science databases to identify studies on UASs published in English. No time period restriction was applied. All original articles reporting about outcomes or innovations were included. Additional articles identified through references lists were also included...
May 11, 2018: BJU International
https://www.readbyqxmd.com/read/29750761/toradol-following-breast-surgery-is-there-an-increased-risk-of-hematoma
#18
Brittany N Nguyen, Ruth J Barta, Christine E Stewart, Cherrie A Heinrich
BACKGROUND: Ketorolac tromethamine (Toradol), a nonsteroidal antiinflammatory drug, is used with increased frequency given its success in postoperative pain control and the subsequent decreased need for narcotics. Its use has been limited in plastic surgery for fear of postoperative bleeding and hematoma formation. In this study of breast surgery patients, the authors investigated whether ketorolac increased the risk of postoperative hematoma formation. METHODS: After obtaining institutional review board approval, the authors retrospectively reviewed the records of patients undergoing breast surgery from January of 2012 through December of 2014...
June 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29749244/influence-of-perioperative-hypothermia-on-blood-clotting-in-children
#19
A Trckova, P Stourac
OBJECTIVES: The decrease of body temperature is one of the causes of blood clotting disorders. BACKGROUND: Accidental hypothermia during anesthesia is a common condition and children, especially newborns, are the most sensitive patients to the side effects of hypothermia. METHODS: Web of Science, SCOPUS and PubMed search was performed to retrieve both original and review articles addressing both, hypothermia during surgery and coagulation disorder in pediatric patients...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29748820/trans-arterial-embolization-of-non-variceal-upper-gastrointestinal-bleeding-is-the-use-of-ethylene-vinyl-alcohol-copolymer-as-safe-as-coils
#20
Marcello Andrea Tipaldi, Gianluigi Orgera, Miltiadis Krokidis, Alberto Rebonato, Daniele Maiettini, Simone Vagnarelli, Cesare Ambrogi, Michele Rossi
PURPOSE: The safety of liquid embolics over the conventional coils for the treatment of non-variceal upper gastrointestinal bleeding (UGIB) approach is still unclear. Purpose of this study is to assess the safety of ethylene-vinyl alcohol copolymer (EVOH 6%) over coils in the treatment of UGIB. MATERIALS AND METHODS: All the upper gastrointestinal tract embolization procedures performed in a single center in a 6-year period were reviewed. Patients embolised with coils (Group A) versus those embolised with EVOH 6% (Group B) were compared...
May 10, 2018: Cardiovascular and Interventional Radiology
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