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19 papers 0 to 25 followers Research Papers used in aid of the in-house ICU registrar teaching programme at Royal Perth Hospital in the first half of 2016.
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No abstract text is available yet for this article.
February 2015: Anesthesiology
Han-Mou Tsai
Until recently, atypical hemolytic uremic syndrome (aHUS), conventionally defined in the pediatric literature as a syndrome of the triad of renal failure, microangiopathic hemolytic anemia, and thrombocytopenia without a prodrome of hemorrhagic diarrhea, has received little attention in adult practice because the patients are commonly given the diagnosis of thrombotic thrombocytopenic purpura (TTP) or TTP/HUS and treated as TTP with plasma exchange, augmented in refractory cases with rituximab and sometimes even splenectomy...
October 2014: Transfusion Medicine Reviews
Peter Verhamme, Henri Bounameaux
No abstract text is available yet for this article.
February 18, 2014: Circulation
Sibylle A Kozek-Langenecker, Arash Afshari, Pierre Albaladejo, Cesar Aldecoa Alvarez Santullano, Edoardo De Robertis, Daniela C Filipescu, Dietmar Fries, Klaus Görlinger, Thorsten Haas, Georgina Imberger, Matthias Jacob, Marcus Lancé, Juan Llau, Sue Mallett, Jens Meier, Niels Rahe-Meyer, Charles Marc Samama, Andrew Smith, Cristina Solomon, Philippe Van der Linden, Anne Juul Wikkelsø, Patrick Wouters, Piet Wyffels
The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia and stabilisation of the macro- and microcirculations in order to optimise the patient's tolerance to bleeding. Third, targeted procoagulant interventions to reduce the amount of bleeding, morbidity, mortality and costs. The purpose of these guidelines is to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible...
June 2013: European Journal of Anaesthesiology
John G Kelton, Donald M Arnold, Shannon M Bates
No abstract text is available yet for this article.
February 21, 2013: New England Journal of Medicine
Thomas L Ortel
Perioperative management of antithrombotic therapy is a situation that occurs frequently and requires consideration of the patient, the procedure, and an expanding array of anticoagulant and antiplatelet agents. Preoperative assessment must address each patient's risk for thromboembolic events balanced against the risk for perioperative bleeding. Procedures can be separated into those with a low bleeding risk, which generally do not require complete reversal of the antithrombotic therapy, and those associated with an intermediate or high bleeding risk...
December 6, 2012: Blood
Michael T McCurdy, Carl B Shanholtz
OBJECTIVES: To provide an up-to-date review of current literature on the pathophysiology, diagnosis, and management of five key malignancy-related complications: superior vena cava syndrome, malignant pericardial effusion, malignant spinal cord compression, hypercalcemia, and acute tumor lysis syndrome. DATA SOURCES: Database searches and review of relevant medical literature. DATA SYNTHESIS: Malignancy-related complications demand increased attention from intensivists due to their frequency and increasing cancer prevalence...
July 2012: Critical Care Medicine
Samuel Z Goldhaber, Henri Bounameaux
Pulmonary embolism is the third most common cause of death from cardiovascular disease after heart attack and stroke. Sequelae occurring after venous thromboembolism include chronic thromboembolic pulmonary hypertension and post-thrombotic syndrome. Venous thromboembolism and atherothrombosis share common risk factors and the common pathophysiological characteristics of inflammation, hypercoagulability, and endothelial injury. Clinical probability assessment helps to identify patients with low clinical probability for whom the diagnosis of venous thromboembolism can be excluded solely with a negative result from a plasma D-dimer test...
May 12, 2012: Lancet
Adam Cuker, Douglas B Cines
Heparin-induced thrombocytopenia is a prothrombotic adverse drug effect induced by platelet-activating antibodies against multimolecular complexes of platelet factor 4 and heparin. Diagnosis rests on a clinical assessment of disease probability and laboratory testing. Management involves immediate discontinuation of heparin and initiation of an alternative anticoagulant. Because of the frequency of thrombocytopenia among heparinized patients, the limited specificity of widely available immunoassays, the limited availability of more specific functional assays, and clinicians' fears of missing a case of true disease, overtesting, overdiagnosis, and overtreatment have become common...
March 8, 2012: Blood
Ajay K Kakkar, Claudio Cimminiello, Samuel Z Goldhaber, Rajiv Parakh, Chen Wang, Jean-François Bergmann
BACKGROUND: Although thromboprophylaxis reduces the incidence of venous thromboembolism in acutely ill medical patients, an associated reduction in the rate of death from any cause has not been shown. METHODS: We conducted a double-blind, placebo-controlled, randomized trial to assess the effect of subcutaneous enoxaparin (40 mg daily) as compared with placebo--both administered for 10±4 days in patients who were wearing elastic stockings with graduated compression--on the rate of death from any cause among hospitalized, acutely ill medical patients at participating sites in China, India, Korea, Malaysia, Mexico, the Philippines, and Tunisia...
December 29, 2011: New England Journal of Medicine
J Van Es, E S Eerenberg, P W Kamphuisen, H R Büller
Venous thromboembolism (VTE) is most commonly initially treated with low molecular weight heparin (LMWH), fondaparinux, or unfractionated heparin, in combination with vitamin-K antagonists (VKA) for long-term treatment. VKA have some drawbacks, however, which has led to the development of new anticoagulants. Most of these new drugs can be administered orally, and have been investigated in several phase III clinical trials. The benefits of these anticoagulants include their stable therapeutic effect, reduced interactions with other medication and food, and, therefore, the reduced need for regular monitoring...
July 2011: Journal of Thrombosis and Haemostasis: JTH
Yasser Sakr
No abstract text is available yet for this article.
2011: Critical Care: the Official Journal of the Critical Care Forum
Nicolas Meneveau
PURPOSE OF REVIEW: Acute pulmonary embolism remains associated with high morbidity and mortality rates despite currently available therapeutic options. This review outlines the most recent changes in this field and summarizes the main indications for thrombolytic therapy and surgical or catheter-based embolectomy in patients with high-risk pulmonary embolism. RECENT FINDINGS: There have been no major advances in therapy for high-risk pulmonary embolism over the past few years...
November 2010: Current Opinion in Cardiology
James N George
Thrombotic thrombocytopenic purpura (TTP) is the common name for adults with microangiopathic hemolytic anemia, thrombocytopenia, with or without neurologic or renal abnormalities, and without another etiology; children without renal failure are also described as TTP. The diagnosis of TTP is an indication for plasma exchange treatment, but beginning treatment requires sufficient confidence in the diagnosis to justify the risk of plasma exchange complications. Documentation of a severe deficiency of plasma ADAMTS13 activity, defined as less than 10% of normal, is not essential for the diagnosis of TTP...
November 18, 2010: Blood
Giancarlo Agnelli, Cecilia Becattini
No abstract text is available yet for this article.
July 15, 2010: New England Journal of Medicine
Thomas L Ortel
Acquired thrombotic risk factors include a variety of noninherited clinical conditions that can predispose an individual to an increased risk for venous thromboembolism. For patients in a critical care setting, certain acquired risk factors represent chronic conditions that the patients may have had before the current acute illness (e.g., malignancy, various cardiovascular risk factors, certain medications), whereas others may be directly related to the reason the patient is in an intensive care unit or the patient's management there (e...
February 2010: Critical Care Medicine
Kristen C Sihler, Lena M Napolitano
Massive transfusion (MT) is a lifesaving treatment of hemorrhagic shock, but can be associated with significant complications. The lethal triad of acidosis, hypothermia, and coagulopathy associated with MT is associated with a high mortality rate. Other complications include hypothermia, acid/base derangements, electrolyte abnormalities (hypocalcemia, hypomagnesemia, hypokalemia, hyperkalemia), citrate toxicity, and transfusion-associated acute lung injury. Blood transfusion in trauma, surgery, and critical care has been identified as an independent predictor of multiple organ failure, systemic inflammatory response syndrome, increased infection, and increased mortality in multiple studies...
January 2010: Chest
Len Verbeke, Michel Delforge, Daan Dierickx
During the last three decades knowledge regarding the pathophysiology of thrombotic thrombocytopenic purpura (TTP) has dramatically increased. The discovery of ADAMTS13 (a disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13) deficiency in a subset of patients with TTP has been an important milestone. Apart from this, the use of therapeutic plasma exchange has reduced mortality rates in TTP from 80-90% to 10-20%. Nevertheless, TTP remains a possibly lethal disorder, in which early recognition of symptoms remains extremely important...
January 2010: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Mark A Crowther, Deborah J Cook
PURPOSE OF REVIEW: Although critically ill patients are at high risk of venous thromboembolism and bleeding, and thromboprophlyaxis is of proven effectivity in other settings, there remain relatively few data to assist clinicians in providing evidence-based care for medical-surgical patients in the intensive care unit. RECENT FINDINGS: Deep vein thrombosis occurs in 5-10% of critically ill patients even if they receive unfractionated heparin for prophylaxis. Both heparin and low molecular weight heparin can be safely administered to the majority of critically ill patients and the low molecular weight heparin dalteparin does not appear to bioaccumulate even when administered to patients with severe renal dysfunction...
October 2008: Current Opinion in Critical Care
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