Massive hemorrhage and transfusion in the operating room
ConclusionsMassive hemorrhage is a multidisciplinary challenge that requires immediate response and communication between clinicians, nurses, other healthcare providers, laboratory testing, and blood banks. Basic knowledge and utilization of available products and therapies are inconsistent. A massive transfusion protocol can be used effectively to reduce chaos and ensure that correct treatments and proper dosing occur in a timely manner.
Decrease in perfusion, which happens during heart attacks and other critical conditions, can cause irreversible damage to the brain. Cooling the brain as soon as possible has been shown to reduce such damage, but doing so is often hindered by the coo...
HYPOTHERMIC CIRCULATORY arrest combined with selective cerebral perfusion commonly is employed to permit surgical repair of the ascending and transverse aorta. A variety of perfusion techniques are employed, including retrograde cerebral perfusion via the superior vena cava (SVC), unilateral antegrade cerebral perfusion (ACP) via the innominate or right subclavian arteries, or perfusion with selective cannulation of both carotid arteries.1 The degree of hypothermia also varies markedly, from deep hypothermic levels (14-18 °C) to more modest levels (26-28°C).
BackgroundThe prevalence of hypothermia in trauma patients is high and rapid recognition is important to prevent further heat loss. Hypothermia is associated with poor patient outcomes and is an independent predictor of increased mortality. The aim of this study was to analyze the changes in core body temperature of trauma patients during different treatment phases in the pre‐hospital and early in‐hospital settings. MethodsA prospective observational cohort study in severely injured patients. Continuous core temperature monitoring using an epitympanic sensor in the auditory canal was initiated at the scene of injury an...
We report a case highlighting the challenge and importance of interdisciplinary planning between cardiothoracic surgeons and anesthesiologists prior to high-risk surgery. Failure to place an endoaortic balloon and percutaneous coronary sinus catheter due to anatomical abnormalities prompted the adoption of an alternate technique involving apical ventricular venting to assist sternal reentry. Apical left ventricular venting was successfully used to prevent ventricular dilation and dysfunction during institution of cardiopulmonary bypass with significant aortic regurgitation and hypothermia-induced ventricular fibrillation.
To determine the relationships between hypothermia and pH at surgery end and postoperative red blood cell (RBC) transfusion in massively transfused adult cardiac surgery patients.
Publication date: 1 January 2018 Source:Life Sciences, Volume 192 Author(s): Viktória Kovács, Valéria Tóth-Szűki, János Németh, Viktória Varga, Gábor Remzső, Ferenc Domoki Aims Perinatal asphyxia (PA) often results in hypoxic–ischemic encephalopathy (HIE) in term neonates. Introduction of therapeutic hypothermia improved HIE outcome, but further neuroprotective therapies are still warranted. The present study sought to determine the feasibility of the activation of the cytoprotective PI-3-K/Akt and the MAPK/ERK signaling pathways in the subacute phase of HIE ...
PMID: 29252474 [PubMed - in process]
We read the article by Chebbout et al. with great interest.1 In their study, participants received in-line intravenous fluid warming during cesarean delivery, and were randomized to have no active body warming, forced air warming, or conduction mattress warming. The authors found no significant difference in mean core temperature on admission to the recovery room, and maternal hypothermia was prevented in all groups, with only 0.3% of patients hypothermic in any of the temperature measurements. They conclude that in- line fluid warming is sufficient to prevent maternal hypothermia (
Conclusions: The use of HHC may be considered as a method to attenuate intraoperative decrease in core temperature during arthroscopic hip surgery performed under general anesthesia and exceeding 2 hours in duration. PMID: 29225745 [PubMed]
CONCLUSIONS: Our results suggest that TTM with therapeutic hypothermia may not improve mortality or neurologic outcomes in postarrest survivors. Using therapeutic hypothermia as a standard of care strategy of postarrest care in survivors may need to be reevaluated. PMID: 29239942 [PubMed - as supplied by publisher]