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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.
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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We describe the case of a 4‐year‐old child undergoing extensive burn surgery with refractory intraoperative hypothermia. A low‐dose nitroglycerin infusion was initiated to reverse vasoconstriction and improve heat absorption, after which the child's temperature steadily improved. In hypothermic burn patients, topical vasoconstrictors may hinder surface warming efforts. A vasodilator infusion may aid in warming the pediatric patient undergoing extensive excision and grafting.
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: CASE REPORT Source Type: research
ConclusionsGBC attenuated cerebral edema following CA/CPR by blocking Sur1 –TRPM4 channels upregulated by CA insult. The effect of GBC was comparable with that of therapeutic hypothermia alone. These results suggest that GBC is an alternative approach for treating CA-evoked cerebral edema.
Source: Neurocritical Care - Category: Neurology Source Type: research
Total joint patients are particularly vulnerable to perioperative hypothermia (PH) (combined effects of anesthesia, radiation and convective heat loss from exposed skin surfaces and cool temperatures in the operating room). There are limited studies on PH in these patients.
Source: The Journal of Arthroplasty - Category: Orthopaedics Authors: Source Type: research
One Sunday in early 2017, my anesthesia coresident Will (not his real name) was brought to the emergency department of our hospital unresponsive. He was quickly triaged, intubated, and transferred to the intensive care unit (ICU), where a hypothermia protocol was initiated. I couldn't visit Will for two days. Those days came like rust, slow and hard. I went to see him with another resident. We met Will ’s family for the first time under the worst of circumstances. I went expecting to offer comfort, prayers, and time. Instead, Will’s family gave me comfort, prayers, and all the time I needed.
Source: JAMA - Category: General Medicine Source Type: research
This study tested the hypothesis that a single, preincision injection of a transient receptor potential vanilloid 1 antagonist could prevent anesthesia-induced hypothermia and decrease the opioid requirement for postsurgical hypersensitivity.Methods General anesthesia was induced in rats and mice with either isoflurane or ketamine, and animals were treated with transient receptor potential vanilloid 1 antagonists (AMG 517 or ABT-102). The core body temperature and oxygen consumption were monitored during anesthesia and the postanesthesia period. The effect of preincision AMG 517 on morphine-induced reversal of postincision...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
In conclusion, hyperoxia proved to be safe during resuscitation from hemorrhagic shock. The lacking organ-protective effects of hyperoxia compared to resuscitation from near-lethal hemorrhage suggest a dependence of the effectiveness of hyperoxia from shock severity. In line with our previous report, therapeutic hypothermia (and rewarming) was confirmed to be detrimental most likely due to vascular barrier dysfunction.
Source: Shock - Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
We thank Dr. Pang et al. [1] for their interest and their relevant comments about our article [2]. As they underlined in their letter [1], during therapeutic hypothermia, there is a vaso-constriction and shivering, that result in skin breakdown and increased oxygen consumption [3], the latest being prevented by anesthetics and sedatives infusion. In the particular context of post-cardiac arrest, the aim of anesthetics and sedatives infusion is also to protect the brain against secondary aggression due to the occurrence of the ischemia-reperfusion syndrome during the first 6h following a brain injury, which involves mitocho...
Source: Resuscitation - Category: Emergency Medicine Authors: Tags: Letter to the Editor Source Type: research
Abstract Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperati...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Joyce Keifer and Zhaoqing Zheng Use of hypothermia as a means of anesthesia for amphibians and reptiles is prohibited by agencies that establish veterinary guidelines. This has recently been called into question by members of the scientific community based on reviews of published literature. Using pond turtles (Trachemys scripta elegans), hypothermia as a method for anesthesia to precede euthanasia by decapitation was assessed. Turtles were subjected to hypothermia using a cooling followed by freezing protocol. Body temperature measurements ranged between –1 to –2°C while core body temperature was –1&...
Source: Journal of Experimental Biology - Category: Biology Authors: Tags: SHORT COMMUNICATION Source Type: research
Editor —I read the meta-analysis by Sultan and colleagues1 and the comment thereon by Nair2 with great interest. Although the duration of a Caesarean section is short, the exposed abdomen loses warmth by radiation and convection, leading to a reportedly high rate of hypothermia after surgery. In addition to the size of the exposed area, temperature loss is proportional to the difference in temperature (Fourier ’s law). I am astonished that neither the review by Sultan and colleagues1, nor other reviews like the one by Munday and colleagues,3 mention the temperature of the operation theatre as an influential fac...
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research
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