Platelet function disorder in trauma patients, an underestimated problem? Results of a single center study.

[Platelet function disorder in trauma patients, an underestimated problem? Results of a single center study]. Anaesthesist. 2019 May 16;: Authors: Hofer V, Wrigge H, Wienke A, Hofmann G, Hilbert-Carius P Abstract BACKGROUND: Plasmatic coagulation disorders in trauma patients are common and their management is subject to current guidelines. Less evidence exists for platelet function. Although it is known that several trauma-associated factors have a negative influence on platelet function, routine monitoring has not yet become established. METHODS: A retrospective single center study was carried out at a German level 1 trauma center from 2010 to 2016. In all patients fulfilling the requirements for the German Trauma Society (DGU) Traumaregister® who were admitted directly from the scene of the incident, platelet function was analyzed using the Platelet Function Analyzer (PFA 100®) with adenosine diphosphate (ADP) and epinephrine as activation factors. After exclusion of patients with intake of long-term anticoagulant and antiaggregant medication, possible influencing factors of a reduced platelet function were identified. RESULTS: The results from 310 patients (44.0 ± 14.7 years, 76% male, Injury Severity Score, ISS 28.4 ± 14.2 points) were available. A delayed platelet activation was found in 25.5% using ADP and 31% using epinephrine. Laboratory parameters indicated a greater blood los...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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In conclusion, the new mild WI protocol is a superior experimental model to study the pathophysiological effects of elevated ICP induced by water intoxication. PMID: 31534063 [PubMed - as supplied by publisher]
Source: Experimental Animals - Category: Research Tags: Exp Anim Source Type: research
This article details the pharmacological and nonpharmacological methods to minimise preoperative anxiety and the techniques of anaesthetic induction in infants and children undergoing surgery. The benefits and limitations of inhalational and intravenous induction and the current status of rapid sequence induction in children are discussed. MEDLINE database was searched for this narrative review using the keywords including preoperative anxiety, child, premedication, paediatric and anaesthetic induction. Search was restricted to articles in English, but without any publication date restrictions.
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
CONCLUSION: Given optimal management JW patients can undergo major surgery without an excessive risk of death. The 6.6% in-hospital mortality observed in this institution was in the range of the 4% generally observed after surgery in Europe. The majority of JW patients accepted a variety of blood conservation strategies following appropriate elucidation. This also included coagulation factor concentrates extracted from human plasma enabling an effective treatment of even severe bleeding complications. In this analysis postoperative hemoglobin concentrations below 6 g/dl in older JW patients were associated with a&nb...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
CONCLUSION: Hemodialysis patients are likely to develop lacrimal hyposecretion mostly because of comorbities. It is therefore important to systematically evaluate lacrimal secretion in these patients. PMID: 30857803 [PubMed - as supplied by publisher]
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
Background: Von Willebrand disease (vWD) is the most common inherited bleeding disorder with a reported prevalence of 1% in epidemiological studies and symptomatic prevalence of 1 in 10,000.Pregnancy in vWD is associated with increased bleeding risk particularly postpartum hemorrhage. Treatment options include desmopressin acetate (DDAVP), plasma derived factor concentrates and antifibrinolytic agents. Human Recombinant von Willebrand factor (vWF) (Vonvendi®) has been approved in the United States for on demand treatment and perioperative management of adults with vWD. It has been shown to maintain sustained levels of ...
Source: Blood - Category: Hematology Authors: Tags: 401. Basic Science and Clinical Practice in Blood Transfusion Source Type: research
Cooper, New York City, 20071.Thursday morning, I woke up, got my kids ready and took them to school. I came home, tidied up the rest of the dishes, and gave my dog Cooper an indulgent breakfast: a full can of her favorite soft dog food —not just a quarter of a can mixed in with her dry food like usual, but the whole thing, every last bit, all to herself. After she finished, I carried her to my car. We drove to the vet, where a kind receptionist showed me into an exam room, past a potted ficus plant and a cheerful wooden sign rea ding, “Think PAWS-ITIVELY!” I sat down on a bench. Cooper stuck her head behi...
Source: the underwear drawer - Category: Anesthesiology Authors: Source Type: blogs
CONCLUSIONS By following the modified STT, QL is established with minimal additional effort over a standard Schirmer test. We predict and observe four different subtypes of imbibition kinetics depending on how short or long the time is for first appearance of the wetting front and on how fast or slow is tear production. For slow lacrimal production rates, the standard 5-min wetting length does not correlate with basal tear production.
Source: Optometry and Vision Science - Category: Opthalmology Tags: Original Investigations Source Type: research
Authors: Demers C, Derzko C, David M, Douglas J Abstract OBJECTIVE: The prevalence of bleeding disorders, notably von Willebrand disease (vWD), among adult women with objectively documented menorrhagia is consistently reported to be 10% to 20% and is even higher in adolescents presenting with menorrhagia. OPTIONS: Diagnostic tools and specific medical and, where appropriate, surgical alternatives to management are reviewed and evidence-based recommendations presented. EVIDENCE: A MEDLINE search of the English literature between January 1975 and November 2003 was performed using the following key words: meno...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
BACKGROUND Prasugrel is a thienopyridine that inhibits platelet aggregation more rapidly and effectively than clopidogrel, with an increased bleeding risk. OBJECTIVE The current study aimed to evaluate the efficacy of three nonspecific haemostatic drugs – recombinant activated factor VII (rFVIIa), tranexamic acid and desmopressin (DDAVP) – to limit blood loss after administration of prasugrel in a rabbit model of bleeding while also evaluating any prothrombotic effects. DESIGN Randomised, placebo-controlled study. SETTING Faculty of Medicine, University of Geneva, Switzerland, in 2013. ANIMALS Ana...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Pharmacology Source Type: research
Blind insertion or blindly inserted? One thing we do in EMS that many of us most pride ourselves on is advanced airway management—though gaining that pride may have required a few moments of pants-wetting terror along the way. For patients in respiratory failure rapidly progressing to respiratory or cardiac arrest, there are few scenarios that run us right up against the front lines of life and death, and with so much potential to affect the outcome. These cases bring into focus the cognitive (knowledge), psychomotor (manual), and affective (emotional/psychological) elements of our job like nothing else we do. Yet ev...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Columns Source Type: news
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