Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients.

Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients. Anesth Analg. 2019 Nov;129(5):1209-1221 Authors: Raphael J, Mazer CD, Subramani S, Schroeder A, Abdalla M, Ferreira R, Roman PE, Patel N, Welsby I, Greilich PE, Harvey R, Ranucci M, Heller LB, Boer C, Wilkey A, Hill SE, Nuttall GA, Palvadi RR, Patel PA, Wilkey B, Gaitan B, Hill SS, Kwak J, Klick J, Bollen BA, Shore-Lesserson L, Abernathy J, Schwann N, Lau WT Abstract Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point-of-care (POC) coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, have increased significantly over the last decade, they are still not widely available in every institution. Therefore, despite continuous efforts, blood transfusion in cardiac surgery has only modestly declined over the last decade, remaining at ≥50% in high-risk ...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research

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ConclusionPBM in obstetrics is based on three main pillars: diagnostic and/or therapeutic interventions during pregnancy, during delivery and in the postpartum phase. These three main pillars should be kept in mind by all professionals taking care of pregnant women, including obstetricians, general practitioners, midwifes, and anaesthesiologists, to improve pregnancy outcome and optimize resources.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
ConclusionsThe study is designed to identify a TxA dose with maximal efficacy and minimal complications. We hypothesize that the high dose has superior efficacy and non-inferior safety to the low dose.
Source: American Heart Journal - Category: Cardiology Source Type: research
Publication date: Available online 18 October 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Jean-Stéphane David, Kenji Inaba
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Comparison of TransFemoral Transcatheter Aortic Valve Replacement Performed With a Minimally Invasive Simplified Technique: "FAST" Versus a Standard Approach. J Invasive Cardiol. 2019 Oct;31(10):300-306 Authors: Lefèvre G, Jégou A, Dambrin G, Picard F, Anconina J, Pouzet B, Guesnier L, Cheikh Khelifa R, Hilpert L, Doan HL, Favereau X Abstract OBJECTIVES: To assess the safety and efficacy of a new simplified procedure for transfemoral (TF) transcatheter aortic valve replacement (TAVR): the FAST protocol. BACKGROUND: A minimalist approach for TF-TAVR has been reported. The goa...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Perioperative coagulopathy and bleeding are common complications in cardiovascular surgery with cardiopulmonary bypass and result in an increased rate of allogeneic blood transfusion. Both bleeding and transfusion can increase postoperative mortality and morbidity. Patient blood management can significantly reduce allogeneic blood transfusions, improve clinical outcomes, and conserve blood resources; however, measures to protect platelets from destruction by cardiopulmonary bypass still are lacking.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Review Article Source Type: research
Inadvertent perioperative hypothermia (IPH), where core body temperature is less than 36 °C or 96.8°F, occurs in 26-90% of patients undergoing elective surgery. This preventable anesthesia- and surgery-related complication affects patients’ outcome and is associated with increased risk for surgical site infections (SSIs), bleeding, blood transfusions, and decreased patient thermal c omfort.
Source: Journal of PeriAnesthesia Nursing - Category: Nursing Authors: Tags: ASPAN National Conference Abstract Source Type: research
ConclusionsOur preliminary experience suggests that intravesical administration of PRP should be considered as a feasible and safe option for the treatment of BK-induced HC after HSCT. Future studies are needed to assess its potential value in other forms of haemorrhagic cystitis.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Allogenic and autologous blood transfusions have been used for the treatment of severe obstetric hemorrhage associated with placenta accreta, placenta previa, and atonic bleeding. However, allogenic transfusion is associated with the risk of infection and allergic reactions, and there is a limit to the amount of autologous blood that can be collected before delivery. Intra-operative cell salvage (ICS), used in cardiovascular, orthopedic and gynecological surgery involves use of blood from the bleeding site collected through a heparinised tube, separation of cells by hemoconcentration, differential centrifugation in 0.9% sa...
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
This article is protected by copyright. All rights reserved. PMID: 31264222 [PubMed - as supplied by publisher]
Source: The Journal of Physiology - Category: Physiology Authors: Tags: J Physiol 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
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