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Condition: Bleeding
Therapy: Dialysis

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Total 447 results found since Jan 2013.

Oral Anticoagulation Therapy in Atrial Fibrillation Patients with Advanced Chronic Kidney Disease: CODE-AF Registry
CONCLUSION: Among AF patients with advanced CKD or ESRD on dialysis, DOAC was associated with a lower risk of major or CRNM bleeding compared to warfarin and a lower risk of composite adverse clinical outcomes compared to no OAC. ClinicalTrials.gov (NCT02786095).PMID:36579375 | PMC:PMC9826956 | DOI:10.3349/ymj.2022.0455
Source: Yonsei Medical Journal - December 29, 2022 Category: Universities & Medical Training Authors: Hanjin Park Hee Tae Yu Tae-Hoon Kim Junbeom Park Jin-Kyu Park Ki-Woon Kang Jaemin Shim Jin-Bae Kim Jun Kim Eue-Keun Choi Hyung Wook Park Young Soo Lee Boyoung Joung Source Type: research

Worldwide experience with the 29-mm Edwards SAPIEN XTTM transcatheter heart valve in patients with large aortic annulus ADULT CARDIAC
CONCLUSIONS The 29-mm Edwards SAPIEN XT™ bioprosthesis provides an excellent outcome in patients with a large aortic annulus undergoing transapical aortic valve implantation. Using this larger transcatheter heart valve, a broader population of high-risk elderly patients with aortic stenosis can be treated by minimally invasive transapical implantation techniques.
Source: European Journal of Cardio-Thoracic Surgery - January 13, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Wendler, O., Thielmann, M., Schroefel, H., Rastan, A., Treede, H., Wahlers, T., Eichinger, W., Walther, T. Tags: ADULT CARDIAC Source Type: research

Fatal dabigatran toxicity secondary to acute renal failure
We describe the case of a 74-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation who presented to the emergency department after 20 mL of hematemesis at home. Laboratory evaluation revealed a partial thromboplastin time of 99 seconds, international normalized ratio of 11.7, and creatine of 3.1 mg/dL (baseline creatine, 0.9 mg/dL). Upper endoscopy revealed diffuse gastritis and bleeding. Despite treatment with packed red blood cells and fresh frozen plasma, the patient's hematemesis persisted resulting in significant aspiration requiring endotracheal intubation. Per poison control center recommendation...
Source: The American Journal of Emergency Medicine - November 19, 2012 Category: Emergency Medicine Authors: Joseph K. Maddry, Mana Kouros Amir, Daniel Sessions, Kennon Heard Tags: Case Reports Source Type: research

Sailing between Scylla and Charybdis: oral long-term anticoagulation in dialysis patients
End-stage renal disease (ESRD) patients exhibit an increased risk of bleeding compared with non-chronic kidney disease (CKD) patients due to uraemic platelet dysfunction, altered vessel architecture and other factors. This renders any long-term oral anticoagulation potentially difficult. While there is little doubt that ESRD patients with recurrent thromboembolism or a mechanical cardiac valve should receive vitamin K antagonists (coumarins), the use of coumarins in ESRD patients with atrial fibrillation is a matter of debate. In non-CKD patients, current guidelines strongly recommend the use of oral anticoagulants for str...
Source: Nephrology Dialysis Transplantation - March 5, 2013 Category: Urology & Nephrology Authors: Kruger, T., Brandenburg, V., Schlieper, G., Marx, N., Floege, J. Tags: CLINICAL SCIENCE AND OUTCOME RESEARCH IN NEPHROLOGY Source Type: research

Case report: hemodialysis for dabigatran overdose
3 out of 5 stars Hemodialysis for the Treatment of Pulmonary Hemorrhage from Dabigatran Overdose. Chen BC et al. Am J Kidney Dis 2013 Apr 15 [Epub ahead of print] Abstract Dabigatran (Pradaxa) is a competitive direct thrombin inhibitor approved in the United States for stroke prophylaxis in patients with nonvalvular atrial fibrillation. Although dabigatran has certain advantages over coumadin related to issues of dosing and testing, there is no readily available test to measure its anticoagulation effect, and there is no antidote to reverse bleeding. Recommendations for treating a patient with dabigatran-associated hemorr...
Source: The Poison Review - April 24, 2013 Category: Toxicology Authors: Leon Tags: Medical dabigatran hemodialysis hemorrhage overdose Source Type: news

Extracorporeal Therapy for Dabigatran Removal in the Treatment of Acute Bleeding: A Single Center Experience.
CONCLUSIONS: Extracorporeal therapy lowered dabigatran concentrations, suggesting that it removed the drug and may effectively accelerate total clearance, especially in patients with impaired kidney function. The use of prolonged intermittent hemodialysis or intermittent hemodialysis followed by continuous renal replacement therapy is recommended for the management of life-threatening bleeding in patients receiving dabigatran. The advantage of extracorporeal therapy should be weighed against the risk of bleeding with catheter insertion. PMID: 23704302 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 23, 2013 Category: Urology & Nephrology Authors: Singh T, Maw TT, Henry BL, Pastor-Soler NM, Unruh ML, Hallows KR, Nolin TD Tags: Clin J Am Soc Nephrol Source Type: research

Outcome of Pericardiectomy for Constrictive Pericarditis in Japan: A Nationwide Outcome Study.
CONCLUSIONS: Pericardiectomy is associated with high morbidity and mortality rates. Careful consideration should be given to these risk factors in the process of patient selection and perioperative management. PMID: 23791164 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - June 21, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Tokuda Y, Miyata H, Motomura N, Araki Y, Oshima H, Usui A, Takamoto S, The Japan Adult Cardiovascular Database Organization Tags: Ann Thorac Surg Source Type: research

New heart op could save 'thousands of lives'
Conclusion This was a well-designed study which showed that over the course of two years, the risk of another non-fatal or fatal heart attack is reduced in heart attack patients who have preventive stents inserted in narrowed arteries at the same time as a procedure to insert stents into the blocked coronary artery that caused their heart attack. However, an important point to note is that the study results do not apply to all patients who have had a heart attack. The study only looked at the group of patients who had a specific type of heart attack – a STEMI – and needed an emergency stent placement operation. ...
Source: NHS News Feed - September 3, 2013 Category: Consumer Health News Tags: Heart/lungs Genetics/stem cells Source Type: news

Safety of Outpatient Laparoscopic Cholecystectomy in the Elderly: Analysis of 15,248 Patients Using the NSQIP Database
Background: Studies have shown that laparoscopic cholecystectomy (LC) in an ambulatory setting is a safe alternative to the traditional overnight hospital stay. However, there are limited data on the morbidity and mortality of outpatient LC in elderly patients. We evaluated the safety of ambulatory LC in the elderly and identified risk factors that predict inpatient admission.Study Design: A retrospective analysis was performed using the American College of Surgeon's NSQIP database between 2007 and 2010. The database was searched for patients older than 65 years of age who underwent elective LC at all participating hospita...
Source: Journal of the American College of Surgeons - August 7, 2013 Category: Surgery Authors: Ajit Rao, Antonio Polanco, Sujing Qiu, Joseph Kim, Edward H. Chin, Celia M. Divino, Scott Q. Nguyen Tags: Original Scientific Articles Source Type: research

Vitamin K Antagonists: Beyond Bleeding
Abstract Warfarin is the most widely used oral anticoagulant in clinical use today. Indications range from prosthetic valve replacement to recurrent thromboembolic events due to antiphospholipid syndrome. In hemodialysis (HD) patients, warfarin use is even more frequent than in the nonrenal population due to increased cardiovascular comorbidities. The use of warfarin in dialysis patients with atrial fibrillation requires particular caution because side effects may outweigh the assumed benefit of reduced stroke rates. Besides increased bleeding risk, coumarins exert side effects which are not in the focus of clinical routin...
Source: Seminars In Dialysis - January 9, 2014 Category: Hematology Authors: Thilo Krüger, Jürgen Floege Tags: Review Source Type: research

Vitamin k antagonists: beyond bleeding.
Abstract Warfarin is the most widely used oral anticoagulant in clinical use today. Indications range from prosthetic valve replacement to recurrent thromboembolic events due to antiphospholipid syndrome. In hemodialysis (HD) patients, warfarin use is even more frequent than in the nonrenal population due to increased cardiovascular comorbidities. The use of warfarin in dialysis patients with atrial fibrillation requires particular caution because side effects may outweigh the assumed benefit of reduced stroke rates. Besides increased bleeding risk, coumarins exert side effects which are not in the focus of clinic...
Source: Seminars in Dialysis - January 1, 2014 Category: Urology & Nephrology Authors: Krüger T, Floege J Tags: Semin Dial Source Type: research

Clinical Experience of Life-Threatening Dabigatran-Related Bleeding at a Large, Tertiary Care, Academic Medical Center: a Case Series.
CONCLUSION: Reversal strategies for dabigatran-related bleeding events at our institution are highly variable. Intracranial hemorrhage in patients on dabigatran was associated with 43 % mortality. Patients with severe dabigatran-related bleeding may benefit from a standardized approach to treatment. PMID: 24385325 [PubMed - as supplied by publisher]
Source: Journal of Medical Toxicology - January 3, 2014 Category: Toxicology Authors: Ross B, Miller MA, Ditch K, Tran M Tags: J Med Toxicol Source Type: research

Black Box Warning: Is Ketorolac Safe for Use After Cardiac Surgery?
Objective: In 2005, after the identification of cardiovascular safety concerns with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the FDA issued a black box warning recommending against the use of NSAIDs following cardiac surgery. The goal of this study was to assess the postoperative safety of ketorolac, an intravenously administered NSAID, after cardiac surgery.Design: Retrospective observational study.Setting: Single center, regional hospital.Participants: A total of 1,309 cardiac surgical patients (78.1% coronary bypass, 28.0% valve) treated between 2006 and 2012.Interventions: A total of 488 of these patie...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 13, 2013 Category: Anesthesiology Authors: Lisa Oliveri, Katie Jerzewski, Alexander Kulik Tags: Original Articles Source Type: research

Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial
Background: To evaluate if an opiate sparing multimodal regimen of dexamethasone, gabapentin, ibuprofen and paracetamol had better analgesic effect, less side effects and was safe compared to a traditional morphine and paracetamol regimen after cardiac surgery. Methods: Open-label, prospective randomized controlled trial. 180 patients undergoing cardiac procedures through median sternotomy, were included in the period march 2007- August 2009. 151 patients were available for analysis. Pain was assessed with the 11-numeric rating scale (11-NRS). Results: Patients in the multimodal group demonstrated significantly lower avera...
Source: Journal of Cardiothoracic Surgery - March 20, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Sulman RafiqDaniel SteinbrüchelMichael WanscherLars AndersenAlbert NavneNikolaj LilleoerPeter Olsen Source Type: research

AF News
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Source: Journal of Cardiovascular Electrophysiology - March 1, 2014 Category: Cardiology Authors: TZE‐FAN CHAO, LI‐WEI LO, SHIH‐ANN CHEN Tags: AF News Source Type: research