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65 records – page 1 of 7.

[A blood transfusion in Sweden--the societal cost].

https://arctichealth.org/en/permalink/ahliterature166918
Source
Lakartidningen. 2006 Sep 20-26;103(38):2752-6
Publication Type
Article

An Adjusted Calculation Model Allows for Reduced Protamine Doses without Increasing Blood Loss in Cardiac Surgery.

https://arctichealth.org/en/permalink/ahliterature284260
Source
Thorac Cardiovasc Surg. 2016 Sep;64(6):487-93
Publication Type
Article
Date
Sep-2016
Author
Gunilla Kjellberg
Ulrik Sartipy
Jan van der Linden
Emelie Nissborg
Gabriella Lindvall
Source
Thorac Cardiovasc Surg. 2016 Sep;64(6):487-93
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Aged
Anticoagulants - administration & dosage - adverse effects
Blood Coagulation - drug effects
Blood Coagulation Tests
Blood Loss, Surgical - prevention & control
Body Height
Body Weight
Cardiac Surgical Procedures - adverse effects
Cardiopulmonary Bypass - adverse effects
Computer simulation
Drug Dosage Calculations
Female
Heparin - administration & dosage - adverse effects
Heparin Antagonists - administration & dosage - adverse effects
Humans
Male
Middle Aged
Models, Biological
Postoperative Hemorrhage - etiology - prevention & control
Protamines - administration & dosage - adverse effects
Sweden
Time Factors
Treatment Outcome
Abstract
Background Heparin dosage for anticoagulation during cardiopulmonary bypass (CPB) is commonly calculated based on the patient's body weight. The protamine-heparin ratio used for heparin reversal varies widely among institutions (0.7-1.3?mg protamine/100 IU heparin). Excess protamine may impair coagulation. With an empirically developed algorithm, the HeProCalc program, heparin, and protamine doses are calculated during the procedure. The primary aim was to investigate whether HeProCalc-based dosage of heparin could reduce protamine use compared with traditional dosages. The secondary aim was to investigate whether HeProCalc-based dosage of protamine affected postoperative bleeding. Patients and Methods We consecutively randomized 40 patients into two groups. In the control group, traditional heparin and protamine doses, based on body weight alone, were given. In the treatment group, the HeProCalc program was used, which calculated the initial heparin bolus dose from weight, height, and baseline activated clotting time and the protamine dose at termination of CPB. Results We analyzed the results from 37 patients, after exclusion of three patients. Equal doses of heparin were given in both groups, whereas significantly lower mean doses of protamine were given in the treatment group versus control group (211?±?56 vs. 330?±?61?mg, p?
PubMed ID
26270199 View in PubMed
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Aprotinin decreases exposure to allogeneic blood during primary unilateral total hip replacement.

https://arctichealth.org/en/permalink/ahliterature198533
Source
J Bone Joint Surg Am. 2000 May;82(5):675-84
Publication Type
Article
Date
May-2000
Author
J M Murkin
G M Haig
K J Beer
N. Cicutti
J. McCutchen
M E Comunale
R. Hall
B B Ruzicka
Author Affiliation
Department of Anaesthesia, London Health Sciences Center-UC, University of Western Ontario, Canada.
Source
J Bone Joint Surg Am. 2000 May;82(5):675-84
Date
May-2000
Language
English
Publication Type
Article
Keywords
Aprotinin - therapeutic use
Arthroplasty, Replacement, Hip - methods
Blood Loss, Surgical - prevention & control
Blood Transfusion
Canada - epidemiology
Double-Blind Method
Female
Hemostatics - therapeutic use
Humans
Infusions, Intravenous
Male
Middle Aged
Postoperative Complications - epidemiology - prevention & control
United States - epidemiology
Venous Thrombosis - epidemiology - prevention & control
Abstract
Aprotinin, a hemostatic agent, regulates fibrinolysis, modulates the intrinsic coagulation pathway, stabilizes platelet function, and exhibits anti-inflammatory properties through inhibition of serine proteases, such as trypsin, plasmin, and kallikrein. Aprotinin has been used successfully for many years in cardiac operations, and there have been preliminary investigations of its use in hip replacement operations. The objectives of this multicenter, randomized, placebo-controlled, double-blind trial were to evaluate the efficacy and safety of aprotinin as a blood-sparing agent in patients undergoing an elective primary unilateral total hip replacement and to examine its effect on the prevalence of deep-vein thrombosis in this population.
Seventy-three patients received a placebo; seventy-six patients, a low dose of aprotinin (a load of 500,000 kallikrein inhibitor units [KIU]); seventy-five, a medium dose of aprotinin (a load of 1,000,000 KIU, with infusion of 250,000 KIU per hour); and seventy-seven patients, a high dose of aprotinin (a load of 2,000,000 KIU, with infusion of 500,000 KIU per hour). The end points for the determination of efficacy were transfusion requirements and blood loss. Patients received standard prophylaxis against deep-vein thrombosis and underwent compression ultrasonography with color Doppler imaging of the proximal and distal venous systems of both legs to evaluate for the presence of deep-vein thrombosis.
Aprotinin reduced the percentages of patients who required any form of blood transfusion (47 percent of the patients managed with a placebo needed a transfusion compared with 28 percent of those managed with low-dose aprotinin [p = 0.02],27 percent of those managed with high-dose aprotinin [p = 0.008], and 40 percent of those managed with medium-dose aprotinin [p = 0.5]). Only 6 percent (twelve) of the 212 patients treated with aprotinin required allogeneic blood compared with 15 percent (ten) of the sixty-eight patients treated with the placebo (p = 0.03). Aprotinin decreased the estimated intraoperative blood loss (p = 0.02 for the low-dose group, p = 0.04 for the medium-dose group, and p = 0.1 for the high-dose group), the measured postoperative drainage volume (p = 0.4 for the low-dose group, p = 0.006 for the medium-dose group, and p = 0.000 for the high-dose group), and the mean reduction in the hemoglobin level on the second postoperative day (thirty-four grams per liter for the placebo group, twenty-eight grams per liter for the low-dose group [p = 0.000], twenty-six grams per liter for the medium-dose group [p = 0.000], and twenty-three grams per liter for the high-dose group [p = 0.0001). The rate of deep-vein thrombosis was similar for all groups.
We concluded that aprotinin is safe and effective for use as a hemostatic agent in primary unilateral total hip replacements. In patients who are at high risk of receiving allogeneic blood, use of aprotinin may be of particular clinical and economic benefit.
PubMed ID
10819278 View in PubMed
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Aprotinin is not associated with postoperative renal impairment after primary coronary surgery.

https://arctichealth.org/en/permalink/ahliterature85873
Source
Ann Thorac Surg. 2008 Jul;86(1):13-9
Publication Type
Article
Date
Jul-2008
Author
Lindvall Gabriella
Sartipy Ulrik
Ivert Torbjörn
van der Linden Jan
Author Affiliation
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden. gabriella.lindvall@karolinska.se
Source
Ann Thorac Surg. 2008 Jul;86(1):13-9
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Aged
Aprotinin - administration & dosage - adverse effects
Blood Loss, Surgical - prevention & control
Blood Transfusion - statistics & numerical data
Case-Control Studies
Coronary Artery Bypass - adverse effects - methods - mortality
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Kidney Failure, Acute - chemically induced - epidemiology - etiology
Kidney Function Tests
Male
Middle Aged
Perioperative Care
Postoperative Complications - etiology - mortality
Probability
Reference Values
Risk assessment
Sensitivity and specificity
Severity of Illness Index
Survival Analysis
Sweden
Tranexamic Acid - administration & dosage - adverse effects
Treatment Outcome
Abstract
BACKGROUND: Studies on the safety of aprotinin in coronary artery surgery have given conflicting results. Therefore, we studied the possible link between perioperative aprotinin treatment and renal dysfunction in patients undergoing first-time coronary surgery with a high risk of bleeding. METHODS: We performed a matched cohort study, comparing 200 patients receiving high-dose aprotinin with 200 patients receiving tranexamic acid during primary isolated coronary surgery. Patients were matched according to age, sex, and presence of acute coronary syndrome. Primary outcome was fractional change in creatinine clearance. Secondary outcomes were other evaluations of postoperative renal function, mortality, stroke, reoperation for bleeding, and transfusion requirements. RESULTS: The groups were similar in baseline characteristics except that triple-vessel disease and history of myocardial infarction were more prevalent in the aprotinin group. No significant differences were found in fractional change in creatinine clearance (-11% versus -12%, medians, p = 0.75) or any other assessments of postoperative renal function between the tranexamic acid and the aprotinin group. Adverse event rates were similar: early mortality (3.5% versus 4.5%, p = 0.80), stroke (1.5% versus 2%, p = 1.0), reoperation for bleeding (3.5% versus 2.5%, p = 0.77), and 5-year survival (87% versus 84%, p = 0.17). Patients in the aprotinin group received fewer transfusions (48% versus 60.5%, p = 0.02), fewer units of packed red blood cells (2.0 versus 1.4, p = 0.02) and plasma (1.3 versus 0.5, p
PubMed ID
18573391 View in PubMed
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Are we doing everything we can to conserve blood during bypass? A national survey.

https://arctichealth.org/en/permalink/ahliterature172391
Source
Perfusion. 2005 Sep;20(5):237-41
Publication Type
Article
Date
Sep-2005
Author
D. Belway
F D Rubens
D. Wozny
B. Henley
H J Nathan
Author Affiliation
Division of Perfusion Services, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Source
Perfusion. 2005 Sep;20(5):237-41
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Blood Loss, Surgical - prevention & control
Blood Transfusion, Autologous - methods - utilization
Canada
Cardiopulmonary Bypass - methods
Centrifugation
Data Collection
Filtration
Humans
Leukocyte Reduction Procedures
Abstract
Despite major advances in biomaterial research and blood conservation, bleeding is still a common complication after cardiopulmonary bypass and cardiac surgery remains a major consumer of blood products. Although the underlying mechanisms for these effects are not fully established, two proposed major etiologies are the hemodilution associated with the use of the heart-lung machine and the impact of reinfusion of shed cardiotomy blood. Therapeutic strategies that primarily encompass the use of devices or technologies to overcome these effects may result in improved clinical outcomes.
To determine the extent to which 1) lipid/leukocyte filtration and centrifugal processing of cardiotomy blood, and 2) modified ultrafiltration (MUF) are currently applied in adult cardiac surgery in Canada.
A questionnaire was mailed to the chief perfusionist at all adult cardiac surgical centers in Canada, addressing details regarding the frequency of use of cardiotomy blood processing and MUF.
All questionnaires (36, 100%) were completed and returned. With regards to cardiotomy blood management, in 21 centers (58%), no specific processing steps were utilized exclusive of the integrated cardiotomy reservoir filter. Of the remaining centers, two (6%) reported using lipid/leukocyte filtration and 15 (42%) reported washing their cardiotomy blood. Three centers (8%) reported using MUF at the end of CPB.
Despite growing concern about the potential detrimental effects of cardiotomy blood, few centers in Canada routinely manage this blood with additional filtration and/or centrifugal processing prior to reinfusion. Similarly, MUF, demonstrated to be effective in the pediatric population, has not seen popular application in adult cardiac surgical practice.
PubMed ID
16231618 View in PubMed
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Bakri balloon for the management of postpartum hemorrhage.

https://arctichealth.org/en/permalink/ahliterature122877
Source
Acta Obstet Gynecol Scand. 2013 Apr;92(4):465-7
Publication Type
Article
Date
Apr-2013
Author
Laura Aibar
Maria Teresa Aguilar
Alberto Puertas
Mercedes Valverde
Author Affiliation
Obstetrics and Gynecology Department, Virgen de las Nieves University Hospital, Granada, Spain.
Source
Acta Obstet Gynecol Scand. 2013 Apr;92(4):465-7
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood Loss, Surgical - prevention & control
Female
Finland
Hemostatic Techniques
Humans
Hysterectomy - statistics & numerical data
Postpartum Hemorrhage - therapy
Pregnancy
Pregnancy Outcome - epidemiology
Spain
Treatment Outcome
Uterine Balloon Tamponade - methods
Uterine Inertia - therapy
Uterus - blood supply
Women's health
Young Adult
Abstract
The aim of this study was to evaluate the effectiveness of the Bakri balloon in treating postpartum hemorrhage refractory to medical treatment. This retrospective study included 24 women with postpartum hemorrhage treated with a Bakri balloon as a conservative therapeutic option. The Bakri balloon was successful in controlling hemorrhage in 87.5% of the women. It was effective in all women with vaginal delivery (five of five) and in all women with uterine atony who did not respond to medical uterotonic treatment (eight of eight). Its ease of use and high effectiveness make the Bakri balloon a useful approach for the conservative management of acute postpartum hemorrhage. This device reduces bleeding, shortens the hospital stay and avoids the need for more aggressive procedures.
PubMed ID
22762694 View in PubMed
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[Balance of hemostasis and anticoagulation therapy techniques for hip arthroplasty].

https://arctichealth.org/en/permalink/ahliterature275704
Source
Khirurgiia (Mosk). 2016;(6):77-82
Publication Type
Article
Date
2016
Author
O A Kaplunov
I V Mikhin
S N Biryukov
Source
Khirurgiia (Mosk). 2016;(6):77-82
Date
2016
Language
Russian
Publication Type
Article
Keywords
Aged
Anticoagulants - therapeutic use
Arthroplasty - adverse effects - methods
Blood Coagulation - drug effects
Blood Loss, Surgical - prevention & control
Blood Transfusion - methods - statistics & numerical data
Female
Hemostasis, Surgical - methods - statistics & numerical data
Hemostatics - therapeutic use
Humans
Male
Monitoring, Intraoperative
Osteoarthritis, Hip - surgery
Outcome Assessment (Health Care)
Postoperative Hemorrhage - therapy
Russia
Abstract
Studied a rational balance of prevention and control of blood loss and antithrombotic therapy in hip arthroplasty.
In view of literature data about significant blood loss during and after the intervention, as well as the formation of the group of patients who refuse blood transfusions for social (including religious) reasons, taken innovative methods for reducing blood loss and needs for blood transfusions.
Complex of techniques, including conducting spinal anesthesia, controlled hypotension with nitroglycerin and pentamine, intraoperative use of systemic hemostatic and preventive use of erythropoietic stimulating agents, was formed in our proprietary technology to reduce blood loss. Its use has allowed to reach a statistically significant reduction of blood loss and transfusion rate in hip arthroplasty patients.
PubMed ID
27296127 View in PubMed
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Balloon occlusion of the internal iliac arteries in the multidisciplinary management of placenta percreta.

https://arctichealth.org/en/permalink/ahliterature124510
Source
Acta Obstet Gynecol Scand. 2013 Apr;92(4):386-91
Publication Type
Article
Date
Apr-2013
Author
Caroline Clausen
Jakob Stensballe
Charlotte K Albrechtsen
Marc A Hansen
Lars Lönn
Jens Langhoff-Roos
Author Affiliation
Department of Cardiovascular Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. clausen.caroline@gmail.com
Source
Acta Obstet Gynecol Scand. 2013 Apr;92(4):386-91
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Balloon Occlusion - methods
Blood Loss, Surgical - prevention & control
Cesarean Section - methods
Denmark - epidemiology
Embolization, Therapeutic - methods
Female
Gynecologic Surgical Procedures - methods
Hemostasis, Surgical - methods
Humans
Iliac Artery
Interdisciplinary Communication
Placenta Accreta - surgery
Pregnancy
Pregnancy Outcome - epidemiology
Abstract
To evaluate our experience with prophylactic balloon occlusion of the internal iliac arteries as a part of a multidisciplinary algorithm for the management of placenta percreta.
Consecutive case series. Setting. Rigshospitalet, Copenhagen University Hospital, Denmark. Sample. Seventeen women with placenta percreta.
Demographic characteristics, intraoperative data and outcomes are summarized and discussed.
Feasibility of local resection, intraoperative blood loss and transfusion requirements.
The multidisciplinary management allowed for local resections in nine of the 11 women who requested preservation of fertility. The mean intraoperative blood loss was 4050 mL (range 450-16 000 mL, median 2500 mL). Adhesions to the bladder or the parietal peritoneum were associated with an intraoperative blood loss >6000 mL.
Prophylactic balloon occlusion of the internal iliac arteries as part of a multidisciplinary algorithm allowed for a safe management of all cases in our consecutive series of 17 women with placenta percreta. However, intraoperative blood loss and transfusion requirements were significant. We have therefore decided to modify our multidisciplinary algorithm to include balloon occlusion of the common iliac arteries rather than the internal iliac arteries.
Notes
Comment In: Acta Obstet Gynecol Scand. 2014 Jan;93(1):122-324576112
PubMed ID
22574880 View in PubMed
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Blood loss in cemented THA is not reduced with postoperative versus preoperative start of thromboprophylaxis.

https://arctichealth.org/en/permalink/ahliterature125464
Source
Clin Orthop Relat Res. 2012 Sep;470(9):2591-8
Publication Type
Article
Date
Sep-2012
Author
Pål O Borgen
Ola E Dahl
Olav Reikerås
Author Affiliation
Martina Hansens Hospital, P.O. Box 23, 1306 Baerum Postterminal, Norway. pborg1@c2i.net
Source
Clin Orthop Relat Res. 2012 Sep;470(9):2591-8
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects
Biological Markers - blood
Blood Loss, Surgical - prevention & control
Blood Transfusion
Bone Cements - therapeutic use
Chi-Square Distribution
Dalteparin - administration & dosage
Double-Blind Method
Drug Administration Schedule
Female
Fibrinolytic Agents - administration & dosage
Hematocrit
Hemoglobins - metabolism
Humans
Injections, Subcutaneous
Male
Middle Aged
Norway
Osteoarthritis, Hip - surgery
Postoperative Care
Postoperative Hemorrhage - blood - etiology - prevention & control
Preoperative Care
Prospective Studies
Time Factors
Treatment Outcome
Abstract
Thrombin formation commences perioperatively in orthopaedic surgery and therefore some surgeons prefer preoperative initiation of pharmacologic thromboprophylaxis. However, because of the potential for increased surgical bleeding, the postoperative initiation of thromboprophylaxis has been advocated to reduce blood loss, need for transfusion, and bleeding complications. Trials on timing of thromboprophylaxis have been designed primarily to detect thrombotic events, and it has been difficult to interpret the magnitude of blood loss and bleeding events owing to lack of information for bleeding volume and underpowered bleeding end points.
We therefore asked whether there are differences in blood loss, transfusion requirements, and other postoperative clinical complications with preoperative versus postoperative start of thromboprophylaxis with dalteparin.
In a double-blind, randomized controlled trial, 80 patients undergoing primary cemented THA were allocated to dalteparin injections starting 12 hours before or 6 hours after surgery. Blood loss was measured by weighing sponges and drapes, volume in suction drains during surgery, and wound drains until removal 24 hours postoperatively. Hemoglobin and hematocrit were recorded at predefined times during and after surgery.
We found no differences in blood loss (1081 mL ± 424 mL versus 1023 mL ± 238 mL), bleeding-related events (10% versus 17%), or number of patients who had transfusions (12 versus five) with preoperative and postoperative thromboprophylaxis, respectively. Other complications were few in both groups.
Our data suggest blood loss is similar with preoperative and postoperative initiation of dalteparin thromboprophylaxis, but indicate a trend toward fewer transfusion requirements which might favor postoperative start of thromboprophylaxis.
Notes
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PubMed ID
22476844 View in PubMed
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65 records – page 1 of 7.