Unexpected excessive bleeding during operation: Role of acetyl salycilic acid

ABSTRACT Tracheostomy plays a vital role in respiratory distress caused by different conditions, like respiratory passage of obstruction, head and neck tumor, surgeries, trauma patients and inflammatory conditions. Timing of the operation and postoperative care deserves more emphasis. Delay in the performance of this operation defeats the purpose of tracheostomy and if managed properly, it is a life saving procedure. The aim of the study was not only to give immediate relief to the patients of respiratory distress. But also to study age and sex distribution indication and evaluate factors associated with morbidity and mortality, intraoperative and postoperative complications associated with this procedure. This study was done on 50 cases of respiratory distress admitted in different department of Rajindra Hospital, Patiala, who underwent tracheostomy as an emergency or elective procedure. Most of the patients (24%) were of 50 to 60 years of age of which 60% were males. Emergency tracheostomy was done in most of the cases (64%). Most common complication was wound infection and granuloma formation (16%). Mortality due to primary disease (tumors of head and neck) was 34%. Followed by head injury (29%). Only one patient died of tracheostomy due to excessive bleeding. How to cite this article Sahni D. Role of Tracheostomy in Respiratory Distress: A Study of 50 Cases. Clin Rhinol An Int J 2015;8(1):20-23.

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Tissue Factor-Negative Cell-Derived Microparticles Play a Distinctive Role in Hemostasis: A Viewpoint Review

Seminars in Thrombosis and Hemostasis ◽

10.1055/s-0039-1688570 ◽

2019 ◽

Vol 45 (05) ◽

pp. 509-513 ◽

Cited By ~ 2

Author(s):

Lawrence L. Horstman ◽

Robert F. McCauley ◽

Wenche Jy ◽

Yeon S. Ahn

Keyword(s):

Potential Role ◽

Clinical Settings ◽

Trauma Patients ◽

Excessive Bleeding ◽

Activated Platelets ◽

Transfusion Requirements ◽

Type C ◽

Improved Methods ◽

Distinctive Role

AbstractCirculating cell-derived microparticles (MPs) exhibit procoagulant activity and have been investigated for a possible role in some human pathologies. However, their potential role in hemostasis has been neglected and often denied. This review brings to attention a specific body of direct clinical evidence supporting an important but distinctive role of MPs in hemostasis. Evidence for a role of MPs in hemostasis includes: (1) two congenital bleeding disorders attributed to impaired release of MPs; (2) two recent studies of trauma patients relating naturally elevated endogenous MPs at admission to reduced transfusion requirements and better outcomes; (3) a study of coronary surgery patients showing that elevated MP before surgery reduces transfusion requirements during surgery; and (4) a clinical study of patients with immune thrombocytopenia demonstrating that those with high circulating MP have reduced bleeding compared to patients with similar platelet counts but lower MP levels. Mechanisms involving potentiating the contact factor pathway are thought to play a key role and are probably synergistic with polyphosphate released from activated platelets at sites of endothelial injury. Hemostatic defect of patients with deficient MP-mediated coagulation resembles deficiency of FXI (hemophilia C), distinct from hemophilia A or B, so can be termed type C hemostasis. A better understanding of this proposed hemostatic pathway may lead to improved methods for controlling excessive bleeding in surgery, trauma, and other clinical settings.

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Diagnosis and management of disseminated intravascular coagulation: the role of heparin therapy

Blood ◽

10.1182/blood.v60.2.284.284 ◽

1982 ◽

Vol 60 (2) ◽

pp. 284-287 ◽

Cited By ~ 137

Author(s):

DI Feinstein

Keyword(s):

Disseminated Intravascular Coagulation ◽

Purpura Fulminans ◽

Underlying Disease ◽

Additional Treatment ◽

Neoplastic Disease ◽

Excessive Bleeding ◽

Intravascular Coagulation ◽

At Iii ◽

Hemostatic Factors

Abstract Disseminated intravascular coagulation (DIC) is caused by a variety of underlying disorders, and criteria for diagnosis are not well defined. However, the most helpful are a low platelet count, positive plasma protamine test, and fibrinogen and fibrin degradation product levels viewed in the context of the patient's underlying disease. The cornerstone of therapy is prompt treatment of the underlying disease and elimination of the trigger mechanism. Additional treatment must be individualized, and generalizations are difficult to make. However, if the patient has low hemostatic factors and is actively bleeding or requires an invasive procedure, then replacement with the appropriate hemostatic factors should be tried. Heparin is indicated in patients with purpura fulminans and venous thromboembolism, but there is little evidence that heparin reverses organ dysfunction associated with DIC. In addition, heparin is also probably indicated in patients with retained dead fetus and hypofibrinogenemia prior to induction of labor, excessive bleeding associated with a giant hemangioma, and neoplastic disease, particularly promyelocytic leukemia. Although the use of heparin in acute forms of DIC remains controversial, the majority of studies suggest that it is not helpful. The role of antithrombin III (AT-III) concentrates is unknown, but they theoretically may be helpful when DIC is associated with very low AT-III levels, as is seen in liver disease.

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Glanzmann’s Thrombastenia: The Role of Tranexamic Acid in Oral Surgery

Case Reports in Dentistry ◽

10.1155/2018/9370212 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Rocco Franco ◽

Michele Miranda ◽

Laura Di Renzo ◽

Antonino De Lorenzo ◽

Alberta Barlattani ◽

...

Keyword(s):

Tranexamic Acid ◽

Autosomal Recessive ◽

Oral Surgery ◽

University Hospital ◽

Chromosome 17 ◽

Bleeding Complications ◽

Excessive Bleeding ◽

Continuous Bleeding

Glanzmann’s thrombastenia (GT) is the most frequent inherited condition. GT is a genetic autosomal recessive disease caused by the alteration of the genes ITGA2B and ITGB3, located on the chromosome 17. The incidence of GT is calculated in 1 on 1000000. The patients, during their life, show episodes of mucocutaneous bleeding, epistaxis, and gingival bleeding. Some subjects required continuous bleeding transfusion. The aim of this case report is to demonstrate that oral assumption of tranexamic acid is a gold standard to prevent excessive bleeding. The patient GM of 36 years old with GT type 1 needs dental extractions of the teeth 4.7 and 4.8 at the “Tor Vergata” University Hospital in Rome. The specialist suggests that 3 days before surgery, the patient must take 6 vials every day of tranexamic acid that is used in obstetrics and gynecology. The teeth were extracted and applied suture. The patient is observed and is recommended mouth rinse with tranexamic acid. No bleeding complications were observed.

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THE ROLE OF PLATELET CONCENTRATION TRANSFUSION ON THE CORRELATION BETWEEN PLATELET NUMBER AND MAXIMUM AMPLITUDE WITH BLEEDING VOLUME POST CARDIOPULMONARY BYPASS

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v25i1.1512 ◽

2018 ◽

Vol 25 (1) ◽

pp. 86

Author(s):

Ryan Bayusantika Ristandi ◽

Nida Suraya ◽

Leni Lismayanti ◽

Sylvia Rachmayati

Keyword(s):

Platelet Count ◽

Maximum Amplitude ◽

Platelet Concentrate ◽

Platelet Dysfunction ◽

Excessive Bleeding ◽

Heart Patients ◽

Bleeding Volume ◽

Platelet Number ◽

Platelet Concentration

Postoperative heart patients with Cardiopulmonary Bypass (CPB) are at risk of excessive bleeding. Excessive bleeding is mainly due to thrombocytopenia and platelet dysfunction. The volume of post-CPB bleeding without the administration of platelet concentrate correlates well with platelet count and Maximum Amplitude (MA). The administration of platelet concentrate in thrombocytopenia and platelet dysfunction post CPB may affect the correlation of platelet count and MA which affects the volume of bleeding. The purpose of this research was to know the role of transfusion of platelet concentration post-CPB on the correlation between platelet number and MA with the volume of bleeding. The analytical observational analytic test with the cross-sectional design was conducted on secondary data from September 2015 to March 2016. A total of 44 postoperative heart patients CPB monitored up to four hours in the room Cardiac Intensive Care Unit (CICU) Dr. HasanxSadikin HospitalxBandung. The platelet count was negatively correlated with bleeding volume (r = -0.157, p = 0.308) and the MA was negatively correlated (very weak) with bleeding volume (r = -0.171, p = 0.266). The post-CPB platelet concentrate concentration led to better patient hemostasis, as evidenced by the majority of platelet counts (97.7%)> 100,000/mm3 and MA (84%)x≥x50xmm. The post-CPB platelet concentrate causes a negative (very weak) correlation between platelet count and MA with bleeding volume

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Unique Case of Brothers with Moderate Factor XI Deficiency and One with Severe Bleeding After Surgery

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/107602969600200104 ◽

1996 ◽

Vol 2 (1) ◽

pp. 14-17

Author(s):

Barbara L. Steel ◽

Kathryn L. Hassell ◽

Chitra Rajagopalan ◽

Audrey A. Merritt ◽

Thomas Parsons ◽

...

Keyword(s):

The Other ◽

Severe Bleeding ◽

Bleeding Diathesis ◽

Invasive Procedures ◽

Factor Xi ◽

Unique Case ◽

Excessive Bleeding ◽

Factor Xi Deficiency ◽

Aptt Reagent

Factor XI is the only contact factor whose de ficiency may result in a bleeding diathesis. This case re port describes two brothers with similar moderate factor XI deficiency (41% and 45%), but one brother had severe bleeding during invasive procedures whereas the other brother undergoing the same surgical procedure had no excessive bleeding. The bleeding in the first brother con tinued despite adequate factor XI levels; however, it was stopped only after EACA therapy. Also discussed is the importance of a sensitive aPTT reagent to the various factors and the role of the aPTT in predicting potential bleeding, since a normal aPTT was obtained prior to the first surgery. This case demonstrates that major bleeding can occur in heterozygous factor XI deficiency and the patient must be considered 'at risk' for potential bleeding and should be treated accordingly.

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Diagnosis and management of disseminated intravascular coagulation: the role of heparin therapy

Blood ◽

10.1182/blood.v60.2.284.bloodjournal602284 ◽

1982 ◽

Vol 60 (2) ◽

pp. 284-287 ◽

Cited By ~ 3

Author(s):

DI Feinstein

Keyword(s):

Disseminated Intravascular Coagulation ◽

Purpura Fulminans ◽

Underlying Disease ◽

Additional Treatment ◽

Neoplastic Disease ◽

Excessive Bleeding ◽

Intravascular Coagulation ◽

At Iii ◽

Hemostatic Factors

Disseminated intravascular coagulation (DIC) is caused by a variety of underlying disorders, and criteria for diagnosis are not well defined. However, the most helpful are a low platelet count, positive plasma protamine test, and fibrinogen and fibrin degradation product levels viewed in the context of the patient's underlying disease. The cornerstone of therapy is prompt treatment of the underlying disease and elimination of the trigger mechanism. Additional treatment must be individualized, and generalizations are difficult to make. However, if the patient has low hemostatic factors and is actively bleeding or requires an invasive procedure, then replacement with the appropriate hemostatic factors should be tried. Heparin is indicated in patients with purpura fulminans and venous thromboembolism, but there is little evidence that heparin reverses organ dysfunction associated with DIC. In addition, heparin is also probably indicated in patients with retained dead fetus and hypofibrinogenemia prior to induction of labor, excessive bleeding associated with a giant hemangioma, and neoplastic disease, particularly promyelocytic leukemia. Although the use of heparin in acute forms of DIC remains controversial, the majority of studies suggest that it is not helpful. The role of antithrombin III (AT-III) concentrates is unknown, but they theoretically may be helpful when DIC is associated with very low AT-III levels, as is seen in liver disease.

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Role of Sharapunkha moola churna with Tandulodaka Anupana in Menorrhagia (Asrigdara) - A Case report

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v8i01.535 ◽

2020 ◽

Vol 8 (01) ◽

Author(s):

Pradipkumar Giri ◽

Jayamala Jadhav

Keyword(s):

Case Report ◽

Side Effects ◽

Specific Effect ◽

Cost Effective ◽

Lower Abdomen ◽

Excessive Bleeding ◽

Gynecological Disorders ◽

Tephrosia Purpurea ◽

Future Pregnancy

Menorrhagia is a most common gynecological problem found in gynaec OPD. It is not a disease but it is symptom found in many gynecological disorders. Menorrhagia is characterized by the excessive bleeding per vaginum in amount and duration both. In Ayurvedic classics, Menorrhagia is termed as ‘Asrigdara’, means excessive discharge of blood per vaginum, backache, pain in lower abdomen and weakness are also present in this disease. Asrigdara, also known as Raktapradara, is mainly due to vitiation of Vata, Pitta and Rakta dosha hence, the treatment should be based on the use of drugs which are having predominance of Kashaya and Tikta rasa. They are known as best astringent and because of this property they plays important role in relieving bleeding discharge due to its Stambhana action. In Ayurveda classics, many preparations can be used for management of Asrigdara by considering factors such as parity, age & desire of patient with regard to contraception, future pregnancy etc. Which are non-hormonal, non-surgical & most effective without side effects and also cost effective. In this case, Sharapunkha (i.e. Tephrosia purpurea, Pers) mula Churna with Tandulodaka was selected for screening and re-establishing its specific effect in the management of Menorrhagia.

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