Antithrombin III And Plasminogen Levels In Moderate And Severe Trauma

1981 ◽  
Author(s):  
F A Dombrose ◽  
A E Seyfer ◽  
J Callahan
Keyword(s):  
Antithrombin Iii ◽  
Surgical Stress ◽  
Elective Surgery ◽  
Severe Trauma ◽  
Screening Tests ◽  
Trauma Patients ◽  
Group Iii ◽  
Acceptable Range ◽  
Group I ◽  
Postoperative Thrombosis

Functional and immunologic levels of antithrombin III (ATIII) and plasminogen were assessed in three groups of nine patients each: elective surgery, moderate and severe trauma. Patients otherwise healthy were classified as follows: I, elective extremity surgery, no blood transfusions, normal coagulation screening tests (14-50y); II, isolated, moderately severe trauma (e.g., replantation or revascularization of one or more digits), no transfusions (14-56y); and III, Isolated, severe trauma to extremities, with replantation and revascularization of a severed arm or leg, receiving 1-4 units of whole CPD blood (20-59y). Preoperative, intraoperative (2 hr into surgery) and 24 hr postoperative values were measured. Group III only had intraoperative sampling, with the exception of two patients who had preoperative values prior to any transfusions. A detailed statistical comparision was made (at the 95% confidence level) of the differences in ATIII activity, ATIII antigen level, the ratio of ATIII activity-to-antigen and plasminogen activity among categories within and between groups. The data suggest that elective surgery and moderate trauma had virtually the same effect on ATIII and plasminogen. Activity and antigen values decreased intraoperatively but on the average not enough to be out of the acceptable range. During the convalescent period most ATIII values returned to their preoperative level while most plasminogen values continued to decline somewhat (although still in the acceptable range). By contrast, both ATIII and plasminogen values in the severe trauma group were markedly depressed compared to preoperative levels In either group I or II. Four of the patients in this group suffered postoperative thrombosis and loss of an extremity even though the limb was initially viable. The transient lowering of both ATIII and available plasminogen is undoubtedly most critical when surgical stress is superimposed on existing trauma.

scholarly journals A STUDY ON CHANGES IN PLATELET COUNT AND PLATELET INDICES IN PATIENTS WITH PREECLMPSIAAND ECLAMPSIA: A CASE CONTROL STUDY

2020 ◽  
pp. 7-9
Author(s):  
Pulakesh Sinha ◽  
Sourav Barik ◽  
Apurba Bikash Pramanik ◽  
Victor Roy ◽  
Debarshi Jana
Keyword(s):  
Platelet Count ◽  
Tertiary Care ◽  
Total Sample ◽  
Screening Tests ◽  
Control Group ◽  
Medical Sciences ◽  
Multisystem Disorder ◽  
Platelet Indices ◽  
Group Iii ◽  
Group I

Preeclampsia is a hypertensive pregnancy specific multisystem disorder. It requires prompt intervention that may include observation in tertiary care setting and termination of pregnancy either by inducing labour or by caesarian section. To study the variation of platelet counts, platelet indices in preeclampsia and eclampsia Department of Pathology and Gynaecology & Obstetrics Ramakrishna Mission Seva Pratisthan, Vivekananda Institute of Medical Sciences from January 2017 to June 2018. Group I: Women affected with convulsion and having signs of preeclampsia during pregnancy or within seven days after delivery after ruling out epilepsy or any other convulsive disorder were treated as eclamptic women. Group II: Women having BP> 140/90 mmhg and significant proteinuria (>300mg/24hrs) and or edema are treated as preeclampsia. Group III: Normotensive women having pregnancy >20weeks were considered as control group. Total sample size was 66 pregnant women. 22 patients are taken from each group. The platelet indices e.g. MPV, PDW and also PLCR are in consistent relationship with PIH. The higher their values, the greater severity of PIH, from preeclampsia to eclampsia. The estimation of platelet count and indices offer early, simple, rapid assessments of the disease for its severity and the risk of complications. Therefore these tests may be considered as screening tests to be routinely performed in antenatal workup of women with PIH.

scholarly journals Comparing the effects of dezocine with lidocaine on prevention of propofol injection pain in adults: a prospective randomized double-blind trial

2019 ◽  
Author(s):  
Xuqin Zhu ◽  
Songlin Jia ◽  
Yajun Xu ◽  
Zhirong Sun
Keyword(s):  
Lower Incidence ◽  
Elective Surgery ◽  
Group Iv ◽  
Patient Comfort ◽  
Injection Pain ◽  
Double Blind ◽  
Group V ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Abstract Background Propofol injection pain (PIP) is common and may decrease patient comfort. The aim of this study was to compare the effects of dezocine with lidocaine on prevention of PIP. Methods 235 patients, who scheduled for elective surgery, aged 18-80 years and ASA (American Society of Anesthesiologists) I or II, were randomly assigned into five groups (n = 47 each). All patients were induced through the dor­sal hand vein or antecubital vein. The five groups were given the following medication intravenously: saline (Group I), lidocaine 20 mg (Group II), lidocaine 40 mg (Group III), dezocine 2 mg (Group IV) and dezocine 4 mg (Group V). Twenty seconds later all patients received a propofol infusion and were asked to grade pain or discomfort in the hand or forearm according to a four-point scale until anesthesia. Results Three groups showed a significantly lower incidence of total PIP than Group I: Group III (OR (Odds ratio): 0.39 (0.16, 0.93)); Group IV (OR: 0.21 (0.09, 0.51)) and Group V (OR: 0.12 (0.05, 0.30)). Group IV showed a significantly lower incidence of total PIP than Group II (OR: 0.32 (0.13, 0.77)). Group V showed a significantly lower incidence of total PIP than Group II (OR: 0.15 (0.06, 0.39)) or Group III (OR: 0.30 (0.13, 0.72)). Conclusion Dezocine is a novel agent to alleviate PIP and appears to be more effective than lidocaine.

scholarly journals Comparing the effects of dezocine with lidocaine on prevention of propofol injection pain in adults: a prospective randomized double-blind trial

2019 ◽  
Author(s):  
Xuqin Zhu ◽  
Songlin Jia ◽  
Yajun Xu ◽  
Zhirong Sun
Keyword(s):  
Lower Incidence ◽  
Elective Surgery ◽  
Group Iv ◽  
Patient Comfort ◽  
Injection Pain ◽  
Double Blind ◽  
Group V ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Abstract Background Propofol injection pain (PIP) is common and may decrease patient comfort. The aim of this study was to compare the effects of dezocine with lidocaine on prevention of PIP.Methods 235 patients, who scheduled for elective surgery, aged 18–80 years and American Society of Anesthesiologists (ASA) I or II, were randomly assigned into five groups (n = 47 each). All patients were induced through the dor­sal hand vein or antecubital vein. The five groups were given the following medication intravenously: saline (Group I), lidocaine 20 mg (Group II), lidocaine 40 mg (Group III), dezocine 2 mg (Group IV) and dezocine 4 mg (Group V). Twenty seconds later all patients received a propofol infusion and were asked to grade pain or discomfort in the hand or forearm according to a four-point scale until anesthesia.Results Three groups showed a significantly lower incidence of total PIP than Group I: Group III (OR [Odds ratio]: 0.39 (0.16, 0.93)); Group IV (OR: 0.21 (0.09, 0.51)) and Group V (OR: 0.12 (0.05, 0.30)). Group IV showed a significantly lower incidence of total PIP than Group II (OR: 0.32 (0.13, 0.77)). Group V showed a significantly lower incidence of total PIP than Group II (OR: 0.15 (0.06, 0.39)) or Group III (OR: 0.30 (0.13, 0.72)).Conclusion Dezocine is a novel agent to alleviate PIP and appears to some extent to be more effective than lidocaine.

scholarly journals Gastric pH in patients premedicated with Esomeprazole or Famotidine undergoing routine surgery under general anaesthesia

2013 ◽  
Vol 1 (2) ◽  
pp. 71-76
Author(s):  
BR Shrestha ◽  
S Shrestha ◽  
S Moktan ◽  
OS Shrestha
Keyword(s):  
General Anaesthesia ◽  
Ph Value ◽  
Elective Surgery ◽  
Gastric Ph ◽  
Control Group ◽  
Ph Indicator ◽  
Double Blind ◽  
Group Iii ◽  
Group I ◽  
American Society

Background: Stress and anxiety in patients planned for surgery under anaesthesia may change pH of gastric secretion. Premedication of surgical patients with pH altering drugs may modify the pH favourably. With the advent of newer agents, premedication has been carried out with different agents. Most of the time choice of drug is made by the perioperative physician on his/her own. Objective: To study gastric pH in patients premedicated either with Esomeprazole or Famotidine. Methods: This is a randomized controlled double blind prospective study conducted in 150 patients of American Society of Anesthesiologists grade I and II posted for elective surgery under general anaesthesia. The patients enrolled in the study were randomly assigned to three groups having 50 patients in each. Group I (control group) did not receive any pH altering drug, Group II (Famotidine Group) received 40 mg of Famotidine and Group III (Esomeprazole Group) received 40 mg of Esomeprazole the night before surgery. The observer was totally blind about the groups or drugs given to the patients. On the day of surgery, after induction of anaesthesia gastric juice was obtained via nasogastric tube and was checked for pH using pH indicator paper. Results: The pH raised by Esomeprazole was statistically significant (p<0.001) when compared to that of control group or Famotidine group. The mean pH value in control group was less than 2.5 whereas the pH value was higher than 2.5 in patients premedicated with either Famotidine or Esomeprazole. Conclusions: Gastric pH is raised by Famotidine or Esomeprazole premedication prior to routine surgery, Esomeprazole being superior to Famotidine, p<0.001. Patients (84%) not premedicated with either of the drugs had pH less than 2.5. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8141 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 71-76

Survival of Donor Leukocyte Subpopulations in Immunocompetent Transfusion Recipients: Frequent Long-Term Microchimerism in Severe Trauma Patients

Blood ◽  
1999 ◽  
Vol 93 (9) ◽  
pp. 3127-3139 ◽  
Author(s):  
Tzong-Hae Lee ◽  
Teresa Paglieroni ◽  
Hitoshi Ohto ◽  
Paul V. Holland ◽  
Michael P. Busch
Keyword(s):  
Magnetic Beads ◽  
Elective Surgery ◽  
Quantitative Polymerase Chain Reaction ◽  
Severe Trauma ◽  
Hla Typing ◽  
Trauma Patients ◽  
Donor Cells ◽  
Male Donor ◽  
Mutual Tolerance

We recently reported detection of a transient increase in circulating donor leukocytes (WBCs) in immunocompetent recipients 3 to 5 days posttransfusion (tx) (Blood 85:1207, 1995). We have now characterized survival kinetics of specific donor WBC subsets in additional tx populations. Eight female elective surgery patients (pts) were sampled pre-tx and on days 1, 3, 5, 7, and 14 post-tx. Ten female trauma pts transfused with a total of 4 to 18 U of relatively fresh red blood cells were sampled up to 1.5 years post-tx. WBC subsets from frozen whole blood were isolated using CD4, CD8 (T cell), CD15 (myeloid), and CD19 (B cell) antibody-coated magnetic beads. Donor WBCs were counted by quantitative polymerase chain reaction (PCR) of male-specific sex determining region (SRY) sequences. PCR HLA typing and mixed leukocyte reaction (MLR) between recipient and donor WBCs were performed on two of the trauma tx recipients who had long-term chimerism of donor cells post-tx. In 6 of 8 female surgery pts, circulating CD4+ male donor cells peaked at day 3 or 5 (0.01 to 1 cell/μL), followed by clearance by day 14. In 7 of 10 female trauma pts, we observed multilineage persistence of male donor WBCs (CD4, CD8, CD15, CD19) for 6 months to 1.5 years post-tx at concentrations of 10 to 100 cells/μL. In 2 trauma recipients studied, MLR showed no, or very low, response to WBC of the single donor implicated as the source of microchimerism by HLA typing. Establishment of long-term multilineage chimerism in trauma recipients is probably caused by engraftment of donor stem cells and mutual tolerance between recipient and donor leukocytes. A better understanding of factors determining clearance versus chimerism of transfused leukocytes is critical to prevention of alloimmunization and transfusion-induced graft-versus-host disease, and, potentially, to induction of tolerance for transplantation.

Effect of intrathecal morphine before and after laminectomy on intraoperative surgical stress response and post-operative pain: A prospective randomized study

2020 ◽  
Vol 16 (1) ◽  
pp. 15-22
Author(s):  
Amany Faheem Abd El Salam Omara, MD ◽  
Asmaa Fawzy Amer, MD
Keyword(s):  
General Anesthesia ◽  
Surgical Stress ◽  
Intrathecal Morphine ◽  
Morphine Group ◽  
Rescue Analgesia ◽  
Group Iii ◽  
General Anesthesia Group ◽  
Group I ◽  
Anesthesia Group ◽  
Group Ii

Study objective: Intrathecal administration of morphine.Design: A prospective, randomized, controlled study.Setting: Operating room.Patients: Ninety patients of American Society of Anesthesiologists physical statuses I and II undergoing lumbar laminectomy.Interventions: Pre-emptive versus post-operative intrathecal morphine injection, compared to a control group.Main outcome: The visual analog score at the time of discharge and 2, 4, 6, 8, 10, 12, 18, and 24 h later, serum cortisol level, the number of patients needing post-operative rescue analgesia, its duration, and the total amount required. Main results: Morphine sulfate consumption as rescue analgesia over 24-h postoperatively was significantly higher in general anesthesia group (Group I) than in pre-emptive intrathecal morphine groups (Group II) [p = 0.001] and then postoperative intrathecal morphine group (Group III) [p = 0.001], and it was higher in Group III than Group II [p = 0.001]. There was a greater need for post-operative rescue morphine in general anesthesia group (Group I) than in the other two groups, and it was greater in post-operative intrathecal morphine group (Group III) than in pre-emptive intrathecal morphine group (Group II). At 30 min after surgical incisions and at 1 and 24 h after surgery, serum cortisol levels were significantly higher in general anesthesia group (Group I) [p = 0.001] and in post-operative intrathecal morphine group (Group III) [p = 0.001] than in pre-emptive intrathecal morphine groups (Group II), with no significant difference between general anesthesia group (Group I) and post-operative intrathecal morphine group (Group III) [p = 0.704, 0.263, and 0.943, respectively].Conclusion: Pre-emptive intrathecal morphine analgesia is an effective technique for controlling surgical stress response and post-lumbar laminectomy pain.

scholarly journals Developmental milestones of vertically HIV infected and seroreverters children: follow up of 83 children

2001 ◽  
Vol 59 (3B) ◽  
pp. 691-695 ◽  
Author(s):  
Isac Bruck ◽  
Tony Tannous Tahan ◽  
Cristina Rodrigues da Cruz ◽  
Luzilma Terezinha Flenik Martins ◽  
Sérgio Antonio Antoniuk ◽  
...  
Keyword(s):  
Screening Tests ◽  
Control Group ◽  
Basal Ganglia Calcification ◽  
Group Iii ◽  
Computed Tomographic ◽  
Group I ◽  
Immunodeficiency Virus ◽  
Neurological Exam ◽  
Group Ii

The aim of the study was to detect neurological abnormalities in human immunodeficiency virus (HIV) infected children. This was achieved by a prospective evaluation, from November/1995 to April/2000, of 43 HIV infected children (group I) and 40 HIV seroreverters children (group II) through neurological exam and neurodevelopmental tests: Denver Developmental Screening Test (DDST) and Clinical Adaptive Test / Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS). A control group (III), of 67 children, were evaluated by CAT/CLAMS. Hyperactivity, irritability and hypotonia were the findings on neurological examination, without statistical differences between group I and II. On CAT/CLAMS, the group I developmental quotient (DQ) was significantly lower than the other groups. The same occurred in DDST, with group I presenting significantly more failures than group II. Nineteen HIV children of group I had brain computed tomographic scan, with abnormalities in three of them (basal ganglia calcification, white matter hypodensity and asymmetry of lateral ventricles). We conclude that in HIV infected children a neurodevelopment delay occur early in the disease, and it can be detected by screening tests.

Survival of Donor Leukocyte Subpopulations in Immunocompetent Transfusion Recipients: Frequent Long-Term Microchimerism in Severe Trauma Patients

Blood ◽  
1999 ◽  
Vol 93 (9) ◽  
pp. 3127-3139 ◽  
Author(s):  
Tzong-Hae Lee ◽  
Teresa Paglieroni ◽  
Hitoshi Ohto ◽  
Paul V. Holland ◽  
Michael P. Busch
Keyword(s):  
Magnetic Beads ◽  
Elective Surgery ◽  
Quantitative Polymerase Chain Reaction ◽  
Severe Trauma ◽  
Hla Typing ◽  
Trauma Patients ◽  
Donor Cells ◽  
Male Donor ◽  
Mutual Tolerance

Abstract We recently reported detection of a transient increase in circulating donor leukocytes (WBCs) in immunocompetent recipients 3 to 5 days posttransfusion (tx) (Blood 85:1207, 1995). We have now characterized survival kinetics of specific donor WBC subsets in additional tx populations. Eight female elective surgery patients (pts) were sampled pre-tx and on days 1, 3, 5, 7, and 14 post-tx. Ten female trauma pts transfused with a total of 4 to 18 U of relatively fresh red blood cells were sampled up to 1.5 years post-tx. WBC subsets from frozen whole blood were isolated using CD4, CD8 (T cell), CD15 (myeloid), and CD19 (B cell) antibody-coated magnetic beads. Donor WBCs were counted by quantitative polymerase chain reaction (PCR) of male-specific sex determining region (SRY) sequences. PCR HLA typing and mixed leukocyte reaction (MLR) between recipient and donor WBCs were performed on two of the trauma tx recipients who had long-term chimerism of donor cells post-tx. In 6 of 8 female surgery pts, circulating CD4+ male donor cells peaked at day 3 or 5 (0.01 to 1 cell/μL), followed by clearance by day 14. In 7 of 10 female trauma pts, we observed multilineage persistence of male donor WBCs (CD4, CD8, CD15, CD19) for 6 months to 1.5 years post-tx at concentrations of 10 to 100 cells/μL. In 2 trauma recipients studied, MLR showed no, or very low, response to WBC of the single donor implicated as the source of microchimerism by HLA typing. Establishment of long-term multilineage chimerism in trauma recipients is probably caused by engraftment of donor stem cells and mutual tolerance between recipient and donor leukocytes. A better understanding of factors determining clearance versus chimerism of transfused leukocytes is critical to prevention of alloimmunization and transfusion-induced graft-versus-host disease, and, potentially, to induction of tolerance for transplantation.

The Effect of Propofol and Alfentanil on the Increase in Intraocular Pressure Due to Succinylcholine and Intubation

2000 ◽  
Vol 10 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Z. Eti ◽  
A. Yayci ◽  
T. Umuroǧlu ◽  
F.Y. Göǧüş ◽  
N. Bozkurt
Keyword(s):  
Intraocular Pressure ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Muscle Relaxation ◽  
Group Iv ◽  
Vecuronium Bromide ◽  
Group Iii ◽  
Group I ◽  
Thiopental Sodium ◽  
Group Ii

Purpose The aim of this study was to evaluate the effects of propofol and alfentanil on the increase in intraocular pressure (IOP) due to succinylcholine and intubation, in comparison with thiopental sodium and vecuronium bromide. Methods Forty patients aged 20–50 years, scheduled for elective surgery requiring endotracheal intubation, were assigned to four groups of ten. General anesthesia was induced with 2.5 mg/kg propofol in Group I, 2.5 mg/kg propofol and 10 μg/kg alfentanil in Group II and 5 mg/kg thiopental in Groups III and IV; muscle relaxation was obtained with either 1.5 mg/kg succinylcholine (Group I, II and III) or 0.1 mg/kg vecuronium bromide (Group IV). In all patients mean arterial pressure, heart rate, oxygen saturation and IOP were recorded before (baseline) and after induction, after the muscle relaxant and after endotracheal intubation. Results Compared with their baseline values in Group I IOP decreased significantly after propofol (p<0.01) and increased significantly after intubation (p<0.01). In Group II IOP decreased significantly after propofol and alfentanyl (p<0.001), remained low after succinylcholine (p<0.01) and did not change after intubation. In Group III IOP decreased significantly after thiopental (p<0.001) and increased significantly after intubation (p<0.001). In Group IV it decreased significantly after thiopental (p<0.001), remained low after vecuronium (p<0.001) and increased significantly after intubation (p<0.05). Conclusions In all Groups, IOP did not increase significantly after succinylcholine, but only anesthesia induced with propofol and alfentanil prevented the increase in IOP due to intubation.

scholarly journals The dynamics of coagulation hemostasis markers in patients with an increased body mass index with polytrauma

2019 ◽  
Vol 23 (1) ◽  
pp. 138-142
Author(s):  
V.V. Kucheriavchenko ◽  
Yu.V. Volkova ◽  
K.Yu. Sharlai
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Antithrombin Iii ◽  
Early Period ◽  
Fast Response ◽  
The Body ◽  
Group Iii ◽  
Group I ◽  
Student’S T ◽  
Immunological Protection

The hemostasis system is one of the fast response systems of the body. The aim of the work was to analyze the dynamics of coagulation hemostasis markers in patients with an increased body mass index (IBMI) with polytrauma. A study of complex hemostasiograms was conducted in 224 patients with IBMI during a month of hospital stay with a diagnosis of Polytrauma and on the 360th control day of the outpatient visit. The patients were divided into 3 groups depending on the starting numbers of the BMI. The study included the study of activated partial thromboplastin time, prothrombin index, antithrombin III, plasma tolerance to heparin and fibrinogen. To process the data obtained, Student’s t test and correlation analysis were used. The condition of the coagulation situation in patients with IBMI in group I (BMI≤29.9) included a slight increase in the aggregative capacity of platelets without disturbing their number, non-intensive increases in the hemostatic potential in all coagulation tests, dysfibrinogenemia and the absence of disturbances in the system of natural anticoagulants in the early period of traumatic illness. For patients in group II (BMI 30.0–39.9) in the early stages — up to the 14th day — hyperfibrinogenemia was characteristic, with a decrease in fibrinolytic activity. For patients in group III (BMI≥40.0), it was characteristic: in the first week there was dysfibrinogenemia, a sharp — by 50% decrease in antithrombin III, and a decrease in plasma tolerance to heparin. It should be noted that a significant and growing in dynamics reduction in the amount of antithrombin III was less than 80% unfavorable for the progression of coagulation disorders. Thus, it is necessary to note the clinical and pathogenetic significance of hemostasiological disorders in traumatic disease in patients with IBMI with polytrauma, the nature, intensity, dynamics and direction of which determine the consequences and possible complications, and require specific correction. In the future we plan to study the functional state of the system of immunological protection in traumatic disease in patients with IBMI.

Sign in / Sign up

Export Citation Format

Share Document