Impact of an Autotransfusion System during Endoluminal Repair of Abdominal Aortic Aneurysms: Does it Decrease the use of Allogeneic Blood?

2005 ◽  
Vol 71 (9) ◽  
pp. 786-790
Author(s):  
Carlos Donayre ◽  
Uzoamaka Adimora ◽  
Tae Song ◽  
George Kopchok ◽  
Maurice Lippmann ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Abdominal Aortic Aneurysms ◽  
Group Iv ◽  
Aortic Aneurysms ◽  
Group Iii ◽  
Endoluminal Repair ◽  
Group I ◽  
Abdominal Aortic ◽  
Group Ii

Endoluminal repair of abdominal aortic aneurysms (AAA) is associated with decreased blood loss and transfusion requirements when compared to open AAA repair. We evaluated the use of an intraoperative autotransfusion system during endoluminal exclusion of AAAs. Fifty endoluminal AAA procedures selected at random were reviewed retrospectively. Patients were divided into 4 groups according to their estimated blood loss: Group I, 20 patients (0–500 cc); Group II, 18 patients (501–1,000 cc); Group III, 7 patients (1,001–1,500 cc); and Group IV, 5 patients (1,501–3,400 cc). The average blood loss was 327 cc for Group I, 728 cc for Group II, 1,217 for Group III, and 2,125, for Group IV. The overall blood loss was 834 cc, but 75 per cent was recovered. Hematuria was always present when greater than 1,000 cc of blood was retransfused, but renal function was not affected even with the concomitant administration of radiographic contrast. Only one patient required an autologous blood transfusion. The use of an autotransfusion device is safe, efficacious, and appears to further limit the need for homologous blood transfusion in patients undergoing endoluminal AAA repair.

A Prospective Study of Changes in Morphology and Dimensions of Abdominal Aortic Aneurysms following Endoluminal Repair: A Preliminary Report

1995 ◽  
Vol 2 (4) ◽  
pp. 343-347 ◽  
Author(s):  
James May ◽  
Geoffrey H. White ◽  
Weiyun Yu ◽  
Richard C. Waugh ◽  
Michael S. Stephen ◽  
...  
Keyword(s):  
Prospective Study ◽  
General Circulation ◽  
Abdominal Aortic Aneurysms ◽  
Progressive Increase ◽  
Aortic Aneurysms ◽  
Contrast Extravasation ◽  
Endoluminal Repair ◽  
Group I ◽  
Abdominal Aortic ◽  
Group Ii

Purpose: The aim of this prospective study was to analyze early changes in morphology and dimensions of abdominal aortic aneurysms (AAA) following endoluminal repair. Methods: Forty-two of 62 patients undergoing endoluminal repair of AAAs between May 1992 and November 1994 were potentially available for follow-up at 6 months or longer after operation. After excluding patients with failed endoluminal repairs, patients who died within 6 months of operation, and patients with anastomotic aneurysms, a study group of 30 patients remained. Contrast-enhanced computed tomography (CE-CT) was performed preoperatively, within 10 days of operation, and at 6 and 12 months postprocedure. Based on the postoperative CE-CT findings, patients were divided into two groups: those with no extravasation of contrast into the aneurysmal sac (group I; n = 26), and those in which there was contrast extravasation (“leak”) into the aneurysmal sac (group II; n = 4). Results: The mean maximum diameters of AAAs in group I diminished progressively at 6 and 12 months, while those in group II increased. Twenty-three (88%) patients in group I had decreased diameter of AAA, while all patients in group II had progressive increase in AAA diameter. Patients who had an increase in AAA diameter had a significantly higher incidence of leak compared with those who had a decrease in diameter (p = 0.001). Conclusions: The majority of AAAs in which the sac has been excluded from the general circulation diminish in size following successful endoluminal repair. An increase in size occurs in those AAAs in which a communication exists between the aortic lumen and the sac. These results suggest that successfully excluded AAAs that continue to increase in size should be suspected of having an undetected leak.

scholarly journals Acute hypervolemic hemodilution combined with controlled hypotension to minimize blood loss during operations of spine fusion: remifentanil versus magnesium sulfate

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Khaled Mohammed Elnaghy ◽  
Ibrahimabd-Elsalam Nasr ◽  
Eman Mohamed Kamal
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Magnesium Sulfate ◽  
Spine Fusion ◽  
Controlled Hypotension ◽  
Group Iii ◽  
Group I ◽  
Estimated Blood Loss ◽  
Hypervolemic Hemodilution ◽  
Group Ii

Abstract Background Blood loss is one of the major problems during operations of spine fusion. Several blood-conservative measures were applied to reduce the incidence of blood loss—among them, acute hypervolemic hemodilution (AHH) and controlled hypotension (CH). This study was designed to detect the effect of combination of AHH with CH induced by remifentanil versus magnesium sulfate on the volume of blood loss, allogeneic blood transfusion, hemodynamics, coagulation, and electrolytes during operations for spine fusion which are risky operations with high incidence of blood loss and blood transfusion. Sixty patients scheduled for posterior fusion of the spine were randomly allocated into three groups of 20 patients each (group I (AHH), group II (AHH combined with remifentanil-based CH), and group III (AHH combined with magnesium sulfate-based CH)). Estimated blood loss and total volume of packed red blood cells (PRBCS) transfused were recorded. Arterial blood pressure (ABP) and heart rate (HR) measures were recorded. Blood samples were obtained for the detection of hemoglobin (Hb) and hematocrit (HCT). Results Estimated blood loss, percentage blood loss, and intraoperative RBC transfusion units were significantly high in group I in relation to group II and group III (Table 2). Cardiac output was significantly higher in group I in relation to group II and group III at 10, 15, 30, 45, and 60 min after start of AHH. MBP and HR results were significantly high in group I in comparison with group II and group III at 30, 45, 60, and 90 min and 2 and 3 h after start of study drugs. CVP results were significantly high in group I in relation to group II and group III at 15, 30, 45, 60, and 90 min after start of AHH. PTT was significantly increased in the three study groups in comparison with baseline inside each group after AHH. Conclusion Combination of AHH with CH induced by remifentanil or magnesium sulfate was associated with reduction in estimated blood loss, and total volume of PRBCS transfused. There was no significant difference between hemodynamic parameters with the use of remifentanil or magnesium sulfate except that SBP, DBP, and MBP results were significantly high with magnesium sulfate at 15 min after drug infusion. There was significant increase in PT and PTT after AHH that was not reflected by significant blood oozing from the operative field, or by difficulty in hemostasis.

scholarly journals Effects of hypercholesterolism on expansion of abdominal aortic aneurysm in rat model

2021 ◽  
Author(s):  
Jong Seok Lee ◽  
Sun Cheol Park ◽  
Sang Dong Kim
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Statin Therapy ◽  
Rat Model ◽  
Group Iv ◽  
Group Iii ◽  
Infusion Group ◽  
Group I ◽  
Abdominal Aortic ◽  
Group Ii

Abstract Background Inflammation is recognized as a critical process in expansion of abdominal aortic aneurysm (AAA). A relationship between effects of cholesterol and statin in this process have been suggested, but remain untested. Therefore, current study aimed to examine the effects of hypercholesterolism on expansion of AAA in a rat model. Methods A total of 16 male rats were divided into 4 groups as follows: group I, normocholesterol diet and saline infusion, group II, normocholesterol diet and porcine pancreatic elastase (PPE) infusion, group III, hypercholesterol diet and PPE infusion, and group IV, hypercholesterol diet, PPE infusion and statin administration. At the 3rd week, saline was infused intraluminally in group I and PPE in groups II-IV to induce AAA. At the 5th week, blood and aortic tissue were obtained from each rat for evaluation of lipid profiles, aortic diameters (ADs), and characteristics of stains. Results AD3 (final) and AD3/AD1 (initial) were significantly different among the four groups (P = 0.042, P = 0.028, respectively). AD3 was significantly larger in group II than group I, and group III than group IV (P = 0.012, P = 0.043, respectively). AD3/AD1 was significantly higher in group II than group I, and group III than group II (P = 0.008, P = 0.030, respectively). Group III showed the highest cellularity for inflammatory cells. Conclusions Though larger experimental and clinical studies are necessary, authors suggest that hypercholesterolism can aggravate expansion of AAA, and that statin therapy can reduce it. Therefore, monitoring for hypercholesterolism and instituting statin therapy may be helpful to suppress expansion of AAA.

scholarly journals Effects of hypercholesterolism on expansion of abdominal aortic aneurysm in rat model

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jong Seok Lee ◽  
Sun Cheol Park ◽  
Sang Dong Kim
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Statin Therapy ◽  
Rat Model ◽  
Group Iv ◽  
Aortic Diameter ◽  
Group Iii ◽  
Group I ◽  
Abdominal Aortic ◽  
Group Ii

Abstract Background Inflammation is recognized as a critical process in expansion of abdominal aortic aneurysm (AAA). A relationship between effects of cholesterol and statin in this process have been suggested, but remain untested. Therefore, current study aimed to examine the effects of hypercholesterolism on expansion of AAA in a rat model. Methods A total of 16 male rats were divided into 4 groups as follows: group I, normocholesterol diet and saline infusion, group II, normocholesterol diet and porcine pancreatic elastase (PPE) infusion, group III, hypercholesterol diet and PPE infusion, and group IV, hypercholesterol diet, PPE infusion and statin administration. At the 3rd week, saline was infused intraluminally in group I and PPE in groups II-IV to induce AAA. At the 5th week, blood and aortic tissue were obtained from each rat for evaluation of lipid profiles, aortic diameters (ADs), and characteristics of stains. Results Post-procedural aortic diameter (AD3) and AD3/pre-procedural aortic diameter (AD1) were significantly different among four groups (P = 0.042, P = 0.028, respectively). AD3 was significantly larger in group II than group I, and group III than group IV (P = 0.012, P = 0.043, respectively). AD3/AD1 was significantly higher in group II than group I, and group III than group II (P = 0.008, P = 0.030, respectively). Group III showed the highest cellularity for inflammatory cells. Conclusions Though larger experimental and clinical studies are necessary, authors suggest that hypercholesterolism can aggravate expansion of AAA, and that statin therapy can reduce it. Therefore, monitoring for hypercholesterolism and instituting statin therapy may be helpful to suppress expansion of AAA.

scholarly journals A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

2017 ◽  
Vol 6 (10) ◽  
pp. 4230
Author(s):  
Amira Mohammed Badawy
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Operative Time ◽  
Pressure Effects ◽  
Control Group ◽  
Group Iii ◽  
Abdominal Myomectomy ◽  
Octreotide Acetate ◽  
Group I ◽  
Group Ii

Background: Symptomatic Uterine leiomyomata may lead to many symptoms including abnormal uterine bleeding, mass pressure effects and infertility. Myomectomy is an option for conservative management, however, it is associated with some disadvantages, mainly increased intra-operative blood loss. Intra-myometrial vasopressin injection during myomectomy is an effective method to decrease the intraoperative bleeding due to its vasoconstrictor effect. Octreotide Acetate (OA) is another vasoconstrictor agent that have not been tested for gynaecologic indications. The current study was conducted to assess the efficacy of local injection of OA in reducing blood loss during conventional abdominal myomectomy, and to compare it with local instillation of vasopressin.Methods: 60 cases with symptomatic leiomyomata were recruited and planned for abdominal myomectomy, they were divided randomly into 3 groups, 20 cases in each. Group I, where local vasopressin was used, group II, where OA was used, and group III (the control group), where no specific medication was used and only free Saline was injected locally.Results: The overall results showed that OA group had significantly less operative time and less blood loss compared to control group. However, when compared to cases in group I, operative time and blood loss were significantly higher. Postoperative haemoglobin levels were significantly lower in group III compared to groups I (P = 0.039) and II (P = 0.044). Blood transfusion was indicated in 9 cases among group III, while only one case needed blood transfusion in group II, and no cases in group I.Conclusions: The use of local intra-myometrial OA is an option for reducing blood loss during myomectomy, but still efficacy is less than local vasopressin. This may be attributed to the low concentrations used, and to the less potency of OA as a vasoconstrictor agent.

scholarly journals Anaesthesia for Endoluminal Repair of Abdominal Aortic Aneurysms

2002 ◽  
Vol 30 (1) ◽  
pp. 66-70 ◽  
Author(s):  
M. J. Davies ◽  
I. Arhanghelschi ◽  
R. Grauer ◽  
G. Heard ◽  
D. A. Scott
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Endoluminal Repair ◽  
Abdominal Aortic

scholarly journals Pain, blood loss, and death from leaking abdominal aortic aneurysms.

1994 ◽  
Vol 47 (3) ◽  
pp. 272-273 ◽  
Author(s):  
P P Anthony ◽  
T Clarke ◽  
P Sarsfield
Keyword(s):  
Blood Loss ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

scholarly journals Effect and mechanisms of reproductive tract infection on oxidative stress parameters, sperm DNA fragmentation, and semen quality in infertile males

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kang-Sheng Liu ◽  
Xiao-Dong Mao ◽  
Feng Pan ◽  
Rui Fang An
Keyword(s):  
Reproductive Medicine ◽  
Reproductive Tract ◽  
Group Iv ◽  
Semen Parameters ◽  
Group Iii ◽  
Reproductive Tract Infection ◽  
Group I ◽  
Sperm Dna ◽  
Group Ii ◽  
Elastase Level

AbstractRecent years have seen a rising incidence of male infertility, mostly caused by the decline of sperm quality. The ratio of infertile males to infertile females has escalated from 3:7 in 2013 to current 5:5, which turns male infertility into the research focus of reproductive medicine. This study aimed to clarify the effect of reproductive tract infection by ureaplasma urealyticum (UU) and chlamydia trachomatis (CT) on the DNA integrity and routine semen parameters of infertile males. A retrospective study was performed. A total of 259 infertile males who were treated at the Andrological Laboratory Examination and Reproductive Medicine Center in our hospital were analyzed. qRT-PCR was used to examine the infection status of CT and UU. According to the eligibility criteria, we evaluated the semen parameters and biochemical data of 253 men. Based on the results of PCR, the subjects were divided into four groups: Group I (CT positive, 63 cases), Group II (UU positive, 60 cases), Group III (CT positive and UU positive, 62 cases), and Group IV (no infection, 68 cases). DNA fragmentation index (DFI), sperm count, vitality and morphology, elastase level, seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) were assessed. Compared to Group IV, three groups (Group I, Group II and Group III) showed difference in semen volume, proportion of sperm with normal morphology, sperm motility, progressive motility, and vitality (P < 0.05). Compared to Group IV, Group II and Group III showed difference in DFI (P < 0.05). Compared to Group IV, Group II and Group III showed difference in elastase level (P < 0.05). VCL, VSL, VAP, WOB, ROS, TM, HDS showed differences between groups of abnormal/normal WBC (*P < 0.01).UU infection significantly increased the level of seminal leukocytes only in Group II, but not in the other three groups, indicating that UU is a factor to increase the level of seminal leukocytes. Compared with the normal leukocyte group, there were significant differences in total motility, forward motility and normal sperm ratio between the two groups. The proportion of sperm with abnormal morphology (mostly in the head) showed obvious difference between groups of high and normal seminal leukocytic levels. At the same time, in this study, SCGE and SCD verified that leukocytes could damage sperm DNA by increasing ROS, which ultimately affects male fertility.

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